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Hi Margaret & Helen & All Interested Fellow Tasmar Takers; Margaret, you wrote: > Hello Fellow Tasmar takers, > > Yesterday I visited my neuro doc and we decided that I would try > taking this drug. He immediately wrote an Rx for a full liver > function test. He wants to review the results PRIOR to my taking the > drug. The test is to be continued on a monthly schedule for 6 > months. Since, tolcapone is absorbed by the small intestine and > metabolized by the liver, there seems to be relevance for taking > this precaution. > > I reviewed the many posts relating to this drug, and did not see > anyone mentioning this 'inconvenience'. I checked some of the > literature and found that a small number of patients may develop > raised levels of alanine aminotransferase (ALT) and aspartane > aminotransferase (AST) between 6-12 weeks after the start of > treatment. In those cases where the subjects stopped their > treatment, the levels returned to normal within 2-4 weeks of > discontinuing treatment without any other hepatic adverse effects > being observed. In patients who continued tocapone treatment, liver > enzyme abnormalities resolved spontaneously without sequelae (morbid > condition following as a consequence). More patients developed > elevated ALT levels than AST levels. The reason for this phenomenon > is not known, and no obvious differences were seen between patients > with or without elevated transaminases in terms of previous or > concomitant medical conditions or medications. > > The preceeding is paraphrasing sections of an article in Neurology > 49, September 1997, p. 665-670, written by C.H. Waters, MD: M. > Kurth, MD; et al > > Does anyone have the insert that comes with the medication? Can you > please check it? I do not mean to alarm anyone, but this may be > important info. > > Thanks, > Margaret > > > > [log in to unmask] > DOB: 1941/Dx: 1980/Cured:ASAP > Slogans wont do it/Hard work will > I believe this is very important info and that anyone on Tasmar (and their prescribing professional) should be aware of this info. Sorry I gave you a quick and dirty answer yesterday............ >You can also look at the Tasmar Prescribing information at: >http://www.parkinsonsdisease.com/pcp/tasmarpi.htm but I was in a big rush and did not have the printed info at my fingertips. Since then I looked for the monograph that comes with the bottle but I must have misplaced it or maybe it got thrown out. I'm certain that it contains a similar precaution to the one at the above web site. (It is recommended that liver transaminases be monitored when starting Tasmar treatment and monthly for the first six months. Treatment should be discontinued if ALT exceeds five times the upper limit of normal or if clinical jaundice develops.) and further (Patients with severe liver impairment and severe renal impairment ((creatinine clearance <30ml/min)) should be treated with caution.) I was part of a one year tolcapone (Tasmar) study from Feb. 9 / 97 to Feb. 9 / 98 and that study included a series of "clinical laboratory tests" (read "blood tests") starting with a pre-study liver assessment and continuing as week 4; week 8; week 12; etc. for 6 months and month 9 and month 12. Since this was a standard used during the double blind research study it seems logical this would also be a standard for later prescribed drug usage. The Tasmar Prescribing Information, at the aforementioned web site, is provided by the manufacturer F. Hoffman LaRoche. I posted the URL's for F.Hoffman LaRoche in an earlier post on March 9th. 98 > I was looking for some info on Tasmar / tolcapone and Roche Canada > is the maker here. This search, focussed on the roche group of companies, > got me all I wanted and more. I found out that Roche Canada has a > website under development and one thread led to another to give me > the F. Hoffman-LaRoche sponsored site at: >http://www.parkinsonsdisease.com/onsite/whatnew0.htm >I found Tasmar Prescribing Information (interesting reading) at: >http://www.parkinsonsdisease.com/pcp/tasmarpi.htm >and COMT inhibitors etc. >I also found exactly what I had been looking for in response to >Ellen Peck's posting and how to contact the maker of tolcapone. >Hoffman-LaRoche has a website form you can fill out with requests >for information and they will e-mail you a reply. >Ellen, the form is at: >http://www.roche.com/pharma/Contact.htm I hope this answers your questions Margaret. Best regards.................................Murray 53/4 Vancouver, B.C. Canada . [log in to unmask]