Indications for NOURIANZ:
As adjunct to levodopa/carbidopa in adults with Parkinson's disease experiencing "off" episodes.
20mg once daily. May increase to max 40mg once daily, if needed and tolerated. Concomitant strong CYP3A4 inhibitors: max 20mg once daily. Moderate hepatic impairment: max 20mg once daily; monitor closely. Smokers (≥20 cigarettes/day): 40mg once daily.
Pre-existing dyskinesia. Avoid in major psychotic disorder. Consider dose reduction or discontinuation if hallucinations, psychotic behaviors, or urges/compulsive behaviors develop. Severe hepatic impairment: avoid. ESRD and/or requiring hemodialysis. Advise females of reproductive potential to use effective contraception during treatment. Pregnancy: not recommended. Nursing mothers.
Adenosine receptor antagonist.
Potentiated by strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, clarithromycin); see Adults. Antagonized by strong CYP3A4 inducers (eg, carbamazepine, rifampin, phenytoin, St. John's wort); avoid concomitant use. Potentiates P-gp substrates (eg, digoxin); monitor. Potentiates CYP3A4 substrates (eg, atorvastatin) when concomitant Nourianz 40mg; monitor. Efficacy may be decreased by tobacco smoking; see Adults.
Dyskinesia (monitor), dizziness, constipation, nausea, hallucination, insomnia; urges/compulsive behaviors.