Nourianz
Nourianz (istradefylline) is a medication 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). But, you still need to continue taking traditional Parkinson's treatment, levodopa/carbidopa (Sinemet, Rytary), with this medication. Nourianz (istradefylline) is convenient because it only needs to be taken once a day, but it's only available as a brand medication so it can be expensive.
What is Nourianz (istradefylline)?
What is Nourianz (istradefylline) used for?
How Nourianz (istradefylline) works
Nourianz (istradefylline) is an anti-Parkinson medication. It's not entirely clear how Nourianz (istradefylline) works to treat symptoms of Parkinson's disease, but it's thought to block adenosine receptors. Adenosine receptors are involved with brain function and in PD, there's too much adenosine activity. By blocking these receptors, Nourianz (istradefylline) can improve movement.
Drug facts
Side effects of Nourianz (istradefylline)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Uncontrolled movements (dyskinesia) (15-17%)
- Dizziness (3-6%)
- Constipation (5-6%)
- Nausea (4-6%)
- Seeing or hearing things that aren't real (hallucinations) (2-6%)
- Problems sleeping (insomnia) (1-6%)
Less Common Side Effects
- Poor appetite
- Skin rash
- Diarrhea
The following Nourianz (istradefylline) 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
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- New or worsening uncontrolled and repetitive movements of the face, mouth, or upper body
- 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 these to your care team if they continue or are bothersome):
- Constipation
- Dizziness
- Nausea
- Trouble sleeping
Pros and cons of Nourianz (istradefylline)
Pros
- Taken only once a day
- Unique mechanism (way) of treating Parkinson's disease that's different than other medications
- Co-pay savings program available for those who qualify
Cons
- Not the best medication for those with liver disease
- Only available at certain specialty pharmacies (e.g., Accredo, CVS, and Walgreens specialty pharmacy)
- Only available as a brand medication so it can be expensive
Pharmacist tips for Nourianz (istradefylline)
- Take Nourianz (istradefylline) once a day. You can take Nourianz (istradefylline) with or without food. Food doesn't affect how well this medication works.
- It doesn't matter what time you take Nourianz (istradefylline) each day, just be consistent (e.g., either take it in the morning every day or in the evening every day). If you experience insomnia (trouble falling or staying asleep) with this medication, try taking it every day in the morning.
- If you accidentally take too much Nourianz (istradefylline), call your provider right away or go to the emergency room.
- Make sure you tell your healthcare provider and pharmacist about all of the medications you're taking. Nourianz (istradefylline) can affect the levels of other medications in your body, and vice versa. This can raise your risk of side effects.
Common questions about Nourianz (istradefylline)
You'll recognize yourself having less "off" time, which is the time when your other Parkinson's disease medication(s) aren't working well and you have more Parkinson symptoms (e.g., tremor, trouble walking). In clinical studies, participants experienced about 6 hours of "off" time per day before starting Nourianz (istradefylline). After taking Nourianz (istradefylline), participants experienced about 1 to 1.5 hours less "off" time per day.
Nourianz (istradefylline) works to treat Parkinson symptoms in a different way than levodopa/carbidopa (Sinemet, Rytary), which can be helpful when your Parkinson's symptoms come back. Additionally, in PD, people have too little dopamine and too much adenosine, which causes trouble with movement. Levodopa/carbidopa (Sinemet, Rytary) helps to raise dopamine levels in the brain, while Nourianz (istradefylline) blocks adenosine activity.
Nourianz (istradefylline) should be taken every day as your provider prescribed, even if your "off" episodes go away. Don't just take it when you have "off" time.
Yes, you can take this medication if you smoke cigarettes. But, if you smoke 20 or more cigarettes per day, you'll need to take a higher dose (40 mg once a day) of Nourianz (istradefylline) because tobacco smoking lowers the amount of medication that gets into your body. It's important you tell your provider about your smoking habits before starting this medication.
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Risks and warnings for Nourianz (istradefylline)
Nourianz (istradefylline) 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.
Movement problems (dyskinesia)
- Risk factors: History of dyskinesias
Nourianz (istradefylline) might cause or worsen involuntary movements (dyskinesia). These abnormal movements could show up in your face, arms, legs, or torso (trunk). Let your provider know if you have a history of dyskinesia before starting this medication.
Hallucinations or psychotic behavior
- Risk factors: History of psychotic episodes or other mental health conditions
Nourianz (istradefylline) can worsen mental health problems such as hallucinations, aggressive behavior, delusional thinking, and mania. This can happen in someone without a history of mental health problems. If this happens to you while taking Nourianz (istradefylline), talk to your provider right away because they may need to lower your dose or stop this medication altogether.
Intense urges
Nourianz (istradefylline) might cause people to develop intense urges that are hard to control. Let your provider know if you experience new urges or habits when taking Nourianz (istradefylline), such as gambling, sexual urges, shopping, or binge eating. If you start acting without thinking or having urges that you can't resist, your provider might adjust or stop your medication. You might not notice these urges yourself, so make sure your loved ones and caretakers know to watch out for these changes as well.
Nourianz (istradefylline) dosage
Typical dosage for Nourianz (istradefylline)
The typical dose of Nourianz (istradefylline) is 20 mg by mouth once a day. Depending on how you tolerate and respond to the medication, your provider may raise your dose to 40 mg by mouth once a day.
The dose might differ depending on what other medications you take, if you have liver disease, or if you smoke tobacco.
What are alternatives to Nourianz (istradefylline)?
Nourianz (istradefylline) images
