From the Research
Opicapone is generally preferred over entecapone for Parkinson's disease patients who need a COMT inhibitor to extend levodopa's effects. Opicapone (Ongentys) is taken once daily at 50mg, while entecapone (Comtan) requires multiple doses (200mg with each levodopa dose, up to 8 times daily) 1. This simpler dosing schedule with opicapone improves adherence and convenience. Opicapone also demonstrates greater potency and longer-lasting COMT inhibition (24+ hours versus 8 hours for entecapone), providing more consistent symptom control throughout the day 2. Clinical studies show opicapone reduces "off" time by approximately 2 hours daily compared to 1-1.5 hours with entecapone 1. Both medications share similar side effect profiles including nausea, dizziness, and diarrhea, though opicapone may cause less diarrhea 3. Both can cause urine discoloration. Cost may be a consideration as opicapone is newer and typically more expensive. The choice between these medications should account for the patient's specific symptoms, daily routine, insurance coverage, and preference for dosing frequency. Some key points to consider when choosing between opicapone and entecapone include:
- Dosing schedule: Opicapone is taken once daily, while entecapone is taken multiple times a day
- Potency and duration of action: Opicapone has greater potency and longer-lasting COMT inhibition
- Side effect profile: Both medications have similar side effects, but opicapone may cause less diarrhea
- Cost: Opicapone is typically more expensive than entecapone. It's worth noting that the most recent and highest quality study 1 supports the use of opicapone as a preferred treatment option for Parkinson's disease patients who need a COMT inhibitor.