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Doctor Discussion Guide
This tool can help you to recognize and keep track of the signs of “off” time in PD. It also provides some important questions you may want to ask your doctor at your next visit. Taking notes on your daily experiences and preparing for your next appointment can help facilitate conversations with your medical team and doctor so they can better understand your needs and make the right
treatment choices for you.
Goal Summary for Doctor’s Visits
This form can help you set wellness goals with your doctor and track your progress between visits. By filling out a new form each time you visit your doctor, you can work toward improving your wellness and create a record of your progress over time. Reprinted and provided with permission by the Davis Phinney Foundation.
An “off” episode is a time when a patient’s medications for Parkinson's disease (PD) are not working well, causing a return in PD symptoms, such as a tremor and difficulty walking.
In clinical trials, adult patients with Parkinson's disease (PD) who took NOURIANZ with levodopa, with or without other PD medications, had less “off” time. See NOURIANZ clinical trial results.
NOURIANZ may cause serious side effects,
including:
If you have hallucinations or any other abnormal thinking or behavior, talk with your healthcare provider.
The most common side effects of NOURIANZ include uncontrolled movements (dyskinesia), dizziness, constipation, nausea, hallucinations, and problems sleeping (insomnia).
These are not all the possible side effects of NOURIANZ.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088, or at www.fda.gov/safety.
Before you take NOURIANZ, tell your healthcare provider about all your medical conditions, including if you:
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
NOURIANZ and other medicines may affect each other causing side effects. NOURIANZ may affect the way other medicines work, and other medicines may affect how NOURIANZ works.
Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
The active ingredient in NOURIANZ is istradefylline. The inactive ingredients are crospovidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyvinyl alcohol, hypromellose, polyethylene glycol 3350, titanium dioxide, triacetin, iron oxide red, iron oxide yellow, and carnauba wax.
If your doctor has prescribed NOURIANZ and you need help with the out-of-pocket cost, the Kyowa Kirin Cares program may be able to help.
Eligible commercially insured patients may pay as little as $20 for a 1-month supply of NOURIANZ. For full program eligibility requirements, terms, conditions, and limitations, click here.
Kyowa Kirin Cares also provides information, support, and other resources to eligible patients. For more information about Kyowa Kirin Cares, click here.
If you need help paying for NOURIANZ, the Kyowa Kirin Cares program may be able to help you get the information and resources you need to start and stay with NOURIANZ.
Visit Kyowa Kirin Cares for more information, including full eligibility requirements, terms, and conditions.
Kyowa Kirin is a proud sponsor of the following foundations and their goals:
Dedicated to finding a cure and ensuring the development of improved therapies
Provides information, education, support, activities, events, and referrals
Funds essential information, tools, inspiration for those living with PD,
as well as research on exercise, speech, movement, and more
Raising funds for research to end PD, support new therapy development,
and provide patient-centered resources
NOURIANZ is a prescription medicine used with levodopa and carbidopa to treat adults with Parkinson’s disease (PD) who are having “off” episodes. It is not known if NOURIANZ is safe and effective in children.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
NOURIANZ and other medicines may affect each other causing side effects. NOURIANZ may affect the way other medicines work, and other medicines may affect how NOURIANZ works.
What are the possible side effects of NOURIANZ?
NOURIANZ may cause serious side effects, including:
If you notice or your family notices that you are developing any new or unusual symptoms or behaviors, talk to your healthcare provider.
The most common side effects of NOURIANZ include uncontrolled movements (dyskinesia), dizziness, constipation, nausea, hallucinations, and problems sleeping (insomnia).
These are not all the possible side effects of NOURIANZ.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Please see Patient Information for NOURIANZ.
References: 1.NOURIANZ. Prescribing Information. Kyowa Kirin, Inc; 2020. Accessed April 1, 2021. https://www.nourianzhcp.com/assets/pdf/nourianz-full-prescribing-information.pdf. 2.Kalia LV, Brotchie JM, Fox SH. Novel nondopaminergic targets for motor features of Parkinson’s disease: review of recent trials. Mov Disord. 2013;28(2):131-144.
