What are the precautions for taking opicapone?

During treatment with opicapone, attention should be paid to the occurrence of cardiovascular effects of the combined medication, sleep onset and drowsiness, hypotension/syncope, movement disorders, hallucinations and psychosis, impulse control/obsessive-compulsive disorder, hyperthermia and confusion after discontinuation of the drug.

1. Cardiovascular effects when combined with drugs metabolized by catechol oxygen methyltransferase (COMT): Regardless of the route of administration (including inhalation), arrhythmias, increased heart rate, and excessive changes in blood pressure may occur when combined with drugs metabolized by COMT (such as isoproterenol, epinephrine, norepinephrine, dopamine, and dobutamine). Monitor patients receiving concomitant therapy with drugs metabolized by COMT.

2. Fall asleep and somnolence: Before starting treatment with opicapone, inform the patient that drowsiness may occur and specifically ask about factors that may increase the risk of drowsiness during dopaminergic treatment, such as concomitant sedative medications or the presence of sleep disorders. If the patient develops daytime sleepiness or falls asleep during activities that require full concentration (eg, driving a motor vehicle, talking, eating), consider discontinuing Opicapone or adjusting other dopaminergic or sedative medications. If the decision is made to continue treatment, patients should be advised not to drive and to avoid other potentially hazardous activities.

3. Hypotension/Syncope: In clinical studies, 5% of patients treated with Opicapone 50 mg experienced hypotension (orthostatic and non-orthostatic), syncope and pre-syncope symptoms. If these adverse reactions occur, consider discontinuing opicapone or adjusting the dose of other medications that lower blood pressure.

4. Movement disorders: It may cause movement disorders or aggravate existing movement disorders. It is also the most common adverse reaction leading to discontinuation of Opicapone. Reducing the patient's daily dose of levodopa or another dopaminergic drug may reduce dyskinesias that occur during treatment with opicapone.

5. Hallucinations and psychosis: 1% of patients taking Opicapone50mg experienced delusions, agitation or aggressive behavior. If hallucinations or psychotic-like behavior occurs, consider discontinuing the medication. Patients with severe psychotic disorders should generally not receive long-dose therapy because of the risk of exacerbation of psychosis through increased central dopaminergic tone. Additionally, psychiatric treatments that antagonize the effects of dopaminergic drugs may worsen the symptoms of Parkinson's disease.

6. Impulse Control/Obsessive-Compulsive Disorder: Patients treated with Opicapone may experience intense urges to gamble, increased sexual desire, an intense desire to spend money, overeating, and/or other intense desires and be unable to control these desires while receiving one or more dopaminergic therapies that increase central dopaminergic tone. In some cases, it has been reported that these urges stopped when the dose was reduced or the medication was stopped. Reevaluate the patient's current treatment for Parkinson's disease and consider discontinuing the medication if the patient experiences such urges while taking opicapone. Use with caution in Parkinson's patients with suspected or diagnosed dopamine dysregulation syndrome.

7. High fever and confusion after drug withdrawal: A syndrome (with no other obvious cause) similar to neuroleptic malignant syndrome (characterized by increased body temperature, muscle rigidity, altered consciousness, and autonomic instability) associated with rapid dose reduction, discontinuation, or changes in drugs that increase central dopaminergic tone. When discontinuation is prolonged, monitor patients and consider adjustment of additional dopaminergic therapy as needed.

Opicapone has not yet been launched in the country, so it is not covered by medical insurance. The European version of Opicapone’s original drug specifications listed overseasThe price per box of 50mg*90 capsules is around RMB 6,000 (the price may fluctuate due to the exchange rate). There is currently no generic version of Opicapone on the market. For more drug information and specific prices, please consult Yaode’s medical consultant.