Ongentys is a COMT inhibitor used for the treatment of Parkinson's disease, and special attention should be paid to drug interactions, neurological side effects, and medication adjustments for specific populations. The following provides a detailed explanation of its precautions from 7 aspects, including key issues such as cardiovascular risk, drowsiness, hypotension, and movement disorders.

1. Risks of drug interactions

(1) Combined use with drugs metabolized by COMT, such as dopamine and adrenaline, may cause arrhythmia and severe blood pressure fluctuations, requiring monitoring of cardiac function.

(2) Prohibition of combination with non selective monoamine oxidase inhibitors may increase the risk of serious side effects.

2 Precautions related to the nervous system

(1) Sudden drowsiness during daily activities: may occur without warning, and falling asleep while driving has caused accidents. It is necessary to evaluate the combination of medication and sleep status.

(2) Illusion and mental illness: If hallucinations occur, consider stopping medication, and patients with severe mental illness should avoid using it.

(3) Impulsive control disorder: may cause pathological gambling, overeating, etc., and symptoms can be reversible after reducing or stopping medication.

3. Cardiovascular system monitoring

(1) Positional hypotension: Common fainting and blood pressure drop require regular monitoring and adjustment of antihypertensive medication.

(2) Abnormal heart rate: Combination with sympathomimetic drugs may cause tachycardia or arrhythmia.

4. Management of movement disorders

(1) Possible aggravation of movement disorders: It is necessary to reduce the dosage of levodopa or other dopaminergic drugs for control.

(2) Withdrawal syndrome: Sudden discontinuation of medication may lead to high fever and blurred consciousness, requiring gradual reduction.

Medication for 5 special populations

(1) Liver dysfunction: Moderate cases should be reduced to 25mg/day, and severe cases should be avoided; End stage renal insufficiency patients should avoid using it.

(2) Elderly patients: The incidence of hallucinations is higher in those over 70 years old, but there is no need for routine dose adjustments.

(3) Pregnancy and lactation: Animals show fetal risk, and the safety during lactation is not clear.

6 Omission and Overtreatment

(1) Missed intake: Normal intake the next day is sufficient, no need for supplementation.

(2) Overdose: Currently, there is a lack of specific antidotes, and symptomatic supportive treatment is needed.

7 Other important warnings

(1) Driving restrictions: Avoid driving or operating machinery during medication.

(2) Alcohol contraindications: May exacerbate central nervous system side effects.