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entacapone

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Brand names: Comtan

COMT Inhibitor Rx

Entacapone is a medicine that helps people with Parkinson's disease. It is always used with levodopa and carbidopa to help reduce "wearing-off" symptoms.

Drug Pricing (NADAC)

Generic Price

$0.32/unit

Generic Available

Yes (5 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Entacapone is used to treat Parkinson's disease.

Common side effects

Uncontrolled movements, Urine discoloration, Diarrhea

Key warnings

If you suddenly stop taking entacapone or quickly lower the dose, your Parkinson's symptoms may get worse.

How It Works

Entacapone belongs to a class of drugs called COMT inhibitors. It works by blocking an enzyme called COMT, which breaks down levodopa in the body. By blocking COMT, entacapone helps levodopa work longer and more effectively.

How to Take It

Take one 200 mg tablet with each dose of levodopa and carbidopa. Do not take it more than 8 times a day, for a total of 1600 mg of entacapone. You can take entacapone with or without food. Your doctor may need to lower your levodopa dose when you start taking entacapone, especially if you take a high dose of levodopa (800 mg or more).

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. It is not known if entacapone will harm your unborn baby. Talk to your doctor about the risks and benefits of taking entacapone while breastfeeding.

Missed Dose

Take the missed dose with your next dose of levodopa and carbidopa. Do not take extra entacapone to make up for the missed dose.

Storage

Store entacapone at room temperature, between 68°F and 77°F.

Side Effects (from patient reports)

Based on 3,272 FDA adverse event reports.

Uncontrolled movements
461
Seeing or hearing things that are not there
459
Falling down
443
Medicine not working
332
Death
318
Parkinson's disease
274
Confusion
255
Trouble walking
254
Shaking
251
Sudden changes in symptoms
225

FDA Adverse Event Report Analysis

Detailed analysis of 3,955 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2003–2025.

Total Reports

3,955

Death-Related Reports

603

Hospitalization Reports

1,340

Top Indication

Parkinson^S Disease

Gender Distribution

Female 1,241 (34%)
Male 2,374 (66%)

Age Distribution

0–17 20
18–44 48
45–64 629
65–74 1,011
75+ 947

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DYSKINESIA 461
2 HALLUCINATION 459
3 FALL 443
4 DRUG INEFFECTIVE 332
5 DEATH 318
6 PARKINSON^S DISEASE 274
7 CONFUSIONAL STATE 255
8 GAIT DISTURBANCE 253
9 TREMOR 251
10 ON AND OFF PHENOMENON 225
11 SOMNOLENCE 190
12 CONSTIPATION 188
13 FATIGUE 184
14 NAUSEA 184
15 HALLUCINATION, VISUAL 181

Reactions in Death Reports

DEATH 318
PARKINSON^S DISEASE 88
HALLUCINATION 74
FALL 71
PNEUMONIA 45
DYSKINESIA 44
CONFUSIONAL STATE 42
AGITATION 35
DEMENTIA 25
HYPONATRAEMIA 25

Reactions in Hospitalization Reports

FALL 238
DYSKINESIA 195
HALLUCINATION 159
CONFUSIONAL STATE 120
ON AND OFF PHENOMENON 105
PARKINSON^S DISEASE 102
GAIT DISTURBANCE 97
URINARY TRACT INFECTION 88
MUSCLE RIGIDITY 87
TREMOR 84

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

If you suddenly stop taking entacapone or quickly lower the dose, your Parkinson's symptoms may get worse. This could also cause a high fever and confusion. If you stop taking entacapone, your doctor should watch you closely and adjust your other medicines as needed. It is best to slowly lower the dose before stopping completely.

Known Drug Interactions

7 DRUG INTERACTIONS Drugs metabolized by COMT: use with caution ( 5.10 , 7.2 ) Anti-hypertensive agents: dose adjustment may be required ( 7.3 ) Tricyclic antidepressants: risk of hypertension and dyskinesia reported during concomitant use with carbidopa/levodopa ( 7.4 ) Dopamine D2 receptor antagonists, isoniazid, phenytoin, papaverine and iron salts: may reduce efficacy of carbidopa, levodopa and entacapone tablets ( 7.5 , 7.6 , 7.7 , 7.8 , 7.9 ) Drugs that interfere with biliary excretion, glucuronidation and intestinal beta-glucuronidase: dose adjustment of carbidopa, levodopa and entac...

Mechanism: Entacapone is designed to block the enzyme that breaks down levodopa, which helps the medicine stay in your system longer. This can increase the effects of the levodopa on your brain and body.

