Opcapone (Ongentys) is a selective and reversible catechol-O-methyltransferase (COMT) inhibitor. It is used as an adjunctive treatment to levodopa/carbidopa for improving "off" period symptoms in patients with Parkinson's disease (PD).

How to Use Opcapone (Ongentys)

Administration Regimen

Recommended Dosage: 50mg once daily, taken orally before bedtime.

Dietary Restrictions: Fasting is required for 1 hour before and after taking the medication to avoid the impact of food on drug absorption.

Management of Missed Doses: If a dose is missed, take it at the originally scheduled time on the next day; there is no need to make up for the missed dose.

Combined Medication Use

It must be used in combination with levodopa/carbidopa and cannot be used alone.

During the medication period, it is necessary to monitor the need for dosage adjustment of other anti-Parkinsonian drugs. In particular, the dose of levodopa may need to be reduced to prevent the exacerbation of dyskinesia.

Dosage Adjustment of Opcapone (Ongentys)

Patients with Hepatic Impairment

Moderate Hepatic Impairment (Child-Pugh Class B): Reduce the dosage to 25mg once daily.

Severe Hepatic Impairment (Child-Pugh Class C): Opcapone is contraindicated.

Mild Hepatic Impairment (Child-Pugh Class A): No dosage adjustment is required, but close monitoring of adverse reactions is necessary.

Patients with Renal Impairment

Mild to Severe Renal Impairment (CLcr ≥ 15 mL/min): No dosage adjustment is required.

End-Stage Renal Disease (ESRD, CLcr < 15 mL/min): Use should be avoided due to the lack of safety data.

Discontinuation and Transition

Sudden discontinuation may lead to withdrawal-related hyperthermia or confusion. It is recommended to gradually reduce the dosage and adjust the dosages of other dopaminergic drugs.

Precautions for Opcapone (Ongentys) Use in Special Populations

Pregnancy and Lactation

Pregnancy: Animal studies have shown embryotoxicity, and human data are limited. It should be used only when the benefit outweighs the risk.

Lactation: Whether opcapone is excreted in human milk is unclear. It is recommended to weigh the pros and cons before deciding to discontinue the medication or suspend breastfeeding.

Other High-Risk Populations

Patients with Cardiovascular Diseases: Combined use with drugs metabolized by COMT (such as epinephrine) may cause arrhythmias or blood pressure fluctuations, requiring close monitoring.

Patients with a History of Mental Illness: It may exacerbate hallucinations or psychiatric symptoms, so careful assessment is needed.