Parkinson Disease TreatmentParkinson Disease

Opicapone, New medication for Parkinson’s Disease got FDA approval

Opicapone, got FDA approval for Parkinson’s Disease Treatment

Parkinson’s disease treatment got a new drug for its management. Opicapone a newer once a day medication helps in better functioning of levodopa/carbidopa (Syndopa / LCD / Madopar / Sinemet). It got Food and Drug Administration (FDA) of USA approval under the brand name of ONGENTYS. It comes with 25mg and 50mg capsules. It helps to treatment and improvement of ON periods in Parkinson’s disease. The company Neurocrine Biosciences plans to launch ONGENTYS later this year.

Opicapone blocks the enzyme catechol-O-methyltransferase (COMT) effectively (>90% at therapeutic doses), selectively and reversibly, and only outside the central nervous system. It dissociates slowly from COMT, resulting in a duration of action longer than 24 hours despite its short blood plasma half-life. As COMT and DOPA decarboxylase are the main enzymes for degrading levodopa, blocking the two effectively increases its concentrations in the bloodstream. More levodopa reaches the brain, where it is activated to dopamine. This helps to improve the symptoms of Parkinson’s disease, such as stiffness and slowness of movement.In June 2016, it was authorised for use in the European Union. It was authorised for use in the United States in April 2020.

This drug is contraindicated in people with cancers that secrete catecholamines (for example epinephrine), such as phaeochromocytoma or paraganglioma, because as a COMT inhibitor it blocks catecholamine degradation. Other contraindications are a history of neuroleptic malignant syndrome (NMS) or non-traumatic rhabdomyolysis, and combination with monoamine oxidase inhibitors that are not used as antiparkinsonians, because of possible drug interactions

People taking opicapone very commonly (18%) experience dyskinesia. Other common side effects (in 1 to 10% of patients) include dizziness, strange dreams, hallucinations, constipation, dry mouth, orthostatic hypotension (low blood pressure), and muscle spasms. Apart from spasms, these side effects are also known from tolcapone and entacapone

Parkinson Disease

First Apomorphine Pump Initation in India – Vikram Hospitals, Bangalore

Finally, the Apomorphine pumps are available in Indian market. The first instillation of the Apomorphine pump happened in India at Vikram Hospitals, Bangalore on 15th May 2019. This young patient had been affected with Parkinson’s disease for almost 10 years now with currently medication alone working for about 45mins to one hour. With Apomorphine it is expected to significantly even out the motor fluctuations (On and OFF phenomenons) in the patients.

To recaptuate, Apomorphine is a medication used to manage the symptoms of Parkinson’s Disease. It is a strong dopamine agonist (Medications which act to stimulate nerve cells to release more dopamine). This leads to improvement of body functions in patients with Parkinson’s disease, who have low dopamine levels. Despite its name, apomorphine does not contain morphine. Unlike other dopamine agonist drugs (like Pramipexole, Ropinirole), which are taken as tablets or patches, apomorphine is given by injection or continuous infusion, using a pump. Apomorphine doesn’t help everyone manage their Parkinson’s symptoms, and it may not replace oral medication entirely. It usually suggested for patients who have: 1. Oral medications taking long time to act, 2. Have sudden and unpredictable changes in symptoms, 3. Severe OFF periods, 4. Cannot be considered for surgery for other medical issues / Patient not willing for surgery, 5. Patients who cannot take medications orally

It is expected that over next year, the medications should be available across the Indian market, with many from medical community getting trained for the same.

Apomorphine Therapy

Apomorphine Launched in India