Opicapone is a peripheral, selective and reversible inhibitor of catechol-O-methyl transferase (COMT) that increases levodopa plasma levels when used in combination with levodopa and a peripheral DOPA decarboxylase inhibitor (DDCI), such as carbidopa or benserazide (summary of product characteristics [SPC]: opicapone and European public assessment report [EPAR]: opicapone).
Opicapone (Ongentys, Bial Pharma Limited) is a new medicine that received a European marketing authorisation in June 2016 and was launched in the UK in October 2016. It is licensed for adjuvant therapy for the treatment of Parkinson's disease in adults who are experiencing end-of-dose motor fluctuations and cannot be stabilised on levodopa/DDCI (SPC: opicapone).
The recommended dose of opicapone is 50 mg taken once daily at bedtime at least 1 hour before or after levodopa combinations (SPC: opicapone). The SPC states that dose adjustment to levodopa therapy within the first days to first weeks after initiating treatment with opicapone is often necessary.
No dose adjustment is needed in people with renal impairment or mild hepatic impairment, or in people aged 85 years or less.
Opicapone 50 mg tablets cost £93.90 for 30 tablets (MIMS, February 2017, excluding VAT).