What to do: Use this combination with caution as directed by your doctor. Your healthcare provider may need to adjust your dose to prevent side effects.

Product Clinical Comment on Concomitant Use [See Contraindications (4.1)] ; Predominant Effect/Risk [Hypertensive Reaction (HR) [See Warnings and Precautions (5.3)] ; or Serotonin Syndrome (SS) [See Warnings and Precautions (5.7)] ] Altretamine Use with caution If not otherwise specified in this table, consider avoiding concomitant use (see also information on medication-free intervals , use agent at the lowest appropriate dose, monitor for effects of the interaction, advise the patient to report potential effects, and be prepared to discontinue the agent and treat effects of the interactio...

Mechanism: Using these medications together can cause a sudden, dangerous increase in blood pressure or a serious brain chemical imbalance. Both drugs affect how the body breaks down certain chemicals, leading to a risky buildup.

What to do: Use this combination with extreme caution and at the lowest doses possible. Tell your doctor right away if you experience a severe headache, fast heartbeat, or sudden changes in your mood.

In an interaction study in healthy volunteers, entacapone did not significantly change the plasma levels of S-warfarin while the AUC for R-warfarin increased on average by 18% [Cl90 11% to 26%], and the INR values increased on average by 13% [Cl90 6% to 19%]. Nevertheless, cases of significantly increased INR in patients concomitantly using warfarin have been reported during the postapproval use of entacapone. Therefore, monitoring of INR is recommended when entacapone treatment is initiated or when the dose is increased for patients receiving warfarin.

Mechanism: Entacapone can increase the levels of warfarin in your system, which may cause your blood to become too thin.

What to do: Your doctor should monitor your blood clotting levels (INR) closely when you start entacapone or change your dose.

Common Questions

Can I take entacapone by itself?
No, entacapone must always be taken with levodopa and carbidopa.
What should I do if my urine turns orange-brown?
Urine discoloration is a common side effect of entacapone and is not harmful.
Can I drive while taking entacapone?
Entacapone can cause dizziness or sleepiness. Be careful driving or operating machinery until you know how it affects you.
Will entacapone cure my Parkinson's disease?
No, entacapone helps manage the symptoms of Parkinson's disease but does not cure it.
Can I drink alcohol while taking entacapone?
Talk to your doctor about drinking alcohol while taking entacapone, as it may worsen some side effects.
What if I have liver problems?
Tell your doctor if you have liver problems. They may need to monitor you more closely.
Can entacapone interact with other medications I'm taking?
Yes, entacapone can interact with other medications, especially warfarin. Tell your doctor about all the medicines you take.
How long does it take for entacapone to start working?
Entacapone starts working quickly, usually within 30-60 minutes after taking it.
What if I experience uncontrolled movements (dyskinesia)?
Tell your doctor if you experience uncontrolled movements. They may need to adjust your levodopa dose.
Is it okay to take with food?
Yes, you can take entacapone with or without food.
What are the common side effects of entacapone?
The most commonly reported side effects of entacapone include Uncontrolled movements, Urine discoloration, Diarrhea, Nausea, Excessive movements. Based on 3,272 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does entacapone interact with other medications?
Yes, entacapone has 3 known drug interactions. Notable interactions include carbidopa/levodopa, tranylcypromine, warfarin. Always inform your doctor about all medications you are taking.
What drug class is entacapone?
entacapone belongs to the COMT Inhibitor drug class. It requires a prescription (Rx). Entacapone is used to treat Parkinson's disease.
Is entacapone safe during pregnancy?
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if entacapone will harm your unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has entacapone been recalled?
There is 1 recall associated with entacapone products. Product mix up: complaint received that sealed medication bottle contained Carbidopa, Levodopa, and Entacapone film-coated tablets (37. Check the recalls section below for full details and affected products.

Active Recalls

Class II October 7, 2025

Product mix up: complaint received that sealed medication bottle contained Carbidopa, Levodopa, and Entacapone film-coated tablets (37.5 mg/150 mg/200 mg) instead of labelled lower strength Carbidopa, Levodopa, and Entacapone film-coated tablets (25 mg/100 mg/200 mg).

Rising Pharma Holding, Inc.

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What the FDA Data Shows for entacapone

The FDA label for entacapone (sold under brand names such as Comtan) classifies it as a prescription-only medication in the COMT Inhibitor class. Entacapone is used to treat Parkinson's disease. Official labeling lists 8 commonly reported side effects, including Uncontrolled movements, Urine discoloration, Diarrhea.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 3,272 voluntary reports. The database also lists 3 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.32.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 1 recall record on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: October 7, 2023

All federal data sources used on this page