Medicine Diary

Keeping a medication diary (often PD patients find a computer or typewriter easiest to use) will help patients talk to the doctor. Make sure to note when medication is taken, ON and OFF times, and how long each ON and OFF period lasts. Record this information for a few days and then share it with the doctor.

Include:

• The times of day when you have good symptom control.

• Which symptoms come back during the day and when.

• The symptoms you experience at night (e.g. sleep disturbances).

• Any complications you experience, such as dyskinesia, and how long after you take your medication they occur.

• Mealtimes, to see if the times of day you eat affect your symptom control.

A diary will give the doctor a picture of life outside the office. It will also let them track progress, changes in medications, and will provide a long-term record to look back on.

TASMAR SHOULD NOT BE USED BY PATIENTS UNTIL THERE HAS BEEN A COMPLETE DISCUSSION OF THE RISKS AND THE PATIENT HAS PROVIDED WRITTEN INFORMED CONSENT (SEE PATIENT ACKNOWLEDGEMENT FORM).

WARNING: Because of the risk of potentially fatal, acute fulminant liver failure, TASMAR (tolcapone) should ordinarily be used in patients with Parkinson's disease on l-dopa/carbidopa who are experiencing symptom fluctuations and are not responding satisfactorily to or are not appropriate candidates for other adjunctive therapies (see INDICATIONS and DOSAGE AND ADMINISTRATION sections).

TASMAR therapy should not be initiated if the patient exhibits clinical evidence of liver disease or two SGPT/ALT or SGOT/AST values greater than the upper limit of normal. Patients with severe dyskinesia or dystonia should be treated with caution (see PRECAUTIONS: Rhabdomyolysis).

Laboratory Tests: Although a program of frequent laboratory monitoring for evidence of hepatocellular injury is deemed essential, it is not clear that periodic monitoring of liver enzymes will prevent the occurrence of fulminant liver failure. However, it is generally believed that early detection of drug-induced hepatic injury along with immediate withdrawal of the suspect drug enhances the likelihood for recovery. Accordingly, the following liver monitoring program is recommended.

Please see accompanying complete prescribing information including BOXED warning.

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