Dyskinesia and off time impact patients' daily lives

See how episodes of dyskinesia and OFF time occur unpredictably throughout the day—starting when patients wake up1-4

Dyskinesia Impacts Patients' Daily Life
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ASK YOUR PATIENTS HOW THEIR ADLs ARE IMPACTED


Managing dyskinesia and off time starts with a conversation with your patient and their care partner

Your patients may be more comfortable talking about OFF time than dyskinesia, but that doesn't mean dyskinesia isn't happening. Keep in mind that your patients may5-7:

Downplay their
dyskinesia to avoid
OFF time

Not realize the impact
of their dyskinesia or
OFF time

Believe dyskinesia is
just a sign of
disease progression

Assume there are
no dyskinesia
treatment options

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Listen for cues that may indicate struggles with dyskinesia and OFF time, such as1,5,8-10:

  •  Statements that imply compromise or settling
  •  Referring to ON time negatively
  •  Increases in "accident prone" behaviors
  •  Describing unpredictable episodes of dyskinesia, ON, and OFF time
  •  Difficulties with activities or hobbies
  •  Feeling embarrassed in social situations
  •  Care partner making comments about movement control
  •  Difficulties at work
  • Based on learnings from leading organizations, including The Michael J. Fox Foundation and Parkinson’s Foundation.

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Important Safety Information

Indication

GOCOVRI® (amantadine) extended release capsules is indicated for the treatment of dyskinesia in patients with Parkinson’s disease receiving levodopa-based therapy, with or without concomitant dopaminergic medications.

Contraindications

GOCOVRI is contraindicated in patients with creatinine clearance below 15 mL/min/1.73 m2.

Warnings and Precautions

Falling Asleep During Activities of Daily Living and Somnolence: Patients treated with Parkinson’s disease medications have reported falling asleep during activities of daily living. If a patient develops daytime sleepiness during activities that require full attention (e.g., driving a motor vehicle, conversations, eating), GOCOVRI should ordinarily be discontinued or the patient should be advised to avoid potentially dangerous activities.

Suicidality and Depression: Monitor patients for depression, including suicidal ideation or behavior. Prescribers should consider whether the benefits outweigh the risks of treatment with GOCOVRI in patients with a history of suicidality or depression.

Hallucinations/Psychotic Behavior: Patients with a major psychotic disorder should ordinarily not be treated with GOCOVRI because of the risk of exacerbating psychosis. Observe patients for the occurrence of hallucinations throughout treatment, especially at initiation and after dose increases.

Dizziness and Orthostatic Hypotension: Monitor patients for dizziness and orthostatic hypotension, especially after starting GOCOVRI or increasing the dose.

Withdrawal-Emergent Hyperpyrexia and Confusion: Rapid dose reduction or abrupt discontinuation of GOCOVRI, may cause an increase in the symptoms of Parkinson’s disease or cause delirium, agitation, delusions, hallucinations, paranoid reaction, stupor, anxiety, depression, or slurred speech. Avoid sudden discontinuation of GOCOVRI.

Impulse Control/Compulsive Behaviors: Patients may experience urges (e.g. gambling, sexual, money spending, binge eating) and the inability to control them. It is important for prescribers to ask patients or their caregivers about the development of new or increased urges. Consider dose reduction or stopping medications.

Adverse Reactions

The most common adverse reactions (>10%) were hallucination, dizziness, dry mouth, peripheral edema, constipation, fall, and orthostatic hypotension.

View the full Prescribing Information.

Indication

GOCOVRI® (amantadine) extended release capsules is indicated for the treatment of dyskinesia in patients with Parkinson’s disease receiving levodopa-based therapy, with or without concomitant dopaminergic medications.

References: 1. Pahwa R, Isaacson S, Jimenez-Shaheed J, et al. Impact of dyskinesia on activities of daily living in Parkinson’s disease: Results from pooled phase 3 ADS-5102 clinical trials. Parkinsonism Relat Disord. 2019;60:118-125. 2. Hauser RA, Kremens DE, Elmer LW, et al. Prevalence of dyskinesia and OFF by 30-minute intervals through the day and assessment of daily episodes of dyskinesia and OFF: novel analyses of diary data from Gocovri pivotal trials. J Parkinsons Dis. 2019;9(3):591-600. 3. Zadikoff C, Kianirad Y. Managing PD Mid-stride: A Treatment Guide to Parkinson’s Disease. New York, NY: Parkinson’s Foundation. 4. Bhatia S, Gupta A. Impairments in activities of daily living in Parkinson’s disease: implications for management. NeuroRehabilitation. 2003;18(3):209-214. 5. Thanvi B, Lo N, Robinson T. Levodopa-induced dyskinesia in Parkinson’s disease: clinical features, pathogenesis, prevention and treatment. Postgrad Med J. 2007;83:384-388. 6. Dyskinesia. Parkinson’s Foundation. https://parkinson.org/Understanding Parkinsons/Symptoms/Movement-Symptoms/Dyskinesia. Accessed January 22, 2019. 7. What is Parkinson’s disease? Davis Phinney Foundation. https://www.davisphinneyfoundation.org/blog/what-is-parkinsons-disease-dyskinesia/. Published June 12, 2018. Accessed January 22, 2019. 8. The voice of the patient: Parkinson’s disease: a series of reports from the U.S. Food and Drug Administration’s (FDA’s) patient-focused drug development initiative. Center for Drug Evaluation and Research, U.S. Food and Drug Administration; 2016. 9. Unified Dyskinesia Rating Scale (UDysRS). International Parkinson and Movement Disorder Society website. https://www.movementdisorders.org/MDS-Files1/PDFs/UDysRS_English_FINAL.pdf. Accessed January 21, 2019. 10. Dyskinesia. The Michael J. Fox Foundation website. https://www.michaeljfox.org/understanding-parkinsons/living-with-pd/topic.php?dyskinesia. Accessed January 21, 2019.