Duodopa Intestinal Infusion

• Continuous delivery

Duodopa delivers a continuous stream of medication directly into the small intestine for up to 16 hours.

• Reduced fluctuations

Compared to oral Levodopa, Duodopa Intestinal Infusion reduces the frequency and duration of “on” and “off” periods, freezing of gait and dyskinesias throughout the day.

• Convenient treatment

Duodopa replaces Levodopa and most Parkinson’s medications. It makes it much easier for patients and their carers not to worry about taking multiple medications at specific times of the day

• Reduced gastrointestinal side effects

Duodopa is delivered directly into the small intestine, bypassing the stomach. This can reduce the likelihood of gastrointestinal side effects and improve the absorption of the medication.

• Recommended to those who can’t take oral meds

Individuals with dysphagia or those who prefer to take fewer tablets may find Duodopa to be a suitable alternative.

• Comparable to deep brain stimulation

Duodopa’s ability to decrease “off” time is comparable to that of deep brain stimulation (DBS), a surgical procedure that involves implanting a device to send electrical pulses to the brain and alleviate motor symptoms.

• Some patients may experience adverse reactions to the medication, including nausea, abdominal pain, and diarrhea.
• There is a risk of infection at the site where the tube is inserted.
• Some people have reported experiencing drowsiness, which can be dangerous if it occurs during daily activities such as cooking or driving.
• Patients may also experience discomfort and inconvenience due to the need to wear a portable infusion pump throughout the day.
• You’ll need to change the cassette of Duodopa once daily to ensure continuous medication delivery.

A minor surgery is required to insert the percutaneous endoscopic gastrostomy jejunal tube or PEG-J tube into the gut.

Before Tube Insertion

Before undergoing duodopa intestinal infusion, you will meet with your movement disorders neurologist and then gastroenterologist to discuss the benefits and risks of the treatment. The gastroenterologist will give instructions on how to prepare for the procedure, such as stopping blood thinners and anti-diabetic medications. In addition, may arrange for you for blood tests, chest x-ray, and ECG.

During Tube Insertion

You will be connected to an IV line and given a sedative to help you relax. The gastroenterologist will carefully make a small incision in your abdomen and insert a tube into the small intestine. The tube will be connected to a pump that will deliver the medication. A cassette containing duodopa is attached to the pump. Although the procedure may seem complex, our medical team will be with you every step of the way, ensuring you are well taken care of throughout the process. You will stay for a few days in the hospital to allow for fast recovery after the PEJ tube insertion.

After Tube Insertion

Pain or discomfort around the incision site is expected for a few days after the PEG-J tube insertion. You may experience other side effects, such as bloating, cramping, diarrhea, or constipation, which can be managed with medication or changes in diet. It may take some time for the medication to take effect. The Duodpa dose and delivery rate will be adjusted as recommended by your neurologist to achieve the best results. You and your family will have plenty of training from our Duodopa nurse on using and caring for the tube. Our Nurses will continue to review you in the community periodically, and they can be contacted between visits if needed.

Results

In several well-designed clinical trials, Duodopa increased “on” time for almost 3 – 6 hours compared with oral levodopa-carbidopa. The studies also found that Duodopa eased PD’s motor and non-motor symptoms, including insomnia, pain and cognition and improved well-being and quality of life in people with advanced disease that was not well controlled with conventional treatments.