COMT inhibitors
- Prolong levodopa effect by blocking COMT
- Parkinson motor fluctuations/OFF time
- Entacapone: with each levodopa dose
- Opicapone: once daily
- Tolcapone: effective but liver-toxicity burden
- Can worsen dyskinesia as levodopa rises
- Reduce levodopa dose if needed
Class at a glance
- Prolong levodopa effect by blocking COMT
Members / distinctions
- Entacapone: with each levodopa dose
Safety / monitoring
- Opicapone: once daily
- Tolcapone: effective but liver-toxicity burden
Other member distinctions
- Parkinson motor fluctuations/OFF time
- Can worsen dyskinesia as levodopa rises
- Reduce levodopa dose if needed
Pearls
- Daytime sleepiness and sleep attacks reported
Self-check
- Which COMT inhibitor has a liver-toxicity burden?
Tolcapone. - Which COMT inhibitor is taken with each levodopa dose?
Entacapone.
Drugs in this class (3)
COMT inhibitors prescription history
Animated chart of estimated U.S. prescriptions per year, Parkinson medicines (1948–2026). COMT inhibitors highlighted from 1998.
All drug classes · Open COMT inhibitors in the interactive console ↗