Inbrija
Inbrija (levodopa) is used to treat "off" episodes (periods when your medications are wearing off so your Parkinson's symptoms come back) in people with Parkinson's disease (PD). It comes as an inhaler that can be used as needed up to 5 times per day, but it can cause cough and darken your spit, saliva, and sweat.
What is Inbrija (levodopa)?
What is Inbrija (levodopa) used for?
How Inbrija (levodopa) works
Inbrija (levodopa) is an anti-Parkinson medication. Parkinson's disease (PD) is caused by low dopamine levels in the brain. Inbrija (levodopa) is a dopamine replacement that crosses into your brain, where it's converted into dopamine. This is believed to raise your dopamine levels and relieve your PD symptoms.
Drug Facts
What are the side effects of Inbrija (levodopa)?
Common Side Effects
- Cough (15%)
- Cold or flu infections (6%)
- Change in the color of your saliva or spit (5%)
- Nausea (5%)
Other Side Effects
- Uncontrolled muscle movements (dyskinesia) (4%)
- Vomiting (3%)
- Common cold (3%)
- Falls (3%)
- Bronchitis or pneumonia (lung infection) (2%)
- Headaches (2%)
- Cuts or scrapes (2%)
- Change in color of the mucus from your nose (2%)
- Throat pain (2%)
- Discomfort in your chest (2%)
- Pain in your arms and legs (2%)
- Trouble sleeping (2%)
- Drop in blood pressure when standing from a seated or lying down position (2%)
- Sensation of choking after taking a dose
Serious Side Effects
- Falling asleep during daily activities
- Trouble breathing or wheezing
- Neuroleptic malignant syndrome (NMS): confusion, very high fevers, irregular pulse, sweating, muscle stiffness, changes in blood pressure
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Falling asleep during daily activities
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
- Mood and behavior changes—anxiety, nervousness, irritability and restlessness, confusion, hallucinations, feeling distrust or suspicion of others
- New or worsening uncontrolled and repetitive movements of the face, mouth, or upper body
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Urges to engage in impulsive behaviors such as gambling, binge eating, sexual activity, or shopping in ways that are unusual for you
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Cough
- Dark red or black saliva, sweat, or urine
- Drowsiness
- Nausea
- Runny or stuffy nose
- Sore throat
Pros and cons of Inbrija (levodopa)
Pros
Can be useful for people whose PD medications wear off throughout the day
Can be taken first thing in the morning
Starts to work quickly in as soon as 10 minutes after you take the dose
Can be used up to 5 times per day
Pharmacist tips for Inbrija (levodopa)
Your healthcare provider should show you how to use Inbrija (levodopa). You can also read the Instructions For Use. It's important that you know how to use the medication before you take a dose so you give yourself the right dose and so you don't waste any medication.
The Inbrija (levodopa) capsules should be used with the inhaler only. Don't swallow the capsules because doing so won't relieve your PD symptoms.
Keep the capsules in the original foil packaging (blister pack) until right before you're ready to use them. Don't use any capsules that look damaged or wet.
This medication should be used as needed as soon as you feel an "off" episode starting. You can use Inbrija (levodopa) up to 5 times per day. Don't take more than 2 capsules (84 mg total) per "off" period.
In order to take the full dose (84 mg), you need to inhale two capsules (42 mg each) one at a time, and one right after the other.
A common side effect of Inbrija (levodopa) is coughing. If you can, try to avoid coughing out the medication so that you get the full dose. To prevent coughing, you can try sipping a drink before and after using the inhaler, breathing in slowly until you hear the capsule whirl, or taking more than 1 breath per capsule.
Inbrija (levodopa) can darken your saliva, spit, sweat, and urine. This might discolor your clothing.
Inbrija (levodopa) can cause sleepiness and dizziness. Don't drive or do anything that requires concentration until you know how this medication affects you.
