Tolcapone - Oral

Tolcapone is used together with other medicines to treat Parkinson's disease. Parkinson's disease is a disorder that affects the movement of a person, causing symptoms such as tremors, muscle stiffness, slowed movement, and impaired balance or walking.

Take Tolcapone exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

You may take this medicine with or without food. Try to take it at the same time each day.

Your doctor may advise you to take the first Tolcapone dose of the day at the same time as the dose of levodopa (another medicine for Parkinson's disease).

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your response to the medication.

Tolcapone must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• phaeochromocytoma (rare tumour of the adrenal gland causing high blood pressure)
• severe dyskinesia (uncontrollable involuntary movements such as twitching and jerking)
• history of neuroleptic malignant syndrome (rare reaction to certain medicines characterised by muscle rigidity, fever and mental status changes)
• history of non-traumatic rhabdomyolysis (abnormal muscle breakdown that can cause kidney damage as a result of infection, extreme muscle strain, drugs or alcohol intake)
• history of extremely high body temperature
• liver disease

as Tolcapone may not be suitable for you.

Do not take Tolcapone if you are currently taking a medicine that is used to treat depression known as monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine, and tranylcypromine.

Inform your doctor if you have the following conditions:

• dystonia (a movement disorder that causes the muscle to contract uncontrollably)
• mental illness
• severe kidney disease

Let your doctor know if you are pregnant or breastfeeding.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. liver function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.

Tolcapone may cause drowsiness. If affected, do not drive or take part in any activity in which you need to be alert.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Other side effects include any of the following: headache, dizziness, nausea, vomiting, constipation, dry mouth, indigestion, loss of appetite, muscle cramps, excessive dreaming, and excessive sweating.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• uncontrollable involuntary movements such as twitching and jerking
• severe muscle stiffness, muscle weakness, high fever, confusion, rapid heartbeat
• unusual changes in mood or behaviour (being confused, agitated, aggressive, or having compulsive and impulsive behaviour)
• persistent or severe diarrhoea

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Tolcapone if you are currently taking a medicine that is used to treat depression known as monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine, and tranylcypromine.

Inform your doctor and pharmacist if you are taking any medicines that cause drowsiness or affect your concentration.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.