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is FDA indicated as adjunctive therapy to treat patients with Parkinson disease who
are currently on levodopa/carbidopa( Fig 1.5 ). Only patients who are experiencing
motor fluctuations or who cannot tolerate other therapies should use tolcapone.
Research shows that a majority of patients with Parkinson disease who have received
treatment with levodopa and carbidopa experience a "wearing-off" phenomenon.
During this "wearing-off" phenomenon, patients experience shortened periods of
benefit from their levodopa/carbidopa , tolcapone and other therapy. Patients
experience a so-called "off" time where they do not experience any therapeutic benefit
of their medication; this usually requires an increase in dosage or more frequent
dosing of levodopa so that patients experience more "on" time of therapeutic benefit
from levodopa.[22]
Studies show that patients with Parkinson disease who are currently experiencing
motor fluctuations while taking levodopa and carbidopa showed reduced "off" time
and increased "on" time when adding tolcapone to their medication regimen compared
to placebo. These studies also showed that patients were able to tolerate a dose
reduction of their levodopa. However, if patients do not show improvement on
tolcapone within three weeks of initiation, tolcapone should be discontinued.[23][24]
There are no off-labeled uses for tolcapone. However, researchers have studied the use
of tolcapone in patients with Parkinson's disease who are stable on
levodopa/carbidopa. Researchers found that when they added tolcapone to
levodopa/carbidopa, patients saw improvement in scores for activities of daily living
and motor function on the Unified Parkinson's Disease Rating Scale. The groups
receiving tolcapone also saw a decrease in their total daily dose of levodopa.[25]
is FDA indicated as adjunctive therapy to treat patients with Parkinson disease who
are currently on levodopa/carbidopa( Fig 1.5 ). Only patients who are experiencing
motor fluctuations or who cannot tolerate other therapies should use tolcapone.
Research shows that a majority of patients with Parkinson disease who have received
treatment with levodopa and carbidopa experience a "wearing-off" phenomenon.
During this "wearing-off" phenomenon, patients experience shortened periods of
benefit from their levodopa/carbidopa , tolcapone and other therapy. Patients
experience a so-called "off" time where they do not experience any therapeutic benefit
of their medication; this usually requires an increase in dosage or more frequent
dosing of levodopa so that patients experience more "on" time of therapeutic benefit
from levodopa.[22]
Studies show that patients with Parkinson disease who are currently experiencing
motor fluctuations while taking levodopa and carbidopa showed reduced "off" time
and increased "on" time when adding tolcapone to their medication regimen compared
to placebo. These studies also showed that patients were able to tolerate a dose
reduction of their levodopa. However, if patients do not show improvement on
tolcapone within three weeks of initiation, tolcapone should be discontinued.[23][24]
There are no off-labeled uses for tolcapone. However, researchers have studied the use
of tolcapone in patients with Parkinson's disease who are stable on
levodopa/carbidopa. Researchers found that when they added tolcapone to
levodopa/carbidopa, patients saw improvement in scores for activities of daily living
and motor function on the Unified Parkinson's Disease Rating Scale. The groups
receiving tolcapone also saw a decrease in their total daily dose of levodopa.[25]
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