Foscarbidopa / Foslevodopa Dosage

Medically reviewed by Drugs.com. Last updated on Jan 21, 2025.

Usual Adult Dose for Parkinson's Disease

Initial dose: Individualized based on the total levodopa dosage (TLD) the patient was previously receiving.
Maximum dose (foslevodopa): 3525 mg/day (equivalent to about 2500 mg of levodopa per day), via subcutaneous infusion

Comments:

• Consult the manufacturer product information for instructions on calculations and determination of infusion rates and dosing volumes.
• The continuous infusion rate is based on TLD.
• Adjust infusion rates in increments of 0.01 mL/hr (about 1.7 mg levodopa/hr).

Use: For the treatment of motor fluctuations in adults with advanced Parkinson's disease (PD)

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Dyskinesias: Dose reduction may be required.

Precautions

CONTRAINDICATIONS:

• Concomitant use with nonselective monoamine oxidase (MAO) inhibitors or have recently (within 2 weeks) taken a nonselective MAO inhibitors

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• For subcutaneous use only with the Vyafuser pump.
• The manufacturer product information should be consulted prior to administration of this drug.
• Administer subcutaneously as a continuous infusion, preferably in the abdomen; avoid 2-inch radius around navel and do not infuse into sites that are tender, bruised, red, or hard to touch.
• Rotate infusion sites and ensure that new sites are at least 1 inch from sites used within previous 12 days; use a new infusion set at least every 3 days.
• The hourly base continuous infusion rate in milliliters per hour is calculated by multiplying the total levodopa dose (TLD) by 1.3, then dividing the result by 240. This value is then divided by the number of hours the patient is typically awake.
• Loading doses: May be administered via pump (or oral immediate-release tablets) immediately before starting infusion to achieve symptomatic control if initiating therapy in an "off" state or if the pump has been off for more than 3 hours.
• Extra doses: May be programmed for self-administration via the pump.
• Alternative hourly infusion rates are available for programming on the pump; consult the manufacturer product information and refer to pump instructions.
• Infusion set (cannula) may remain in place for up to 3 days during continuous infusion.

Treatment interruption:

• Avoid sudden rapid dose reductions or discontinuation without use of alternative dopaminergic therapy.
• Treatment may be interrupted for brief periods of time (e.g., during showers).
• Greater than 1 hour: Use a new infusion set and rotate injection site.
• Greater than 3 hours: Consider a self-administered loading dose to reestablish symptom control.
• To avoid underdosing due to interrupted subcutaneous administration, it is advised to prescribe a backup oral carbidopa and levodopa product.

Storage requirements:

• Store refrigerated at 2C to 8C (36F to 46F); do not freeze or shake.
• Product may be stored at room temperature up to a maximum of 30C for a single period up to 28 days; do not return to refrigeration. Discard vial if not used within 28 days.
• Keep vials in the outer carton to protect from breakage.
• Use product immediately (or within 24 hours) once transferred from vial to syringe.

Reconstitution/preparation techniques:

• Use aseptic technique with sterile, single-patient-use components to infuse this drug.
• Vials are for single use only; transfer entire contents into a syringe for administration and do not dilute or mix with other products.
• Visually inspect for particulate matter or discoloration before use, the infusion set can remain in place for up to 3 days with continuous infusion.
• The manufacturer product information should be consulted for preparation instructions.

General:

• This drug is intended for use in patients with Parkinson's disease who are capable of understanding and using the delivery system themselves (or with assistance).

Monitoring:
Cardiovascular: Hypotension
Local: Infusion site reactions and infections (during therapy)
Nervous System: Worsening Parkinson's symptoms (during therapy)
Ocular: Intraocular pressure (after starting this drug)

Patient advice:

• Read the US FDA-approved patient labeling (Patient Information, Instructions for Use, and/or Medication Guide).
• Understand how to properly use the drug delivery system.
• Record the date when this drug is first removed from the refrigerator in the space provided on the carton.
• Ensure that oral carbidopa and levodopa is available in case treatment with this drug is interrupted for 1 hour or longer.
• Use caution when driving or operating heavy machinery; this drug may cause somnolence or sudden sleep onset while engaged in activities of daily living.
• Regularly inspect the infusion site and monitor for changes or infection.
• Consult your healthcare professional before stopping this drug.
• Notify your healthcare provider if you are breastfeeding or plan to breastfeed.
• Inform your healthcare provider if you become pregnant during treatment or plan to become pregnant during treatment.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer