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Carbidopa/levodopa enteral suspension in advanced Parkinson’s disease: a guide to its use

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Abstract

Carbidopa/levodopa enteral suspension [carbidopa/levodopa ES; Duopa™ (USA); Duodopa® (EU, where it is referred to as intestinal gel)] is indicated for the treatment of motor fluctuations in patients with advanced Parkinson’s disease (PD). Its delivery by continuous infusion into the proximal small intestine allows for rapid absorption of levodopa and helps to avoid the fluctuations in levodopa plasma concentrations that occur with oral levodopa therapy. In clinical trials in adults with advanced PD, carbidopa/levodopa ES provided significantly greater improvements in motor fluctuations and troublesome dyskinesia than oral immediate-release carbidopa/levodopa over 12 weeks, and had sustained efficacy in longer-term, open-label studies. Carbidopa/levodopa ES was generally well tolerated in these trials, although complications related to the delivery system were common.

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Acknowledgments

This article was reviewed by: A. Antonini, Parkinson and Movement Disorders Unit, IRCCS Hospital San Camillo, Venice, Italy; D. Nyholm, Department of Neuroscience, Neurology, Uppsala University Hospital, Uppsala, Sweden; M. Steiger, Walton Centre for Neurology and Neurosurgery, Liverpool, UK. During the peer review process, the manufacturer of carbidopa/levodopa ES was offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Sarah L. Greig

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Correspondence to Sarah L. Greig.

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The preparation of this review was not supported by any external funding.

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S. L. Greig is a salaried employee of Adis/Springer, is responsible for the article content and declares no conflicts of interest.

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Greig, S.L. Carbidopa/levodopa enteral suspension in advanced Parkinson’s disease: a guide to its use. Drugs Ther Perspect 32, 177–185 (2016). https://doi.org/10.1007/s40267-016-0297-2

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