Duodopa

Duodopa is a gel containing levodopa and carbidopa, used to treat Parkinson's disease by increasing dopamine levels in the brain to reduce symptoms like tremors and stiffness.

Form
geeli suoleen
Strength
20 mg/ml + 5 mg/ml
Active Ingredient
Levodopa
Manufacturer
AbbVie Oy

How to Use

Dosage

Your doctor will determine your exact dose. Typically, a larger 'bolus' dose is given in the morning, followed by a continuous smaller dose throughout the day, and additional doses can be given as needed, as decided by your doctor.

Method

Duodopa gel is delivered continuously into your small intestine using a pump and a tube.

Important

The maximum daily dose is determined by your doctor. Do not exceed the prescribed amount.

Possible Side Effects

COMMON
  • Falling
  • Weight loss
  • Nausea
  • Constipation
  • Anxiety
  • Depression
  • Trouble sleeping (Insomnia)
  • Involuntary movements (dyskinesia)
  • Worsening Parkinson's symptoms
  • Dizziness or lightheadedness when standing up (due to low blood pressure)
  • Urinary tract infections
  • Abdominal pain
  • Inflammation or thick scar tissue at the tube insertion site in the stomach
  • Problems at the tube insertion site, like pain, swelling, bleeding, or irritation in the mouth, throat, or stomach, and difficulty swallowing, vomiting, or gas.
RARE
  • Sudden eye pain, headache, blurred vision, nausea, or vomiting (may be signs of narrow-angle glaucoma)
  • Fever, sore throat or mouth, or difficulty urinating (may be signs of a severe white blood cell disorder)
  • Swelling of the face, tongue, or throat, difficulty swallowing or breathing, or hives (may be signs of a severe allergic reaction)
  • Neuroleptic Malignant Syndrome (symptoms include rapid heart rate, fluctuating blood pressure, sweating with fever, rapid breathing, muscle stiffness, reduced consciousness, and high blood protein levels)
  • Weight gain, irregular heartbeat or palpitations, loss of appetite, fatigue, weakness, or general discomfort
  • High or low blood pressure, anemia (low iron), neck pain, muscle cramps, or muscle weakness
  • Sudden sleep attacks, severe sleepiness, or sleep disorders; high blood amino acid or homocysteine levels, or low vitamin B6 or B12 levels
  • Dizziness, faintness, difficulty swallowing, dry mouth, bitter taste, or headache
  • Progressive weakness, pain, numbness, or sensory loss in fingers or toes (polyneuropathy); rash, itching, increased sweating, or fluid retention/swelling
  • Urinary retention or incontinence; hallucinations, confusion, unusual dreams, agitation, impulsive behavior, or psychotic disorder
  • Abdominal bloating, diarrhea, gas, or indigestion; rapid or unexpected return of Parkinson's symptoms ('on-off' phenomenon)
  • Impaired sensation, uncontrolled muscle spasms of the eyes, head, neck, or body, or tremor; impulse control disorders (e.g., gambling, excessive spending, binge eating, increased sexual urges)
  • Dark urine, hoarseness, chest pain, hair loss, skin redness, or increased salivation
  • Vein inflammation, gait changes, suicidal thoughts or attempts, or general discomfort
  • Strong feeling of happiness (euphoria), nightmares, dementia, fear, difficulty controlling movements, or severe involuntary movements
  • Difficulty opening eyes, double vision, blurred vision, or optic nerve damage; abnormal thinking or uneven breathing
  • Painful, prolonged erection; new or worsening unusual skin marks/moles or skin cancer (melanoma)
  • Dark saliva or sweat, burning tongue, teeth grinding, or hiccups; changes in blood test results
  • Horner's syndrome (an eye condition); red or purple rash resembling small bruises (Henoch-Schönlein purpura)
  • Prolonged pupil dilation or impaired eye movements; infection at the surgical site or after intestinal tube insertion
  • Inflammation of the stomach wall or intestine; tube movement or blockage in the intestine
  • Pain with breathing, shortness of breath, or respiratory tract infections (including aspiration pneumonia); large intestine inflammation (colitis); pancreas inflammation (pancreatitis)
  • Tube penetration through the colon wall; intestinal blockage, bleeding, or ulcer; intussusception (part of intestine sliding into another); tube blockage by food
  • Abscess after tube insertion in the stomach; reduced blood flow to the small intestine; tube penetration through the stomach or small intestine wall; blood poisoning (sepsis)

Important Warnings

  • Do not use Duodopa if you are allergic to levodopa, carbidopa, or any other ingredient in this medicine.
  • Tell your doctor if you have severe heart problems, a history of stroke, or an adrenal gland tumor.
  • Do not use Duodopa if you are taking certain antidepressants called MAO inhibitors.
  • Inform your doctor if you have glaucoma, severe hormone problems, or a history of skin cancer or unusual moles.
  • Do not suddenly stop or greatly reduce your dose without talking to your doctor, as this can cause a serious condition called neuroleptic malignant syndrome.
Show 4 more warnings
  • Be careful if you experience sudden sleepiness or dizziness, and do not drive or operate machinery until these symptoms have passed.
  • Tell your doctor if you notice new or changing skin spots or moles.
  • Inform your doctor if you or your family notice unusual urges or behaviors, such as compulsive gambling, excessive spending, binge eating, or increased sexual urges.
  • If you are pregnant, planning to be, or breastfeeding, discuss this with your doctor before using Duodopa. It is not recommended during breastfeeding.

Use in Elderly Patients

Category A

Suitable for older adults. Consider potential interactions especially with antipsychotics and metoclopramide. (updated 6.10.2025)