New Treatment for Parkinson’s Disease on the PBS

Vyalev® (foslevodopa + foscarbidopa) has been added to the Pharmaceutical Benefits Scheme (PBS) for the management of advanced Parkinson’s disease in patients with severe disabling motor fluctuations not adequately controlled by oral therapy.

Many patients with Parkinson’s disease require complex treatment regimens with frequent oral dosing. In contrast, Vyalev® is administered as a continuous subcutaneous infusion. While patients require training to use the delivery system, Vyalev® may simplify therapy, potentially improving adherence and overall quality of life. Studies demonstrate a reduction in “off” time and an increase in “on” time without dyskinesia when compared to immediate-release levodopa + carbidopa tablets.

General administration considerations include:

• Dosing is individualised and requires specialist oversight.
• Infusion site and infusion set must be changed at least every 3 days.
• Pump must be disconnected for bathing and swimming.
• Disconnections > 1 hour require a new infusion set and a different infusion site.
• Interruptions > 3 hours may require a loading dose.
• Sudden discontinuation or rapid dose reduction should be avoided unless alternative dopaminergic therapy is used.

Vyalev® is presented in 10 mL vials containing foslevodopa 240 mg/mL and foscarbidopa 12 mg/mL (equivalent to approximately 170 mg levodopa and 9 mg carbidopa per 1 mL). The solution is high in sodium which should be considered for patients on a low salt diet.