Vyalev vs. Sinemet for Parkinson's Disease: Important Differences and Potential Risks.

Vyalev

(foscarbidopa / foslevodopa)

Carbidopa / levodopa

(Sinemet)

Summary for Vyalev

Prescription only

Vyalev (foscarbidopa / foslevodopa) is used to treat movement problems in adults with advanced Parkinson's disease (PD). It's given as a continuous infusion under the skin of the stomach using the Vyafuser pump. This anti-Parkinson medication helps raise and keep dopamine levels high in the brain. Side effects can include hallucinations and uncontrolled movements. It can also cause skin reactions where the medication is infused.

Indications for Vyalev

Advanced Parkinson’s disease (PD)

Pros and Cons for Vyalev

Pros

First continuous, non-surgical treatment option for people with advanced PD
Can help control symptoms for 24 hours
No need to time doses around food

Cons

Can cause irritation at the injection site
Requires training on how to use the Vyafuser pump to take the medication
Not approved for people with early stages of Parkinson's disease

Common Side Effects for Vyalev

Reaction at the infusion or catheter site (62%)
Infection at the infusion or catheter site (28%)
Hallucination (12%)
Uncontrolled movements (11%)
"On and off" phenomenon (8%)

Warnings for Vyalev

Sleepiness or falling asleep during activities
Hallucinations and changes in behavior and thoughts
Difficulty controlling impulsive behavior
Infusion site reactions and infections
High fevers and confusion when lowering the dose or stopping too suddenly
Uncontrolled movements
Low vitamin B6 levels and seizures
Heart attack and abnormal heart rhythm
Higher eye pressure in people with glaucoma

Summary for Sinemet

Prescription only

Carbidopa / levodopa (Sinemet) is a first-choice option for Parkinson's disease (PD) in adults. It's also used to treat adults with conditions that cause PD symptoms, like shakiness and slowed movement. This medication helps raise and keep dopamine levels high in the brain to help with movement. But it's usually taken multiple times per day to relieve PD symptoms. Immediate-release tablets are available as brand name Sinemet and generic. Extended-release tablets and orally disintegrating tablets are generic only. Side effects can include movement problems, nausea, and possible hallucinations.

Indications for Sinemet

Parkinson's disease (PD)
Parkinsonism (conditions that cause people to have PD symptoms, like slowness, stiffness, and tremors)

Pros and Cons for Sinemet

Pros

First-choice option for treating PD symptoms
Available in many forms: immediate-release (IR) tablets, extended-release (ER) tablets, and orally disintegrating tablets (ODTs)
Might work within 1 hour

Cons

Usually need to take many times per day to control PD symptoms
Can make you very sleepy and possibly fall asleep suddenly
Can darken the color of your saliva, sweat, and urine

Common Side Effects for Sinemet

Involuntary movements (dyskinesia or dystonia)
Nausea

Warnings for Sinemet

Sleepiness or falling asleep during activities
High fevers and confusion when lowering the dose or stopping too suddenly
Hallucinations and changes in behavior and thoughts
Difficulty controlling impulsive behavior
Risk of depression and thoughts of suicide
Low vitamin B6 levels and seizures
Caution use in people with a history of heart attack and arrhythmia
Caution use in people with a history of stomach ulcers
Higher eye pressure in people with glaucoma
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only