If you are prescribed Comtess®, take one 200 mg tablet at the same time as your co-careldopa or co-beneldopa.

If you are prescribed Stalevo®, this is a combination of entacapone and co-careldopa in one tablet. These tablets are available in different strengths.

Entacapone may cause your urine to become reddish-brown. This is nothing to be concerned about.

The most common side-effects are feeling sick and uncontrollable muscle movements. Your doctor will discuss these with you.

About entacapone

Type of medicine Dopaminergic agent (catechol-O-methyltransferase inhibitor)
Used for Parkinson's disease
Also called Comtess®
Stalevo® (contains entacapone combined with levodopa and carbidopa)
Available as Tablets

About entacapone

The cause of Parkinson's disease is still unknown but its symptoms of tremor, stiffness and slow movement are due to there being less of a chemical called dopamine in your brain.

You will already be taking a medicine called either co-beneldopa or co-careldopa. These contain levodopa which helps relieve the symptoms of Parkinson's disease. Levodopa is converted into dopamine in your body and this increases the level of dopamine in your brain.

Entacapone works by increasing the effectiveness of levodopa. It is mainly prescribed for people who have had Parkinson's disease for a while and whose symptoms deteriorate between medicine doses.

Before taking entacapone

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking entacapone it is important that your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have problems with the way your liver works.
  • If you have heart disease.
  • If you have been told you have a tumour on your adrenal gland, or if you have ever had rhabdomyolysis (a condition affecting your muscles), or neuroleptic malignant syndrome (a reaction to antipsychotic medicines). These are all rare conditions.
  • If you are taking or using any other medicines. It is especially important that your doctor knows if you have recently taken an antidepressant known as a monoamine oxidase inhibitor (MAOI). You should also tell your doctor if you are taking any medicines which you have bought without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.

How to take entacapone

  • Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of entacapone you have been given, and a full list of side-effects which you may experience from taking it.
  • Take the tablets exactly as your doctor tells you to. If you are prescribed Comtess®, take one 200 mg tablet at the same time as your co-careldopa or co-beneldopa tablet or capsule. Stalevo® tablets are available in different strengths. You will be prescribed the strength of tablet that best suits your condition. Your doctor or pharmacist will tell you when you should take the tablets, and your dose will be on the label of the packs to remind you.
  • You can take entacapone before or after meals.
  • When you first start taking entacapone, your doctor may need to adjust the doses of your other medicines. This is to help reduce any side-effects caused by these tablets increasing the effectiveness of your usual dose of levodopa.

Getting the most from your treatment

  • It is important you try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
  • Some people taking medicines for Parkinson's disease can feel very sleepy during the day. You may experience this. Some people have even fallen asleep suddenly without much warning of being tired. If this happens to you, do not drive or use tools or machines, and discuss it with your doctor at your next appointment.
  • Entacapone may cause your urine to turn a reddish brown colour. This is harmless and is nothing to worry about.
  • As your condition improves and your movements become easier, be careful not to overdo things. Your activities must be increased gradually to allow your body to adjust to the changes in balance, circulation and co-ordination. This is especially important if you are elderly.
  • Keep taking these tablets until your doctor tells you otherwise. Stopping suddenly can cause problems and your doctor may want you to reduce your dose gradually if this is necessary.
  • If you buy any medicines, check with a pharmacist that they are suitable to take with entacapone. You should not take any medicines or vitamin preparations containing iron at the same time as your entacapone tablets. This is because iron can reduce the amount of entacapone your body absorbs and vice versa. If you need to take an iron preparation, leave at least 2 hours between taking entacapone and the iron preparation.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.

Can entacapone cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common entacapone side-effects
What can I do if I experience this?
Feeling or being sick, abdominal pain Stick to simple foods - avoid rich or spicy meals
Feeling tired or sleepy If this happens, do not drive or use tools or machines. Discuss it with your doctor, especially if you find yourself falling asleep during the day without feeling tired beforehand
Diarrhoea Drink plenty of water to replace lost fluids. If this continues, let your doctor know
Constipation Try to eat a well-balanced diet and drink plenty of water each day
Feeling dizzy Getting up or moving more slowly should help. If you begin to feel dizzy, lie down so that you do not faint, then sit for a few moments before you stand. If this continues, speak with your doctor
Dry mouth Try chewing sugar-free gum or sucking sugar-free sweets
Uncontrolled or unusual body movements, increased sweating, feeling confused, seeing or hearing things that are not real, chest pains, and difficulty sleeping Let your doctor know if you experience any of these

Some people taking dopaminergic medicines for Parkinson's disease like entacapone, can experience changes in their behaviour. This may include things like an increased desire to gamble, or an increased sex drive. If you experience either of these things, you should let your doctor know about it as soon as possible

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store entacapone

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.