The US Food and Drug Administration has approved levodopa inhalation powder (Inbrija, Acorda Therapeutics) for intermittent treatment of “off” episodes in people with Parkinson’s disease who are already taking an oral carbidopa-levodopa regimen.
The efficacy of levodopa inhalation powder was demonstrated in the randomized, double-blind, placebo-controlled, phase 3 SPAN-PD trial of patients with mild to moderate Parkinson’s who experienced “off” periods while taking carbidopa-levodopa. Onset of action was early as 10 minutes. The most common adverse reactions with inhaled levodopa were cough, upper respiratory tract infection, nausea, and discolored sputum. Inbrija is expected to be available by prescription in the United States and will be distributed through a network of specialty pharmacies.