BPT) - Russ, who owns a small farm in Iowa, was in his 40’s when he was loading grain onto one of his trucks and noticed something strange. His right hand was “kind of sticking” to his side, as he describes it. This loss of movement control continued and Russ knew he needed to see a doctor.
A neurologist diagnosed Russ with Parkinson’s disease, a chronic movement disorder affecting approximately 1 million people in the U.S. that gets worse over time. Parkinson’s disease results in part from a progressive loss of brain cells that produce dopamine, a chemical that helps control movement of the body.
As levels of dopamine in the brain get lower, motor symptoms of Parkinson’s may include tremors, muscle stiffness, slow movements and difficulty maintaining balance.
When he was first diagnosed with Parkinson’s, Russ didn’t fully understand the condition, but his wife was familiar with the disease. “My wife is a nurse, and she knew what was coming. The future started to feel very scary,” Russ recalls. As he learned more about how the disease progresses, he decided he would do everything possible to fight it.
Russ’ doctor prescribed carbidopa/levodopa pills to treat his Parkinson’s. But as his disease progressed, he started to experience more frequent and more persistent periods of off-time slowness, stiffness and impaired mobility. He was taking carbidopa/levodopa pills every 90 minutes and was still having motor fluctuations.
As Parkinson’s disease progresses to more advanced stages, some patients may begin to have the increasing “off” episodes that Russ was experiencing – meaning the movement issues are not as well controlled.
Russ began researching other treatment options and discovered DUOPA™ (carbidopa and levodopa) enteral suspension, a prescription medicine used for treatment of advanced Parkinson’s disease.
As Parkinson’s progresses, the body may go through changes, including changes in how the stomach empties and digests food and medicine. Those changes may delay the movement and absorption of oral levodopa, since levodopa is primarily absorbed in the small intestine. DUOPA is delivered by a surgically-placed tube straight into the intestine, bypassing the stomach. A portable pump delivers the medicine continuously through the tube over 16 hours per day at a dose appropriate for the patient.
“Before I had the procedure to place the tube and deliver DUOPA, I asked my doctor to tell me everything I needed to know about complications and risks involved with the procedure and the drug,” says Russ. His doctor discussed the possibility of serious problems that can occur, including ones that are potentially fatal or may require surgery.
The most common side effects of DUOPA include complications of tubing placement procedure, swelling of legs and feet, nausea, high blood pressure (hypertension), depression, and mouth and throat pain.
“Every day when I wake up, I feel so fortunate that I have this pump and I don’t know where I would be today without it,” Russ says.
If you are living with Parkinson’s disease and you or your caregiver notice any of the below, your Parkinson’s may be advancing:
1. Are Parkinson’s motor symptoms becoming more persistent and taking up more of your day?
2. Are you taking Parkinson’s medicines frequently, but still experiencing persistent off time?
If you are experiencing any of these issues, talk to your doctor. This is Russ's experience, but it is important to talk to your doctor about any treatment options to determine if a treatment is right for you.
“I am happy to share my story so that others who are living with advanced Parkinson’s disease can know that this treatment is available,” Russ says.
Learn more at www.DUOPA.com.
Important Safety Information and Indication
What is the most important safety information I should know about DUOPA?
- Stomach and intestine (gastrointestinal) problems and problems from the procedure you will need to have to receive DUOPA (gastrointestinal procedure-related problems) may occur. Some of these problems may require surgery and may lead to death.
Your healthcare provider will talk to you about the stoma procedure. Before the stoma procedure, tell your healthcare provider if you ever had a surgery or problems with your stomach.
Talk to your healthcare provider about what you need to do to care for your stoma. After the procedure, you and your healthcare provider will need to regularly check the stoma for any signs of infection.
- Symptoms of infection may include: drainage, redness, swelling, pain, or feeling of warmth around the small hole in your stomach wall (stoma).
Tell your healthcare provider right away if you have any of the following symptoms of stomach and intestine problems and gastrointestinal procedure-related problems: stomach (abdominal) pain; constipation that does not go away; nausea or vomiting; fever; blood in your stool; or a dark tarry stool.
Do not take DUOPA if you currently take or have recently taken (within 2 weeks) a medication for depression called a non-selective monoamine oxidase (MAO) inhibitor. Ask your healthcare provider or pharmacist if you are not sure if you take an MAO Inhibitor.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Using DUOPA with certain other medicines, including medications for high blood pressure, MAO inhibitors, antipsychotics, metoclopramide, isoniazid, and iron or vitamin supplements, may cause serious side effects. High-protein foods may affect how DUOPA works. Tell your healthcare provider if you change your diet.
DUOPA may cause serious side effects. Talk to your doctor before starting DUOPA and while on DUOPA if you have had or have any of these:
- Falling asleep during normal daily activities without warning. DUOPA may cause you to fall asleep while you are doing daily activities such as driving, which may result in an accident. This can happen as late as one year after starting DUOPA. Do not drive or operate machinery until you know how DUOPA affects you. Tell your healthcare provider if you take medicines that can make you sleepy, such as sleep medicines, antidepressants, or antipsychotics.
- Low blood pressure when you stand or sit up quickly. After you have been sitting or lying down, stand up slowly to help reduce dizziness, nausea, sweating, or fainting until you know how DUOPA affects you.
- Seeing, hearing, or feeling things that are not real (hallucinations).
- Unusual urges. Some people taking medicines for Parkinson’s disease, including DUOPA, have reported urges such as excessive gambling, compulsive eating, compulsive shopping, and increased sex drive.
- Depression and suicide. DUOPA can cause or worsen depression. Pay close attention to changes in your mood, behavior, thoughts, or feelings. Call your healthcare provider right away if you feel depressed or have thoughts of suicide.
- Uncontrolled sudden movements (dyskinesia). If you have new dyskinesia or your dyskinesia gets worse, tell your healthcare provider. This may be a sign that your dose of DUOPA or other Parkinson’s medicines may need to be adjusted.
- Progressive weakness or numbness or loss of sensation in the fingers or feet (neuropathy).
- Heart attack or other heart problems. Tell your healthcare provider if you have experienced increased blood pressure, a fast or irregular heartbeat, or chest pain.
- Parkinson’s disease patients are at an increased risk of developing melanoma, a form of skin cancer. See your healthcare provider for regular skin examinations when taking DUOPA.
- Abnormal blood tests. DUOPA may cause changes in certain blood tests, especially certain hormone and kidney blood tests.
- Worsening of the increased pressure in your eyes (glaucoma). The pressure in your eyes should be checked after starting DUOPA.
Do not stop using DUOPA or change your dose unless you are told to do so by your healthcare provider. Tell your healthcare provider if you develop withdrawal symptoms such as fever, confusion, or severe muscle stiffness.
The most common side effects of DUOPA include: complications of tubing placement procedure, swelling of legs and feet, nausea, high blood pressure (hypertension), depression, and mouth and throat pain.
Please see the full Prescribing Information at www.rxabbvie.com including Medication Guide for additional information about DUOPA. Talk to your healthcare provider if you have questions.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatchor call 1-800-FDA-1088.
If you cannot afford your medication, contact www.pparx.org for assistance.
Use
DUOPA (carbidopa and levodopa) enteral suspension is a prescription medicine used for treatment of advanced Parkinson's disease. DUOPA contains 2 medicines: carbidopa and levodopa.
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