 |
 |
John Lawley wrote: > > Query from Erika, > In Joe Bruman's Current Science Reviews, in the first section, > there is a mention of tolcapone (Tasmar) requiring blood tests. Can > anyone tell me why these bloodtests are necessary? > Is tolcapone freely available in most countries? It is, as far as I > understand, not approved in Australia. > Thank you. > Erika. Late last year, tolcapone (Tasmar) was taken off the market in Europe (I think) and retained in the U.S., only with a strong admonition to prescribers that blood should be tested frequently for elevation of certain enzymes (alanine aminotransferase or ALT, and aspartate amino- transferase or AST) that are released from dead liver cells. In a very few cases, I believe 3 out of some 60,000 Tasmar users, patients developed a life-threatening condition called fulminant hepatic failure (FHF), where the liver is simply destroyed, and died, either because FHF was not recognized in time or because it was already too late. The blood tests are supposed to provide timely warning (the treatment is a full or partial liver transplant) but that isn't completely certain. FHF is rare, due most often to hepatitis B virus infection, but also to several other drugs, notably valproate. I'm not sure of the current marketing status, nor whether there have been any cases to confirm or deny the effectiveness of blood testing as a warning. Like some other Tasmar users, I reluctantly gave it up to wait for entacapone. Cheers, Joe -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013