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GETTING STARTED ON DUOPA TREATMENT

Ask your doctor

Your doctor may refer you to a Movement Disorder Specialist (MDS) who’s specially trained in Parkinson’s. An MDS will help you learn more and discuss whether Duopa might be right for you. This is the time to get answers to all your questions about Duopa, so don’t hold back!

  • 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 doctor if you change your diet.

Please see additional Important Safety Information and full Prescribing Information.

PEG-J procedure

Long-term use of Duopa requires a procedure to make a small hole (called a stoma) in your stomach wall to place a PEG-J tube into your small intestine. This procedure allows medication to flow from the cassette into your body, and it will be performed by a specialist experienced in this procedure, sometimes a gastroenterologist. Your doctor will talk to you about the stoma procedure.

  • Before the stoma procedure, tell your doctor if you ever had a surgery or problems with your stomach.

  • Stomach and intestine (gastrointestinal) problems and problems from the procedure (gastrointestinal procedure-related problems) may occur. Some of these problems may require surgery and may lead to death.

  • Tell your doctor 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.

Please see additional Important Safety Information and full Prescribing Information.

Learn more about how Duopa is delivered

Starting Duopa

  • Your doctor will help you learn how to use the pump and care for your tubing and stoma.You will need to check the stoma for signs of infection, such as pain, fever, redness, warmth, and drainage from your stoma. Tell your doctor right away if you notice any of these signs.

Your doctor will start your treatment with Duopa by programming your pump. Your dose will be adjusted to your individual needs in a process called titration, which involves finding the dose that’s right for you. To find that dose, your doctor will ask you to keep track of your symptoms in a diary. Your dose should only be changed by your healthcare provider or while you are with your healthcare provider.

Adjustments to other parkinson's medicines may also be needed. And additional dose adjustments may be neccessery over time based on your level of activity and how your disease advances.

Please see additional Important Safety Information and full Prescribing Information.

Daily routine

Your doctor will help you learn how to use the pump and care for your tubing and stoma.

 

In the morning, you’ll connect a cassette and start your pump to receive your morning dose. After that, your continuous dose will start automatically and continue for 16 hours.

 

At bedtime, you’ll disconnect the pump and flush the PEG-J tube. You may get a prescription for Parkinson’s medicine to take when the pump is disconnected at night.

  • If you stop Duopa for less than 2 hours, you do not need to take oral carbidopa/levodopa, but your doctor may instruct you to take an extra dose of Duopa before you disconnect the pump. If you stop Duopa for more than 2 hours during your 16-hour dosing time for any reason, call your doctor and take oral carbidopa/levodopa as prescribed until you are able to restart Duopa. You should always have oral carbidopa/levodopa immediate-release pills in case you are unable to give your Duopa infusion.

  • Do not stop using Duopa without talking to your doctor. Suddenly stopping Duopa can cause withdrawal symptoms such as fever, confusion, or severe muscle stiffness.

Please see additional Important Safety Information and full Prescribing Information.

PEG-J = percutaneous endoscopic gastrostomy with jejunal tube.

Planning to talk to your doctor about Duopa?

 

Come prepared with this helpful Discussion Guide. It can help you ask the right questions.

View the Discussion Guide
Levodopa

A commonly prescribed Parkinson’s treatment. Levodopa works by replacing the dopamine lost in Parkinson’s. It’s combined with carbidopa.

Stoma

An opening in the skin created surgically to allow for the passage of medicine to an internal organ or to allow for the passage of waste products from the body.

Important Safety Information

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 including Medication Guide for additional information about DUOPA. Talk to your healthcare provider if you have questions.

Use

DUOPA (carbidopa and levodopa) enteral suspension is a prescription medicine used for treatment of advanced Parkinson’s disease. DUOPA contains two medicines: carbidopa and levodopa.

IMPORTANT SAFETY INFORMATION

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.