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The following information outlines important safety warnings associated with the use of entacapone (Comtan). It is crucial to carefully review these points and discuss any concerns with your healthcare provider.

• Sleepiness and Sudden Sleep Episodes: Entacapone (Comtan) and carbidopa/levodopa medications may cause unexpected sleepiness or sudden sleep episodes during daily activities, posing a risk of accidental injury. Exercise caution when driving or performing activities that require focus until you understand how this medication affects you. Inform your healthcare provider if you experience excessive daytime sleepiness or unexpected sleep episodes, especially if you have a history of sleep disorders or are taking other sedatives.

• Low Blood Pressure and Fainting: This medication can enhance the effects of carbidopa/levodopa, potentially leading to low blood pressure and fainting when transitioning from sitting or lying down to standing. To reduce the risk of falls, rise slowly from such positions. Notify your provider if you experience dizziness or unusual drops in blood pressure.

• Hallucinations and Behavioral Changes: Some individuals may experience hallucinations or changes in behavior and thoughts, such as paranoia or confusion, shortly after starting entacapone (Comtan) or following a dosage increase. It is not recommended for those with certain mental health conditions, as some psychiatric medications may interact adversely. Report any behavioral or cognitive changes to your healthcare provider.

• Impulse Control Issues: Entacapone (Comtan) may lead to impulsive behaviors such as gambling or excessive spending. These urges can be difficult to control and may negatively impact your life. Discuss any new or worsening urges with your provider, who may adjust your dosage or discontinue treatment if necessary.

• Diarrhea and Colitis: Diarrhea is a common side effect, occurring mostly within the first few months of treatment and potentially indicating colon inflammation (colitis). Severe diarrhea can cause dehydration and low potassium levels. Maintain hydration and report any symptoms of diarrhea, colitis, or dehydration to your healthcare provider. Symptoms typically resolve after discontinuing the medication.

• Muscle Damage (Rhabdomyolysis): Severe muscle damage, potentially leading to kidney issues, has been reported in some users. This may be associated with involuntary movements experienced during treatment. Immediately report any muscle pain, dark urine, or weakness, as these may indicate serious muscle damage.

• Neuroleptic Malignant Syndrome (NMS): Rarely, medications for Parkinson's disease can cause NMS, characterized by high fever, irregular pulse, muscle stiffness, and confusion, typically during abrupt cessation or dose reduction. Seek medical attention if these symptoms occur.

• Drug Interactions: Entacapone (Comtan) inhibits the COMT protein, affecting the breakdown of medications like apomorphine and epinephrine. This can prolong their presence in the body, increasing the risk of side effects such as irregular heart rhythm and altered blood pressure. Discuss all medications you are taking with your healthcare provider to avoid potential interactions.

When taking this medication, you might experience some common side effects such as nausea, vomiting, diarrhea, dry mouth, tiredness, increased sweating, and abdominal pain. These effects are generally mild, but if they become bothersome or worsen, it's important to consult your healthcare provider. Dizziness or lightheadedness can also occur, especially when standing up quickly, so rising slowly can help minimize these sensations. Additionally, you might notice a harmless change in your urine color to brownish-orange.

In some instances, people have reported involuntary movements, muscle spasms, or slowed movements. While these effects are usually not severe, it's advisable to inform your doctor if they persist. Furthermore, dizziness, back pain, constipation, and shortness of breath have been noted by some users.

It's crucial to be aware of rare but serious side effects, such as sudden sleepiness during daily activities, unusual strong urges, or mental changes like confusion or hallucinations. If you experience severe diarrhea, muscle stiffness, or any signs of an allergic reaction like rash or swelling, seek immediate medical attention. Very rarely, conditions like neuroleptic malignant syndrome, characterized by high fevers and muscle stiffness, or severe muscle damage, evidenced by muscle aches and dark urine, can occur and require urgent care. Always inform your healthcare provider of any unusual or severe symptoms.

Entacapone, marketed as Comtan, can interact with several other medications. It is important to inform your doctor and pharmacist about all the medications and supplements you are currently using, whether prescribed, over-the-counter, vitamins, or herbal products. Some drugs, especially certain MAO inhibitors like isocarboxazid, Linezolid, methylene blue, phenelzine, procarbazine, and Tranylcypromine, should not be combined with Entacapone.

Other MAO inhibitors, such as safinamide, Selegiline, and Rasagiline, may be used with caution under close medical supervision. If you're taking rasagiline or selegiline for Parkinson's disease, consult your doctor about continuing these medications. Furthermore, Entacapone may affect the metabolism and effectiveness of other drugs, including apomorphine, dobutamine, and Methyldopa, among others like Desipramine, Fluvastatin, and Warfarin.

Additionally, be cautious with medications that cause drowsiness, such as alcohol, marijuana, antihistamines like Cetirizine and diphenhydramine, sleep or anxiety medications like Alprazolam, Diazepam, and Zolpidem, muscle relaxants, and opioid pain relievers like codeine. Always check with your pharmacist to ensure the safe use of over-the-counter products, especially those for allergies or colds, as they may contain ingredients that induce drowsiness.