Parkinson's is a progressive disease.1
What's the point of referral?

Referral for advanced therapy may help unlock disease control.1

The point of referral for non-oral therapy is the point when...

...the patient has an increased pill burden2,3

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...the patient experiences increased 'off' time2

...the patient is troubled by dyskinesia2,4

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Impact of delayed gastric emptying

An overview of non-oral therapies
(not intended for therapy comparison)


When the levodopa works but the delivery doesn't, Duodopa may help unlock disease control for eligible patients.1,7

Duodopa’s unique system delivers consistent and individually tailored levodopa and carbidopa levels direct into the duodenum or upper jejunum.7

This bypasses the stomach, allowing immediate absorption.8

And allows you to reassure your patients that the medicine is the same, it's the delivery that's changed.7

Deep Brain Stimulation

Surgically implanted, battery-operated neurostimulation for patients who respond poorly to drugs, have severe side effects from medication or who have severe motor fluctuations in response to drugs.9

Deep brain stimulation alters the function of the brain nuclei (thalamus, subthalamic nucleus, and/or globus pallidus) affected by Parkinson's disease.9

Very fine needles are inserted into the brain through small holes made in the skull to determine the exact position of the nucleus to be stimulated. Once the nucleus is identified, a permanent electrode is placed into it and this electrode is then connected to a pulse generator, which is implanted subcutaneously on the anterior chest wall.9


Apomorphine is a dopamine agonist which may be used to treat motor fluctuations in patients who are not sufficiently controlled by oral medication.10

Apomorphine is a direct stimulant of dopamine receptors.10

It is available in two forms for patients with severe motor complications:

Subcutaneous injections which may be used intermittently to reduce 'off' time

Continuous subcutaneous infusions to reduce 'off' time and dyskinesia11

Further information is available in the Apomorphine SmPC on

Potential factors influencing choice of non-oral treatment12

Presence of side effect/complication strengthens the decision to select the device-aided therapy.

Presence of side effect/complication does not influence the decision.

Presence of side effect/complication argues against selecting the device-aided therapy.

Adapted from Worth PF 2013. The table is based largely upon clinical experience and expert opinion in the absence of published robust comparative evidence.

*All patients treated with Duodopa should be monitored carefully for the development of mental changes, depression with suicidal tendencies, and other serious mental changes. Patients with past or current psychosis should be treated with caution. Please read the full Prescribing Information.