What is Tasmar (Tolcapone)?

When used with carbidopa and levodopa (Atamet, Parcopa, Sinemet), tolcapone increases levels of levodopa in the body.
Tolcapone is used together with carbidopa and levodopa to treat symptoms of Parkinson’s disease, such as stiffness, tremors, muscle spasms, and poor muscle control.
This medication is usually reserved for use only in people who have used carbidopa and levodopa without success in treating their Parkinson’s disease.
Tolcapone is usually given to people who are already taking carbidopa and levodopa but have not had successful treatment of symptoms.
Tolcapone may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Tasmar (Tolcapone)?

You should not use this medication if you are allergic to tolcapone, if you have liver disease, or if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days.
Serious or fatal side effects on the liver have occurred in some people taking this medication. You may be required to read and sign a Patient Consent form before you get a prescription for tolcapone.
Call your doctor at once if you have nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Drinking alcohol can increase certain side effects of tolcapone.
Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by tolcapone. Tell your doctor if you regularly use any of these other medicines.
Do not stop using tolcapone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using tolcapone.
You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking this medication. Talk with your doctor if you believe you have any intense or unusual urges while taking tolcapone.

What should I discuss with my healthcare provider before taking Tasmar (Tolcapone)?

You should not use this medication if you are allergic to tolcapone, or if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days.
Serious or fatal side effects on the liver have occurred in some people taking tolcapone. You may be required to read and sign a Patient Consent form before you get a prescription for tolcapone.
You should not use tolcapone if you are allergic to it, or if you have:

• liver disease; or
• if you have ever had muscle damage or fever and confusion caused by a medication

If you have any of these other conditions, you may need a tolcapone dose adjustment or special tests:

• low blood pressure; or
• kidney disease

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking tolcapone. It is not known whether the medicine actually causes this effect. Talk with your doctor if you believe you have any intense or unusual urges while taking tolcapone.
Tolcapone may cause hallucinations (the sensation of hearing or seeing something that is not there), most commonly among elderly people. Call your doctor if you experience hallucinations.
Some people taking Parkinson’s disease medications have developed skin cancer (melanoma). However, people with Parkinson’s disease may have a higher risk of melanoma. Talk to your doctor about this risk and what skin symptoms to watch for. You may need to have regular skin exams.
FDA pregnancy category C. It is not known whether tolcapone will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication..
It is not known whether tolcapone passes into breast milk or if it could harm a nursing baby. Do not take tolcapone without telling your doctor if you are breast-feeding a baby.

Tasmar Side Effects

What are the possible side effects of Tasmar (Tolcapone)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)
• feeling like you might pass out
• fever, stiff muscles, confusion, and sweating (especially when you first start taking tolcapone)
• hallucinations
• tremors (uncontrolled shaking)
• tight feeling in your chest, trouble breathing
• pain or burning when you urinate
• severe or ongoing diarrhea; or
• muscle pain, tenderness, or weakness with fever or flu symptoms and dark colored urine

Less serious side effects may include:

• diarrhea or constipation
• dry mouth
• headache, tired feeling
• unusual skin changes
• dizziness, drowsiness
• cold symptoms such as stuffy nose, sneezing, sore throat
• sleep problems (insomnia), dreaming more than usual; or
• agitation or anxiety

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tasmar Interactions

What other drugs affect Tasmar (Tolcapone)?

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by tolcapone. Tell your doctor if you regularly use any of these other medicines, or any other Parkinson’s medications..
Tell your doctor about all other medicines you use, especially:

• apomorphine (Apokyn)
• a blood thinner such as warfarin (Coumadin)
• desipramine (Norpramin)
• dobutamine (Dobutrex)
• epinephrine (Epi-Pen, and others)
• isoproterenol (Isuprel, Medihaler-Iso); or
• methyldopa (Aldomet)

This list is not complete and other drugs may interact with tolcapone. Tell your doctor about all medications you use. This includes prescription, over the counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

What should I avoid while taking Tasmar (Tolcapone)?

Tolcapone may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
Drinking alcohol can increase certain side effects of tolcapone.

Tasmar Dosage

How should I take Tasmar (Tolcapone)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Tolcapone must be taken together with carbidopa and levodopa. Tolcapone used alone will not treat symptoms of Parkinson’s disease.
Your doctor may occasionally change your dose to make sure you get the best results.
Tolcapone is usually taken three times a day. The first dose is taken with your first daily dose of carbidopa and levodopa. The second and third doses of tolcapone are taken 6 and 12 hours later.
Tolcapone may be taken with or without food.
To be sure this medicine is not causing harmful effects, your blood will need to be tested often. Your liver and kidney function may also need to be tested. Visit your doctor regularly.
Call your doctor if your symptoms do not improve after 3 weeks of using tolcapone.
Do not stop using tolcapone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using tolcapone.
Store at room temperature in a tightly closed container, away from moisture and heat.

What happens if I overdose on Tasmar (Tolcapone)?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include nausea, vomiting, and dizziness.

What happens if I miss a dose of Tasmar (Tolcapone)?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Edited from everydayhealth.com