Entacapone causes diarrhea?

[Lionore]

I’ve been taking Entacapone for exactly three months because of wearing off times about 45 minutes prior to next Sinemet dose. It has provided a modest improvement in my overall functioning. I’ve been taking it three times per day with 25/100 c/l. Aside from the yellow urine no side effects until ten days ago when I started having cramps and diarrhea. I hadn’t changed my diet or been exposed to anything. Tried eliminating various foods with no improvement and the diarrhea kept getting worse. OTC medication didn’t help. Finally consulted Dr Google and voila this medication can cause severe diarrhea in 10-20% of patients. On call neurologist said to discontinue immediately. I will speak with my MDS next business day. Probably just have to live with the off times as opposed to having to be near a bathroom for most of the day.

[healthabc]

I have similar wearing off- so I take 1/2 sinemet under my tongue an hour before my next full sinemet dose. does the trick for me.

[Lionore in reply to healthabc]

Thanks I’ll try it! My doctor has given me permission to take the extra half Sinemet when needed.

[jeffreyn in reply to healthabc]

Hi healthabc,

What is the size of your full dose and at what times do you take a full dose? At what times do you take food? Do you always take the extra half tablet or only when you detect "wearing off "?

Sorry for so many questions. I'm trying to work out if I could benefit from this tactic.

[healthabc in reply to jeffreyn]

My 'regular' dose is 1& 1/2 (one and a half) 25/100 every 3 hours, but it starts to wear off just after 2 hours. So I take 1/2 tablet under my tongue at 2 hrs. That gets me smoothly thru to the regular dose (one and a half tablets) at the 3 hr mark.

For example- 9am 1&1/2 tablets

11am 1/2 under tongue

12noon 1&1/2 tablets

2pm 1/2 under tongue

3pm 1&1/2 tablets

...and so on.

Eating- I like to eat as soon as I feel my 'regular' dose taking effect. That might be somewhere around 40-50 mins after taking my 'regular' dose. .. because then, an hour or so later, if food is still in my tummy, the 1/2 tablet is absorbed sublingually, under my tongue, bypassing my stomach. Which then gets me to my next 'regular' dose smoothly.

Does that make sense?

[jeffreyn in reply to healthabc]

Thanks very much for the detailed reply.

Assuming, say, that your last dose is at 9pm, then your prescription is for 7 and a half pills per day, and you take an extra 2 pills per day for smoothness. I assume that, for convenience, you have a dozen alarms set up on a smart phone, and that every evening you load up a multi-compartment pill container in readiness for the next day.

It sounds do-able, but only if Sinemet can really be absorbed sublingually. I have tried it with my Madopar tablets, and it doesn't seem to work with them. What seems to be happening is that the Madopar half tablet gets dissolved by saliva and is eventually swallowed.

[healthabc in reply to jeffreyn]

yes, that's correct, that's the way i do it. Alarms on my phone are vital.

[JuliBee]

I had the exact same situation with entacapone. Didn’t suspect it was the medication as I had been on it for several months. I have since been prescribed opicapone (Ongentys) once a day in the evening but I haven’t started it yet.

[Gymsack]

I take CD/LD every three hours and it lasts about 2.5 hours . I tried entacapone for almost 3 weeks and had to quit it but it's effect lasted for 2 more weeks . It did cause a strange diarrhea but I stopped taking it because 2 days after starting it I was seeing things that were not there and when I quit it I was seeing , hearing and feeling things that were not there and I had a severe change in personality. Full blown hallucinations that slowly wore off, it was kinda humorous for the first few days then not so much . Ronald Mcdonald in his flying car got really nasty.

Now my neurologist is looking into a pump that I will wear that will continuously supply CD / LD under my skin that will be loaded by a nurse every two weeks.

PS : The entacapone did a very good job of extending the effect of the CD/LD and did cause some dyskinesia and if I had been able to continue it would probably have allowed me to reduce the CD/LD .

[Lionore in reply to Gymsack]

Wow, thanks Gymsack! Nasty as the diarrhea has been your hallucinations would be much more scary especially since I drive myself to my Rock Steady Boxing class. MDS is suggesting that I take a week off then go back on a reduced dose. Other alternative is to live with the off periods as in not going anywhere or doing much. Hope that the pump works out for you.

[Gymsack in reply to Lionore]

Probably a good idea . I would maybe try just one a day myself but my wife was kind of adamant that I stop taking it, scared her a bit I guess. hahahahahhh

[Lionore in reply to Gymsack]

Your wife probably freaked out at those weird side effects. It’s so unfortunate that almost all PD medication can potentially cause severe problems. It’s called pick your poison. Alternatively I’m for lifestyle choices to adapt to progression as long as possible. I have to avoid comparing myself to others my age (77) who don’t have PD or other debilitating conditions and instead practice gratitude for an angel partner, decent income, health care and so far relatively slow progression.

[Farooqji in reply to Gymsack]

Does sinemet makes you completely normal when ON? Or there are still some symptoms

[Gymsack]

From the day I was diagnosed and started taking medication there has never been a completely normal . The medication is pretty good but it is not my own dopamine. We each must find our own way through our own PD and adapt to what medications we can tolerate. That is about the best we can hope for , medication we can take or at the least we can tolerate, and the fact that someone else can or can not take a certain medication means nothing. There are no doubt many people who take entacapone and are wondering what all the fuss is about.