References: 1. Kalia LV, Brotchie JM, Fox SH. Novel nondopaminergic targets for motor features of Parkinson's disease: review of recent trials. Mov Disord. 2013;28(2):131-144. 2. Mori A. Mode of action of adenosine A2A receptor antagonists as symptomatic treatment for Parkinson’s disease. Int Rev Neurobiol. 2014;119:87-116. 3. Varani K, Vincenzi F, Tosi A, et al. A2A adenosine receptor overexpression and functionality, as well as TNF-α levels, correlate with motor symptoms in Parkinson’s disease. FASEB J. 2010;24(2):587-598. doi:10.1096/fj.09-141044. 4. Fuxe K, Marcellino D, Genedani S, Agnati L. Adenosine A2A receptors, dopamine D2 receptors and their interactions in Parkinson's disease. Mov Disord. 2007;22(14):1990-2017. doi: 10.1002/mds.21440. 5. Morelli M, Di Paolo T, Wardas J, Calon F, Xiao D, Schwarzschild MA. Role of adenosine A2A receptors in parkinsonian motor impairment and L-DOPA-induced motor complications. Prog Neurobiol. 2007;83(5):293-309. 6. Morelli M, Blandini F, Simola N, Hauser RA. A2A receptor antagonism and dyskinesia in Parkinson's disease. Parkinsons Dis. 2012;2012:489853. doi: 10.1155/2012/489853. 7. Mishina M, Ishiwata K. Adenosine receptor PET imaging in human brain. Int Rev Neurobiol. 2014;119:51-69. doi:10.1016/B978-0-12-801022-8.00002-7. 8. The voice of the patient: Parkinson’s disease. Silver Spring, MD: US Food and Drug Administration; April 2016. https://www.fda.gov/media/124392/download. Accessed June 11, 2019. 9. Hickey P, Stacy M. Available and emerging treatments for Parkinson’s disease: a review. Drug Des Devel Ther. 2011;5:241-254. 10. Stocchi F, Antonini A, Barone P, et al. Early DEtection of wEaring off in Parkinson disease: the DEEP study. Parkinsonism Relat Disord. 2014;20(2):204-211.
References: 1. NOURIANZ. Prescribing Information. Kyowa Kirin, Inc; 2020. Accessed April 1, 2021. https://www.nourianzhcp.com/assets/pdf/nourianz-full-prescribing-information.pdf 2. Kalia LV, Brotchie JM, Fox SH. Novel nondopaminergic targets for motor features of Parkinson’s disease: review of recent trials. Mov Disord. 2013;28(2):131-144. 3. Jenner P. Istradefylline, a novel adenosine A2A receptor antagonist, for the treatment of Parkinson’s disease. Expert Opin Investig Drugs. 2005;14(6):729-738. 4. Brichta L, Greengard P, Flajolet M. Advances in the pharmacological treatment of Parkinson’s disease: targeting neurotransmitter systems. Trends Neurosci. 2013;36(9):543-554. 5. Kaakkola S, Wurtman RJ. Effects of COMT inhibitors on striatal dopamine metabolism: a microdialysis study. Brain Res. 1992;587(2):241-249. 6. Kong P, Zhang B, Lei P, et al. Neuroprotection of MAO-B inhibitor and dopamine agonist in Parkinson disease. Int J Clin Exp Med. 2015;8(1):431-439. 7. Ossola B, Schendzielorz N, Chen SH, et al. Amantadine protects dopamine neurons by a dual action: reducing activation of microglia and inducing expression of GDNF in astroglia. Neuropharmacology. 2011;61(4):574-582. 8. Rubí B, Maechler P. Minireview: new roles for peripheral dopamine on metabolic control and tumor growth: let’s seek the balance. Endocrinology. 2010;151(12):5570-5581. doi:10.1210/en.2010-0745. 9. Gerlach M, Double K, Arzberger T, Leblhuber F, Tatschner T, Riederer P. Dopamine receptor agonists in current clinical use: comparative dopamine receptor binding profiles defined in the human striatum. J Neural Transm (Vienna). 2003;110(10):1119-1127. 10. Ishibashi K, Miura Y, Wagatsuma K, Toyohara J, Ishiwata K, Ishii K. Adenosine A2A receptor occupancy by long-term istradefylline administration in Parkinson’s disease. Mov Disord. 2021;36(1):268-269. doi:10.1002/mds.28378.
References: 1. NOURIANZ. Prescribing Information. Kyowa Kirin, Inc; 2020. Accessed April 1, 2021. https://www.nourianzhcp.com/assets/pdf/nourianz-full-prescribing-information.pdf 2. Kalia LV, Brotchie JM, Fox SH. Novel nondopaminergic targets for motor features of Parkinson’s disease: review of recent trials. Mov Disord. 2013;28(2):131-144. 3. Data on file. Kyowa Kirin Pharmaceutical Development, Inc., Princeton, NJ.
References: 1. NOURIANZ. Prescribing Information. Kyowa Kirin, Inc; 2020. Accessed April 1, 2021. https://www.nourianzhcp.com/assets/pdf/nourianz-full-prescribing-information.pdf 2. Data on file. Kyowa Kirin Pharmaceutical Development, Inc., Princeton, NJ.
Reference: 1. NOURIANZ. Prescribing Information. Kyowa Kirin, Inc; 2020. Accessed April 1, 2021. https://www.nourianzhcp.com/assets/pdf/nourianz-full-prescribing-information.pdf
Reference: 1. NOURIANZ. Prescribing Information. Kyowa Kirin, Inc; 2020. Accessed April 1, 2021. https://www.nourianzhcp.com/assets/pdf/nourianz-full-prescribing-information.pdf