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Make Your Next
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Chapter 1

Chapter 2

Chapter 3

Chapter 4

Program Objectives

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Explore the role of the adenosine receptor pathway in PD

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Review the MOA, efficacy, and safety data of NOURIANZ for the treatment of “off” episodes in adult patients with PD

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Discuss dosing considerations and the use of NOURIANZ in special patient populations

The precise mechanism of action by which NOURIANZ exerts its therapeutic effect in PD is unknown.

Clinical Perspectives presented by:


Jill M. Giordano Farmer, DO, MPH

Global Neurosciences Institute
Lawrenceville, NJ


Drew Falconer, MD

Inova Parkinson's and Movement Disorders Center
Alexandria, VA

Presenters have been compensated by Kyowa Kirin, Inc.


NOURIANZ® (istradefylline) is an adenosine receptor antagonist indicated as adjunctive treatment to levodopa/carbidopa in adult patients with Parkinson's disease (PD) experiencing “off” episodes.


Dyskinesia: NOURIANZ in combination with levodopa may cause dyskinesia or exacerbate pre-existing dyskinesia. In clinical trials, 1% of patients treated with either NOURIANZ 20 mg or 40 mg discontinued treatment because of dyskinesia, compared to 0% for placebo.

Hallucinations / Psychotic Behavior: Because of the potential risk of exacerbating psychosis, patients with a major psychotic disorder should not be treated with NOURIANZ. Consider dosage reduction or discontinuation if a patient develops hallucinations or psychotic behaviors while taking NOURIANZ.

Impulse Control / Compulsive Behaviors: Patients treated with NOURIANZ and one or more medication(s) for the treatment of Parkinson's disease (including levodopa) may experience intense urges to gamble, increased sexual urges, intense urges to spend money, binge or compulsive eating, and/or other intense urges, and the inability to control these urges. In clinical trials, 1 patient treated with NOURIANZ 40 mg was reported to have impulse control disorder, compared to no patient on NOURIANZ 20 mg or placebo.

Drug Interactions

The maximum recommended dosage in patients taking strong CYP3A4 inhibitors is 20 mg once daily. Avoid use of NOURIANZ with strong CYP3A4 inducers.

Specific Populations

Pregnancy: Based on animal data, may cause fetal harm.

Hepatic impairment: The maximum recommended dosage of NOURIANZ in patients with moderate hepatic impairment is 20 mg once daily. Avoid use in patients with severe hepatic impairment.

Adverse Reactions

The most common adverse reactions with an incidence ≥5% and occurring more frequently than with placebo were dyskinesia (15%, 17%, and 8%), dizziness (3%, 6%, and 4%), constipation (5%, 6%, and 3%), nausea (4%, 6%, and 5%), hallucination (2%, 6%, and 3%), and insomnia (1%, 6%, and 4%) for NOURIANZ 20 mg, 40 mg, and placebo, respectively.

You are encouraged to report suspected adverse reactions to Kyowa Kirin, Inc. at 1-844-768-3544 or FDA at 1-800-FDA-1088 or

Please click here to see full Prescribing Information for NOURIANZ.
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NOURIANZ® is a registered trademark of Kyowa Kirin Co., Ltd.
©2023 Kyowa Kirin, Inc. All rights reserved. COMM-US-NOU-0235 December 2023

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