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Opicapone

COMT Inhibitor · Parkinson's disease

Also known as Ongentys

COMT InhibitorParkinson's disease
CDSCO approved
EXCRETION
not curated
INTERACTIONS
8 major
SEVERE in our sources
PREGNANCY
Avoid—no information available.
FDA category + note
Top interactionssee all 8
  • DextropropoxypheneSevereDatabaseDDInter
  • IsocarboxazidSevereDatabaseDDInter
  • LinezolidSevereDatabaseDDInter
  • Methylene BlueSevereDatabaseDDInter

Mechanism

Opicapone is a long-acting, peripherally selective catechol-O-methyl transferase (COMT) inhibitor. It works by diminishing the peripheral metabolism of levodopa. This action prolongs the presence of levodopa in the system, thereby decreasing its clearance and increasing its relative bioavailability to the brain.

Indications

Adjunct to co-beneldopa or co-careldopa in Parkinson’s disease with ‘end-of-dose’ motor fluctuations (under expert supervision)Parkinson's disease (adjunct to L-DOPA)Adjunctive PD therapy for wearing off

Dosing

Adult
50 mg once daily, dose to be taken at bedtime, at least one hour before or after levodopa combinations
Hepatic adjustment
Manufacturer advises avoid
Geriatric
elderly over 85 years (limited information available)

Pharmacokinetics

Duration
long-acting
Half-life
short plasma t1/2, but slow dissociation rate allows once daily use

Contraindications

  • Catecholamine-secreting neoplasms
  • history of neuroleptic malignant syndrome
  • history of non-traumatic rhabdomyolysis
  • paraganglioma
  • phaeochromocytoma

Side effects

Common
Constipationdizzinessdrowsinessdry mouthhallucinationsheadachehypotensionmovement disordersmuscle complaintssleep disordersvomiting
Serious
  • dyskinesias
  • neuroleptic malignant syndrome
  • rhabdomyolysis

Pregnancy & lactation

Pregnancy

Avoid—no information available.

Lactation

Avoid—present in milk in animal studies.

Drug interactions

Dextropropoxyphene
Severe
Database

Clinical effect not specified

Source: DDInter

Isocarboxazid
Severe
Database

Clinical effect not specified

Source: DDInter

Linezolid
Severe
Database

Clinical effect not specified

Source: DDInter

Methylene Blue
Severe
Database

Clinical effect not specified

Source: DDInter

Phenelzine
Severe
Database

Clinical effect not specified

Source: DDInter

Procarbazine
Severe
Database

Clinical effect not specified

Source: DDInter

Sodium Oxybate
Severe
Database

Clinical effect not specified

Source: DDInter

Tranylcypromine
Severe
Database

Clinical effect not specified

Source: DDInter

4 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.

Related guidelines

Other COMT Inhibitor drugs

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Sources: Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-10 · House clinical team