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----------------------------------------------------------------------- Tolcapone (Tasmar - Hoffman-LaRoche) ----------------------------------------------------------------------- Tolcapone is the most potent COMT inhibitor currently in clinical development. Studies in patients with Parkinson's disease in the United States and Europe are complete and have been submitted to the FDA. Tolcapone prolongs the effects of levodopa thereby decreasing motor response fluctuations in patients and improving quality of life. Patients on levodopa that do not experience motor fluctuations also benefited significantly through improved quality of life and decreased symptoms. Tolcapone is given three times daily in doses from 100 mg to 200 mg in addition to the patient's levodopa medication schedule. Peak effect of tolcapone is reached in about 1 - 2 hours and maintained for the duration of the 6 hour dosing interval. Patients experience better control of their Parkinsonian symptoms while needing lower doses of levodopa. Side effects are few, but include occasional mild headache, nausea, loose stools, change in urine color, and in some patients a transient increase in dyskinesia. Tolcapone is absorbed by the small intestine and metabolized by the liver. Food delays the absorption of tolcapone somewhat, but this does not appear to be clinically significant. The ability of this compound to prolong blood and brain levels of levodopa while reducing the levels of potentially toxic metabolites should be an important development in the treatment of Parkinson's disease. --------------------------------------------------------------- Date: Wed, 21 May 1997 12:18:24 -0400 Subject:Up And Coming Medical Therapies for Parkinson's Disease --------------------------------------------------------------- by Matthias C. Kurth, MD, Ph.D., Medical Director and Advisor for Young Parkinsonians and the US NPR YOPPERS FORUM --------------------------------------------------------------- [log in to unmask]