Inbrija (levodopa) can cause your blood pressure to drop as you stand from a seated or lying down position. This can lead to dizziness, fainting, and falls. To avoid getting hurt, get up slowly after sitting or lying down.
Inbrija (levodopa) can cause or worsen uncontrolled muscle movements. If this becomes bothersome, let your provider know. They might have you stop taking Inbrija (levodopa) or adjust your other PD medications.
Taking Inbrija (levodopa) with iron or vitamins that contain iron might affect how well Inbrija (levodopa) works. Let your provider or pharmacist know if you're taking iron before you start this medication.
Frequently asked questions about Inbrija (levodopa)
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What are the risks and warnings for Inbrija (levodopa)?
Inbrija (levodopa) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Sleepiness or falling asleep during activities
Risk factors: History of drowsiness | History of sleep problems | Taking sedatives or medications that make you drowsy
Levodopa, which is the main ingredient in Inbrija (levodopa), can make you fall asleep out of nowhere, even if you don't feel sleepy. This can happen more than one year after you start using Inbrija (levodopa). Because of this risk, avoid driving or doing things that require you to focus until you know how this medication affects you, especially if you normally feel sleepy or if you take other medications that make you drowsy. Let your provider know if you feel very sleepy during the daytime or if you fall asleep during normal daily activities, like eating or having a conversation.
High fevers and confusion
Although rare, stopping Inbrija (levodopa) or lowering your dose suddenly can cause side effects similar to those of neuroleptic malignant syndrome (NMS). This is a life-threatening condition that's caused by certain mental health medications. It can cause very high fevers, confusion, irregular pulse, muscle stiffness, and changes in blood pressure. NMS is treatable if it's recognized early. Don't stop taking Inbrija (levodopa) or lower your dose without talking to your provider, so they can instruct you on how to stop the medication safely.
Hallucinations and changes in behavior and thoughts
Risk factors: History of certain mental health conditions
Inbrija (levodopa) can cause hallucinations and changes in behavior and thinking, such as paranoia, delusions, confusion, aggressive behavior, trouble sleeping, lots of dreaming, and less awareness of your surroundings. Because of this risk, you shouldn't take Inbrija (levodopa) if you have certain mental health conditions. Certain mental health medications, such as haloperidol or risperidone (Risperdal), can worsen your Parkinson's disease and might affect how well Inbrija (levodopa) works.
Difficulty controlling impulsive behavior
Inbrija (levodopa) can cause changes in people's behavior, including strong sexual or gambling urges, urges to spend a lot money, and binge eating. This medication can also make it hard to control these urges. If these urges start to have a negative impact on your life, let your provider know. They might have you stop taking the medication.
Trouble breathing (bronchospasm) in people with lung conditions
Risk factors: Asthma, COPD, or other lung conditions
If you have asthma, COPD, or another lung condition, using Inbrija (levodopa) can make it more difficult for you to breathe. Because of this risk, you shouldn't take Inbrija (levodopa) if you have any lung conditions. If you experience trouble breathing or wheezing while using this medication, contact your provider or get medical help right away.
High eye pressure
Risk factors: Glaucoma
Inbrija (levodopa) can raise the pressure in your eye if you have glaucoma. Your provider might check your eyes while you're using Inbrija (levodopa).
Inbrija (levodopa) dosage forms
Typical dosing for Inbrija (levodopa)
The typical dose is 84 mg (two 42 mg capsules) inhaled by mouth as needed for "off" episodes, up to 5 times per day. Don't take more than 84 mg (two 42 mg capsules) per "off" episode, and don't use more than 420 mg (5 doses) per day.
Inbrija (levodopa) contraindications
Take or have taken certain monoamine oxidase inhibitor (MAOI) medications (e.g., phenelzine (Nardil), tranylcypromine (Parnate)) within the last 2 weeks
What are alternatives to Inbrija (levodopa)?
"Off" episodes in people with advanced Parkinson's disease (PD)
Inbrija (levodopa) images
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