Ongentys (opicapone) is a selective and reversible peripheral catechol-O-methyltransferase (COMT) inhibitor. Used as an adjunctive therapeutic agent to levodopa/carbidopa, it is indicated for improving "off" episodes in patients with Parkinson's disease.
Precautions for Ongentys (Opicapone) Administration
Dosage and Administration Regimen
The standard recommended dosage of opicapone is 50 mg once daily, to be taken orally before bedtime.
For patients with moderate hepatic impairment (Child-Pugh Class B), the dosage should be reduced to 25 mg once daily.
Patients with severe hepatic impairment (Child-Pugh Class C) should avoid using this medication.
Fasting is required for 1 hour before and after taking the medication to ensure optimal drug absorption.
Administration in Special Populations
Pregnant women should use opicapone with caution, as animal studies have shown that it may cause harm to the fetus.
Lactating women should weigh the benefits and risks before deciding whether to use this medication.
Elderly patients aged 65 years and above generally do not require dosage adjustment, but close monitoring for adverse reactions is necessary.
Patients with end-stage renal disease (CLcr < 15 mL/min) should avoid using this medication.
Drug Interactions
Concurrent use of opicapone with non-selective monoamine oxidase (MAO) inhibitors (such as phenelzine and isocarboxazid) is strictly prohibited, as it may trigger severe cardiovascular reactions.
This medication is also contraindicated in patients with a history of pheochromocytoma, paraganglioma, or other catecholamine-secreting tumors.
Diet and Lifestyle Recommendations
Patients must strictly adhere to the requirement of fasting for 1 hour before and after taking the medication.
Since daytime somnolence may occur, patients should avoid driving or operating hazardous machinery during the treatment period.
It is recommended to maintain a regular daily routine and avoid sudden changes in body position to prevent orthostatic hypotension.
Medication Monitoring for Ongentys (Opicapone)
Cardiovascular System Monitoring
When opicapone is used in combination with COMT-metabolized drugs (such as isoprenaline and adrenaline), close monitoring of heart rate, heart rhythm, and blood pressure changes is required.
Clinical observation should focus particularly on potential risks such as arrhythmias, increased heart rate, and abnormal fluctuations in blood pressure.
Nervous System Symptom Monitoring
During the treatment period, regular assessment of dyskinesia is necessary, as approximately 20% of patients may experience the onset or worsening of dyskinesia.
At the same time, attention should be paid to episodes of daytime somnolence, especially when engaging in activities that require high concentration (such as driving).
If uncontrollable sleep episodes occur, consideration should be given to adjusting the treatment regimen.
Psychiatric and Psychological Status Monitoring
Healthcare providers should regularly inquire whether patients have developed psychotic symptoms such as hallucinations and delusions, with an incidence rate of approximately 3%.
Special attention should be paid to impulse control disorders such as pathological gambling, hypersexuality, and compulsive shopping; these symptoms may resolve after discontinuing the medication.
