4. Ask Your Physician About Steady Drug Supply
One strategy to doubtlessly keep away from fluctuations in treatment supply and dopamine ranges (and doubtlessly scale back dyskinesias) is thru a steady drug supply system akin to Duopa.
Levodopa is nearly all the time mixed with a medicine referred to as carbidopa to assist enhance uptake. Duopa remedy is a type of carbidopa-levodopa that treats the identical motion signs, however it’s additionally designed to enhance absorption and scale back “off” instances by delivering the drug by way of a tube instantly into the small gut, moderately than being taken as a capsule.
Earlier than you can begin Duopa, you could have surgical procedure to make a small gap (referred to as a stoma) in your stomach to be able to place a tube in your gut. A pump then delivers Duopa on to your gut by way of this tube.
An alternative choice is a steady subcutaneous (underneath the pores and skin) infusion, through which a small machine just like an insulin pump is clipped to the clothes. In late 2024, the U.S. Meals and Drug Administration authorised foscarbidopa and foslevodopa (Vyalev) as the primary and at the moment solely subcutaneous 24-hour infusion of levodopa-based remedy for the remedy of motor fluctuations in adults with superior Parkinson’s illness.
Vyalev makes use of a pump machine that you just put on always, besides if you bathe, bathe, or swim. By delivering treatment repeatedly by way of the day and evening, it’s meant to supply extra “on” instances and assist easy out “off” instances when signs return, together with dyskinesia.
One other steady subcutaneous infusion choice is one which delivers a gradual dose of the treatment apomorphine (Apokyn), a dopamine agonist, which can scale back “off” instances, improve “on” instances, and decrease dyskinesia signs.
