Tolcapone, Oral

What are other names for this medicine?

Type of medicine: anti-Parkinson's; reverse COMT inhibitor

Generic and brand names: tolcapone, oral; Tasmar

What is this medicine used for?

This medicine is taken by mouth to treat Parkinson's disease. It is used to help levodopa and carbidopa work better.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• kidney disease
• liver disease
• low blood pressure or problems with dizziness or fainting spells

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant while taking this medicine. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not stop taking this medicine without your healthcare provider's approval. Do not take more of this medicine than prescribed.

You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach. Tell your healthcare provider if stomach upset continues.

Your healthcare provider may adjust your dosage after you begin taking this medicine. Be sure you understand when to take each medicine and how much to take.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, dizziness.

What should I watch out for?

This medicine may cause liver problems. Your provider will test your liver function before, during and after treatment with this medicine. Keep all appointments for these tests. If you develop signs of liver problems, stop using this drug and contact your healthcare provider right away. Signs of liver problems include:

• yellowing of the eyes or skin
• unusual tiredness
• loss of appetite
• dark urine
• constant nausea
• stomach pain

When you get up too quickly from sitting or lying down, you may have dizziness, nausea, fainting, and sometimes sweating. Try getting up slowly. These feelings usually lessen after you have taken this medicine for a while.

This medicine may make you drowsy or dizzy. Do not drive or operate machinery unless you are fully alert and know how this medicine will affect you.

This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

If you need emergency care, surgery, or dental work, tell your healthcare provider you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Serious (report these to your healthcare provider): Trouble moving, fainting, severe dizziness when you stand, hallucinations (seeing things that are not there), chest pain, irregular heartbeat, trouble breathing, yellowing of the skin or eyes, dark urine, unusual tiredness, loss of appetite, stomach pain, severe or bloody diarrhea, twitching.

Other: Trouble sleeping, drowsiness, dizziness, confusion, muscle cramps, muscle stiffness, vomiting, mild diarrhea, constipation, headache.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antihistamines such as diphenhydramine (Benadryl), hydroxyzine (Atarax, Vistaril), and chlorpheniramine (Chlor-Trimeton)
• apomorphine (Apokyn)
• herbs with sedative effects such as kava, St. John's wort, gotu kola, and valerian
• isoproterenol (Isuprel)
• MAO inhibitor antidepressants such as phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan) (Do not take an MAO inhibitor and this medicine within 14 days of each other.)
• methyldopa (Aldomet)
• muscle relaxants such as cyclobenzaprine (Flexeril), carisoprodol (Soma), tizanidine (Zanaflex), methocarbamol (Robaxin), and baclofen (Lioresal)
• pain medicine such as codeine, hydrocodone (Vicodin, Lortab), oxycodone (Percocet, Tylox, OxyContin), morphine (MS Contin), propoxyphene (Darvocet N-100), pentazocine (Talwin), meperidine (Demerol), fentanyl (Duragesic patches), methadone (Dolophine), tramadol (Ultram), and hydromorphone (Dilaudid)
• sleeping pills such as phenobarbital, butabarbital (Butisol), flurazepam (Dalmane), pentobarbital (Nembutal), secobarbital (Seconal), zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta)
• tranquilizers such as diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan), and alprazolam (Xanax)
• tricyclic antidepressants such as amitriptyline, desipramine (Norpramin), nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), and doxepin (Sinequan)
• warfarin (Coumadin)

Do not drink alcohol while you are taking this medicine without your healthcare provider's approval.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.

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