What Is Tolcapone Used For? (Cont.)

Effects of Tolcapone

Although carbidopa-levodopa is an effective Parkinson's medication, its benefits are often limited to a few years, when it may begin to lose its effectiveness and cause intolerable side effects. It is not clear at this time why this might occur; some people think it is simply a manifestation of the worsening of the disease that normally happens over time. Adding tolcapone to carbidopa-levodopa has been shown to decrease the "off" times (when the medication does not work well) and increase the "on" times (when the medication does work well).
 
Due to the risk of a potentially fatal tolcapone side effect (liver failure), people should take this drug only if they are experiencing symptom fluctuations (such as wearing-off) and if other treatment alternatives are not appropriate or have failed.
 

How Does Tolcapone Work?

Tolcapone is always used in combination with carbidopa and levodopa; it is not effective at treating Parkinson's disease when used alone. The drug works by increasing blood levels of levodopa and helping it last longer in the body. Tolcapone works by inhibiting an enzyme known as catechol-O-methyltransferase (COMT) that breaks down levodopa before it has a chance to reach the brain.
 

Is Tolcapone Used in Children?

Tolcapone is not approved for use in children. Discuss the potential risks and benefits of the drug with your child's healthcare provider.
 

Is Tolcapone Used for Off-Label Reasons?

On occasion, your healthcare provider may recommend tolcapone for something other than the conditions discussed in this article. At this time, there are no universally accepted off-label tolcapone uses.
 

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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;