Comtan Dosage/Direction for Use

One 200-mg tab is taken with each levodopa/dopa decarboxylase inhibitor dose. The maximum recommended dose is 200 mg 10 times daily ie, 2 g of entacapone.
Entacapone enhances the effects of levodopa. Hence, to reduce levodopa-related dopaminergic adverse effects eg, dyskinesias, nausea, vomiting and hallucinations, it is often necessary to adjust levodopa dosage within the 1st days to 1st weeks after initiating entacapone treatment. The daily dose of levodopa should be reduced by about 10-30% by extending the dosing intervals and/or by reducing the amount of levodopa per dose, according to the clinical condition of the patient.
If entacapone treatment is discontinued, it is necessary to adjust the dosing of other antiparkinsonian treatments, especially levodopa, to achieve a sufficient level of control of the parkinsonian symptoms.
Entacapone increases the bioavailability of levodopa from standard levodopa/benserazide preparations slightly (5-10%) more than from standard levodopa/carbidopa preparations.
Hence, patients who are taking standard levodopa/benserazide preparations may need a larger reduction of levodopa dose when entacapone is initiated.
Renal insufficiency does not affect the pharmacokinetics of entacapone and there is no need for dose adjustment. However, for patients who are receiving dialysis therapy, a longer dosing interval may be considered (see Pharmacokinetics under Actions).
Children: As entacapone has not been studied in patients <18 years, the use of the medicinal product in patients under this age cannot be recommended.
Elderly: No dosage adjustment of entacapone is required for elderly patients.
Administration: Entacapone is administered orally and simultaneously with each levodopa/carbidopa or levodopa/benserazide dose. The prescribing information for these levodopa preparations is applicable to their concomitant use with entacapone. Entacapone can be taken with or without food (see Pharmacokinetics under Actions).