The Daily Impact of OFF and Dyskinesia
More GOOD ON Time With GOCOVRI
Understanding What Sets GOCOVRI Apart
Patient Case Discussion: Bringing the Benefits of GOCOVRI to Life
Stuart H. Isaacson, MD, FAAN
Director, Parkinson’s Disease and Movement Disorders Center of Boca Raton
Boca Raton, FL
Understand the physical, social, and emotional impact of increased dyskinesia and OFF time that occurs with Parkinson’s disease progression.
GOCOVRI is contraindicated in patients with creatinine clearance below 15 mL/min/1.73 m2.
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.
The most common adverse reactions (>10%) were hallucination, dizziness, dry mouth, peripheral edema, constipation, fall, and orthostatic hypotension.
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
As adjunctive treatment to levodopa/carbidopa in patients with Parkinson’s disease experiencing “off” episodes
It is not known if GOCOVRI is safe and effective in children.