Drug Interaction Report

MONITOR: COMT inhibitors affect the elimination of drugs metabolized by catechol-O-methyltransferase (COMT) and may potentiate their effects. Arrhythmias, increased heart rate, and blood pressure changes may occur. Entacapone has increased heart rates up to 80% when coadministered with isoproterenol and epinephrine. Ventricular tachycardia has also been reported.

MANAGEMENT: The manufacturer recommends that caution be exercised when these drugs are given together. Monitoring for changes in hemodynamic status and ECG is recommended.

ADJUST DOSING INTERVAL: Food may reduce the rate and extent of absorption of opicapone. When opicapone was administered following a moderate fat/moderate calorie meal, mean opicapone peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 62% and 31%, respectively, while the time to reach peak concentration (Tmax) was delayed by 4 hours.

MANAGEMENT: Patients should avoid eating 1 to 2 hours before and after taking opicapone.

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.