Tasmar

— THERAPEUTIC CATEGORIES —
  • Parkinsonism

Tasmar Generic Name & Formulations

General Description

Tolcapone 100mg; tabs.

Pharmacological Class

COMT inhibitor.

How Supplied

Tabs—90

Tasmar Indications

Indications

Adjunct to carbidopa/levodopa in idiopathic Parkinson's disease patients who have symptom fluctuations and for whom other adjunctive therapies are inappropriate or inadequate.

Tasmar Dosage and Administration

Adult

100mg three times daily; may cautiously increase to 200mg three times daily. Discontinue if no substantial benefit after 3 weeks.

Children

Not applicable.

Tasmar Contraindications

Contraindications

Liver disease (clinical evidence or serum transaminases 2xULN). Previous tolcapone-associated hepatocellular injury. History of non-traumatic rhabdomyolysis or fever and confusion possibly related to medication.

Tasmar Boxed Warnings

Boxed Warning

Risk of potentially fatal, acute fulminant liver failure.

Tasmar Warnings/Precautions

Warnings/Precautions

Obtain informed written consent. Risk of liver injury. Before starting and when increasing dose: do transaminases at baseline, then every 2–4 weeks for 6 months, then periodically if clinically relevant. Discontinue if signs/symptoms of liver disease (eg, jaundice, fatigue, anorexia) develop or if serum transaminases >2xULN. Reduce levodopa dose if dyskinesias appear or worsen. Orthostatic hypotension/syncope. Diarrhea (follow-up if persistent). Severe renal impairment (CrCl <25mL/min). Monitor for compulsive behaviors; consider reduce dose or discontinuation. Do periodic skin exam. Monitor patient closely when withdrawing therapy. Pregnancy (Cat.C). Nursing mothers.

Tasmar Pharmacokinetics

See Literature

Tasmar Interactions

Interactions

Concomitant non-selective MAOIs (eg, phenelzine, isocarboxazid, tranylcypromine): not recommended. Reduce concomitant levodopa dose. CNS depression potentiated with alcohol, other CNS depressants. May potentiate other drugs metabolized by COMT (eg, methyldopa, dobutamine, isoproterenol); monitor and reduce dose as needed. Monitor warfarin.

Tasmar Adverse Reactions

Adverse Reactions

Dyskinesias, nausea, sleep disorders, dystonia, excessive dreaming, anorexia, muscle cramps, orthostatic complaints, somnolence, diarrhea, confusion, dizziness, headache, hallucinations, vomiting, constipation, fatigue, upper respiratory or urinary tract infection, falling, increased sweating, syncope, xerostomia, urine discoloration (yellow); liver injury (may be fatal), rhabdomyolysis, hematuria, compulsive behavior, others.

Tasmar Clinical Trials

See Literature

Tasmar Note

Not Applicable

Tasmar Patient Counseling

See Literature