Opicapone (Ongentys) is used as an adjunctive medication in the treatment of Parkinson's disease. It prolongs the efficacy of levodopa by inhibiting the COMT enzyme; however, its use requires strict attention to side effects and medication administration guidelines.
What are the Side Effects of Opicapone (Ongentys)?
Common Side Effects
Neurological abnormalities: Dyskinesia (20%), dizziness (3%).
Gastrointestinal reactions: Constipation (6%), dry mouth (3%).
Metabolic abnormalities: Weight loss (4%), elevated creatine kinase (5%).
Cardiovascular issues: Hypotension/syncope (5%), hypertension (3%).
Psychiatric symptoms: Hallucinations (3%), insomnia (3%).
Serious Side Effects of Opicapone (Ongentys) That Require Vigilance
Cardiovascular Risks
Manifestations: Concurrent use with COMT-metabolized drugs (e.g., epinephrine, dopamine) may lead to arrhythmias and severe blood pressure fluctuations.
Management: When used in combination, closely monitor heart rate and blood pressure. Concomitant use with non-selective MAO inhibitors is contraindicated.
Excessive Daytime Sleepiness
Risk: Patients may experience sudden onset of sleep during driving or daily activities, leading to accidents.
Recommendation: Evaluate the patient's history of sleep disorders before initiating medication. If sleepiness occurs, reduce the dosage or discontinue the drug.
Impulse Control Disorders
Manifestations: Uncontrollable behaviors such as gambling, binge eating, and hypersexuality.
Response: Patients and their family members should be aware of these symptoms; seek medical attention immediately if they occur.
Neuropsychiatric Symptoms
Hallucinations/Psychosis: 3% of patients experience hallucinations or delusions; discontinue the drug if symptoms are severe.
Neuroleptic Malignant Syndrome: Sudden drug withdrawal may cause hyperthermia and muscle rigidity. The dosage should be reduced gradually and the patient closely monitored.
Effects on Hepatic and Renal Function
Hepatic Impairment: Dosage adjustment is required for patients with moderate to severe hepatic impairment (Child-Pugh Class B: 25mg/day; Child-Pugh Class C: contraindicated).
Renal Impairment: Avoid use in patients with end-stage renal disease.
Precautions for Opicapone (Ongentys) Administration
Correct Medication Administration
Dosage: The recommended dose is 50mg once daily, taken orally before bedtime; for patients with moderate hepatic impairment, reduce the dose to 25mg once daily.
Dietary Restrictions: Fasting for 1 hour before and after medication administration is required to avoid affecting drug absorption.
Contraindications and Drug Interactions
Absolute Contraindications: Concomitant use with non-selective MAO inhibitors (e.g., phenelzine) and use in patients with pheochromocytoma are contraindicated.
Drugs Requiring Caution: Sympathomimetic drugs (e.g., albuterol) may exacerbate cardiovascular side effects.
Key Patient Education Points
Avoid sudden drug withdrawal; dosage reduction should be gradual under the guidance of a physician.
Regularly monitor blood pressure, liver function, and psychiatric symptoms.
Seek immediate medical attention if palpitations, hallucinations, or behavioral abnormalities occur.
