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Tasmar (tolcapone) Disease Interactions

There are 6 disease interactions with Tasmar (tolcapone):

Major

Dopamine agonists (applies to Tasmar) hypotension

Major Potential Hazard, Moderate plausibility.

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension, especially during dose escalation. Therapy with dopamine agonists should be monitored carefully in patients with Parkinson's disease since they may have an impaired ability to respond to an orthostatic challenge, and also in patients receiving antihypertensive drugs.

References

  1. Iwasaki S, Hamaguchi K, Iwasaki A, Takakusagi M, Narabayashi Y "Hypotensive effect of long-term levodopa in patients with Parkinson's disease." Eur Neurol 30 (1990): 194-9
  2. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  3. Hoehn MM "Levodopa-induced postural hypotension. Treatment with fludrocortisone." Arch Neurol 32 (1975): 50-1
  4. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim, Ridgefield, CT.
  5. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn, Kalamazoo, MI.
  6. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
View all 6 references
Major

Dopaminergic antiparkinson agents (applies to Tasmar) psychosis

Major Potential Hazard, Moderate plausibility.

Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinson agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs.

Moderate

Tolcapone (applies to Tasmar) hallucinations

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis

Reversible hallucinations have occurred (usually within the first 2 weeks of therapy) in patients receiving tolcapone. Confusion, occasional insomnia, and excessive dreaming commonly accompany the hallucinations. Therapy with tolcapone should be administered cautiously in patients with or predisposed to psychoses or emotional disorders. Reducing the levodopa dosage may result in resolution of hallucinations. Clinical monitoring of mental status is recommended.

References

  1. "Product Information. Tasmar (tolcapone)." Valeant Pharmaceuticals, Costa Mesa, CA.
Moderate

Tolcapone (applies to Tasmar) hepatic dysfunction

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Transaminase (AST/ALT) levels >3 times (occasionally 8 times) the upper limits of normal have occurred in 1% to 3% of patients administered tolcapone, depending on the dosage. Approximately 1/3 of these patients also developed diarrhea. Tolcapone is extensively metabolized by the liver to inactive forms and < 0.5% is eliminated unchanged by the kidney. A 50% reduction in clearance and volume of distribution has occurred in patients with moderate liver cirrhosis, resulting in a 2 fold increase in concentration of unbound tolcapone. Therapy with tolcapone should be administered cautiously in patients with compromised hepatic function. Clinical monitoring of hepatic function is recommended prior to initiation of tolcapone, monthly during the first 3 months, and every 6 weeks for the next 3 months of therapy.

References

  1. "Product Information. Tasmar (tolcapone)." Valeant Pharmaceuticals, Costa Mesa, CA.
Moderate

Tolcapone (applies to Tasmar) hypotension/syncope

Moderate Potential Hazard, Moderate plausibility.

Tolcapone-enhanced bioavailability of levodopa can induce orthostatic hypotension and/or syncope. Adjunct therapy with tolcapone should be administered cautiously in patients with, predisposed to, or adversely affects by hypotension and/or syncope.

References

  1. "Product Information. Tasmar (tolcapone)." Valeant Pharmaceuticals, Costa Mesa, CA.
Moderate

Tolcapone (applies to Tasmar) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Approximately 60% of tolcapone is eliminated by the kidney and < 0.5% is excreted unchanged in the urine. Dosage modification is not indicated for patients with mild to moderate renal impairment. The pharmacokinetic disposition of tolcapone has not been determined in patients with severe renal impairment and tolcapone should be administered cautiously in these patients.

References

  1. "Product Information. Tasmar (tolcapone)." Valeant Pharmaceuticals, Costa Mesa, CA.

Tasmar (tolcapone) drug interactions

There are 266 drug interactions with Tasmar (tolcapone)

Tasmar (tolcapone) alcohol/food interactions

There is 1 alcohol/food interaction with Tasmar (tolcapone)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.