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Old 03-14-2016, 11:04 AM
johnt johnt is offline
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Join Date: Apr 2009
Location: Stafford, UK
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15 yr Member
johnt johnt is offline
Senior Member
 
Join Date: Apr 2009
Location: Stafford, UK
Posts: 1,059
15 yr Member
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As far as I know, the Duodopa system has no automated real-time dose control.

emc describes [1] the use of the Duodopa system as involving a morning dose, a continuous maintainence dose for 16 hours through the day, and extra "bolus doses" which can be taken as needed. The decision whether or not to use the bolus doses is left to the patient, so in this sense it is a dynamic system.

The advantages of the Duodopa system are:
1. it delivers a continuous dose (1-10ml/hour, where 1ml Duodopa gel is equivalent to 20mg levodopa and 5mg carbidopa) which allows for concentration levels to be more stable;
2. the pump places the drug in the duodenum or upper jejunum, thus reducing the bioavailability uncertainties of the normal, oral approach.

For the person using the normal, oral system immediate release levodopa/carbidopa it is possible to approximate a continuous delivery by taking smaller doses more frequently. Where the available pill sizes are large or where pill cutting is not possible, the pill can be dissolved in vitamin-C and the dose drunk.

I can't find any reference to a trial comparing the performance of high frequency oral dosing of levodopa to the Duodopa system.

Reference:

[1] https://www.medicines.org.uk/emc/medicine/20786

John
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Born 1955. Diagnosed PD 2005.
Meds 2010-Nov 2016: Stalevo(75 mg) x 4, ropinirole xl 16 mg, rasagiline 1 mg
Current meds: Stalevo(75 mg) x 5, ropinirole xl 8 mg, rasagiline 1 mg
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