Opicapone (Ongentys) is a selective, reversible peripheral catechol-O-methyltransferase (COMT) inhibitor. It is used as an adjunctive therapy to levodopa/carbidopa to improve "off" period symptoms in patients with Parkinson's disease.

Side Effects of Opicapone (Ongentys)

Common Side Effects

Neurological abnormalities: Dyskinesia (20%), dizziness (3%).

Gastrointestinal reactions: Constipation (6%), dry mouth (3%).

Psychiatric effects: Hallucinations (3%), insomnia (3%).

Abnormal laboratory indicators: Increased creatine kinase (5%), weight loss (4%).

Vascular system changes: Hypotension/syncope (5%), hypertension (3%).

Severe Side Effects of Opicapone (Ongentys)

Cardiovascular System Risks

Warning for concomitant use with COMT-metabolized drugs: When used together with drugs such as isoprenaline, adrenaline, noradrenaline, dopamine, and dobutamine.

It may induce arrhythmias, tachycardia, and excessive blood pressure fluctuations, requiring close monitoring of cardiac function.

Sudden Somnolence During Daily Activities

Patients receiving dopaminergic drug therapy (including opicapone) have reported sudden onset of sleep during daily activities, such as while driving, conversing, or eating, which may lead to accidents.

Patients may not perceive warning symptoms such as excessive drowsiness.

Motor Function Abnormalities

Worsened dyskinesia: Opicapone enhances the effect of levodopa and may induce or exacerbate existing dyskinesia.

If necessary, the dosage of levodopa or other dopaminergic drugs needs to be adjusted.

Psychiatric and Neurological Reactions

Hallucinations and psychotic symptoms: Including visual hallucinations, auditory hallucinations, delusions, agitation, or aggressive behavior.

Impulse control disorders: Manifested as abnormal behaviors such as gambling urges, hypersexuality, binge eating disorder, and compulsive spending.

Withdrawal syndrome: Rapid dose reduction or discontinuation may trigger symptoms similar to neuroleptic malignant syndrome, such as hyperthermia, confusion, and muscle rigidity.

Precautions for Opicapone (Ongentys)

Drug Interactions

Non-selective MAO inhibitors: Concomitant use is prohibited, as it may significantly increase catecholamine levels.

COMT-metabolized drugs: Concomitant use requires caution, with enhanced electrocardiographic and blood pressure monitoring.

Monitoring and Follow-up Requirements

Blood potassium monitoring: Regular testing before and during the initial stage of treatment.

Neurological assessment: Close attention to changes in motor function and mental status.

Cardiovascular monitoring: Enhanced monitoring is required when used concomitantly with specific drugs.

Patient Education

Clearly inform patients of the risk of drowsiness and advise them to avoid dangerous activities such as driving.

Instruct patients on the correct medication time and dietary interval requirements.

Remind patients to promptly report changes in symptoms such as behavioral abnormalities and hallucinations.