opicapone at a glance
Medicine class
Peripheral COMT inhibitor
Role
Add-on treatment for end-of-dose motor fluctuations in adults taking levodopa
Administration
Swallow the capsule whole with water; follow prescribed bedtime instructions and keep it separate from levodopa combinations
Important effect
It can increase both the benefits and adverse effects of levodopa
What is opicapone used for?
UK-licensed use represented by the selected product:
Adjunctive treatment with levodopa plus a DOPA decarboxylase inhibitor in adults with Parkinson’s disease whose end-of-dose motor fluctuations cannot be stabilised on those treatments alone.
How does opicapone work?
COMT normally breaks down levodopa outside the brain. Opicapone reversibly blocks this enzyme in the periphery, increasing levodopa exposure and helping its clinical effect last more consistently. It does not provide useful Parkinson’s treatment on its own.
opicapone preparations and strengths
Capsule
Route: Oral
Strengths: 25 mg, 50 mg
How to take opicapone
Follow the dispensing label and Parkinson’s specialist’s instructions.
Swallow the hard capsule whole with water.
It is normally taken at bedtime and separately from levodopa combinations.
Do not change or stop opicapone or levodopa treatment without discussing this with the prescriber, because levodopa effects may change.
opicapone side effects
Common or expected effects
- Involuntary movements or dyskinesia
- Dizziness, headache or sleepiness
- Hallucinations or unusual dreams
- Difficulty sleeping
- A fall in blood pressure on standing
- Constipation, dry mouth, nausea or vomiting
- Muscle spasms
- Raised blood creatine phosphokinase
Get urgent medical advice
- Collapse or fainting
- Severe breathing difficulty
- Severe or distressing hallucinations or confusion
- Marked involuntary movements that affect safety or daily activities
- New compulsive gambling, spending, sexual behaviour or eating
opicapone in pregnancy
Human pregnancy information is absent or very limited, so the selected UK product is not recommended during pregnancy or for someone who could become pregnant and is not using contraception. Discuss pregnancy plans or a suspected pregnancy promptly with the Parkinson’s specialist; do not stop treatment without advice.
opicapone while breastfeeding
It is unknown whether opicapone enters human milk, and risk to a breastfed infant cannot be excluded. The selected UK product states that breastfeeding should be discontinued during treatment, so specialist advice is needed to consider treatment and feeding options.
opicapone interactions
Check all prescribed, over-the-counter and herbal products with a pharmacist or prescriber. Important interactions include:
Levodopa combinations
Opicapone increases levodopa exposure and may intensify dyskinesia, hallucinations, nausea, vomiting, sleepiness or postural hypotension.
Non-Parkinson’s monoamine oxidase inhibitors, including phenelzine, tranylcypromine and moclobemide
Concurrent use is contraindicated because catecholamine metabolism may be excessively inhibited.
Safinamide
There is no clinical experience with the combination, so particular caution is required.
Common questions about opicapone
Answers are fully visible for fast scanning and source review.
Can opicapone be used without levodopa?
No. It is licensed as an add-on to levodopa combined with a DOPA decarboxylase inhibitor and has no useful Parkinson’s effect by itself.
Does opicapone cure Parkinson’s disease?
No. It helps manage end-of-dose motor fluctuations but does not cure Parkinson’s or stop its progression.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.