Selegiline and entacapone
Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.
Selegiline and entacapone (brand names Eldepryl, Comtan) — Antiparkinson adjuncts; MAO-B inhibitor (selegiline); COMT inhibitor (entacapone).
Identification
- Therapeutic class: Antiparkinson adjuncts.
- Pharmacologic class: MAO-B inhibitor (selegiline); COMT inhibitor (entacapone).
Pharmacology
- Mechanism of action: Selegiline blocks MAO-B to preserve dopamine; entacapone blocks COMT to extend levodopa effect.
- Onset / peak / duration: Adjunctive effect; entacapone given with each levodopa dose.
- Half-life / therapeutic level: Variable; level not routine.
Clinical use
- Indications: Adjuncts to levodopa for motor fluctuations.
- Usual dose, route, frequency: Selegiline PO; entacapone 200 mg with each levodopa dose.
- Maximum dose / adjustments: Selegiline dietary tyramine caution at higher doses.
Safety
- Contraindications: Selegiline with other MAO inhibitors, meperidine, or serotonergic drugs.
- Black box warning: None.
- Interactions: Selegiline with serotonergic drugs (serotonin syndrome), tyramine foods at higher doses; entacapone increases levodopa effect.
- Pregnancy / lactation: Use only if essential.
- High-alert: No.
Adverse effects
- Common side effects: Dizziness, nausea; entacapone causes brown-orange urine.
- Serious effects to report: Hypertensive crisis (selegiline with tyramine), serotonin syndrome, severe diarrhea (entacapone).
- Antidote / reversal: Supportive care.
Nursing process
- Assessment before administration: Diet, concurrent serotonergic drugs, motor status.
- Interventions during therapy: Reinforce tyramine avoidance at higher selegiline doses.
- Monitor: Blood pressure, motor function.
- Evaluation / expected outcome: Smoother motor control.
Patient teaching
- Patient teaching: Entacapone harmlessly discolors urine; follow diet limits for selegiline.
- Notify provider if: Severe headache, agitation with fever, severe diarrhea.
- Administration tips: Entacapone with each levodopa dose.