DUOPA

Your prescribed dose will be programmed into your pump by your care team. Your care team will show you how to use this medication cassette with the pump before you use it for the first time. See the "Instructions for Use" for complete instructions. Your dose will only be changed by your care team or while you are with your care team. Do not stop using this medication or change your dose without the approval of your care team.
This medication should be used at room temperature. Take one medication cassette out of the refrigerator and out of the carton 20 minutes prior to use. Use the product at room temperature, or you may not get the right dose. The medication is given continuously over 16 hours. A small pump (CADD-Legacy 1400) is used to move the medication from the medication cassette into your PEG-J tube. Each cassette can only be used one time. An opened cassette should not be reused. The cassette should not be used for longer than 16 hours.
Disconnect the pump from your PEG-J tube after the 16 hour dosing time is finished. Use a syringe filled with room temperature water to flush your PEG-J tube. After your daily infusion, you should take your usual nighttime dose of oral carbidopa-levodopa tablets as prescribed. Keep a supply of oral regular-release carbidopa-levodopa tablets with you in case you are unable to receive your infusion.
This medication is not used in children.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse.
A severe reaction similar to neuroleptic malignant syndrome (NMS) may occur if you reduce the dose of or stop taking this medication too quickly. Symptoms of NMS include high fever, stiff muscles, increased sweating, fast or irregular heartbeat, and confusion. Contact your care team right away if think you have NMS.
This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.
When taking this medication, you may fall asleep without notice. You may be doing activities, such as driving a car, talking, or eating. You may not feel drowsy before it happens. Contact your care team right away if this happens to you.
There have been reports of increased sexual urges or other strong urges, such as gambling while taking this medication. If you experience any of these while taking this medication, you should report this to your care team as soon as possible.
You may experience a 'wearing off' effect before it is time to take your next dose of this medication. You may also experience an 'on-off' effect where the medication seems to stop working for minutes to hours, then suddenly starts working again. Tell your care team if this happens to you. Your dose may need to be adjusted.
Eating high protein foods may affect how this medication works. Tell your care team if you change your diet.
If you have diabetes, you may get a false-positive result for sugar in your urine. Check with your care team.
This medication can make your saliva, sweat, or urine look dark red or black. This is normal but may stain clothing or fabrics.
This medication may cause low levels of vitamin B6 in your body. Make sure that you get enough vitamin B6 while you are taking this medication. Discuss the foods you eat and the vitamins you take with your care team.
Talk to your care team about what you need to do to care for your PEG-J tube site. Watch for signs of infection. Contact your care team right away if you experience stomach pain, constipation that does not go away, nausea, vomiting, fever, or black stools.
If your PEG-J tube becomes kinked, knotted, or blocked, this may cause your Parkinson symptoms to worsen or cause recurring movement problems. Call your care team if your Parkinson symptoms get worse, or you have slow movement while you are taking this medication.

If you stop your infusion for more than 2 hours during your 16 hour dosing time for any reason, call your care team and take oral carbidopa-levodopa tablets as prescribed until you are able to restart your infusion. If you stop your infusion for less than 2 hours, you do not need to take the carbidopa-levodopa tablets, but your care team may tell you to take an extra dose of your infusion.
Keep a supply of oral immediate-release carbidopa-levodopa tablets with you in case you are unable to receive your infusion.

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Keep out of the reach of children.
Store unopened cassettes in the refrigerator between 2 degrees C and 8 degrees C (36 degrees F to 46 degrees F). Do not freeze. Protect the cassette from light and keep it in the carton before using. Use before the expiration date printed on the cassette. Throw away any expired medication.
Once a carton is removed from the refrigerator, opened, or in use, discard after 16 hours, even if it contains medication. Use before the expiration date printed on the cassette.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.