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In 2018, the U.S. Food and Drug Administration (FDA) approved Inbrija (inhaled levodopa) for the treatment of Parkinson’s “off” times — when symptoms return between medication doses. Inbrija is inhaled and absorbed through the lungs. In the brain, levodopa turns into dopamine, the chemical that decreases in Parkinson’s, causing movement problems. Levodopa is the most effective and most commonly prescribed Parkinson’s medication, and many people take levodopa pills (Sinemet, for example) to control symptoms. Inbrija typically works quicker than pills taken by mouth. It can be taken as needed when symptoms return, up to five times per day, in addition to regularly scheduled Parkinson’s medications. (Similar to an asthma rescue inhaler for breathing problems, you’d keep it on hand to use when necessary.)

Pros

Inbrija is the first inhalable formulation of levodopa and can quickly relieve Parkinson’s symptoms. It’s an option to treat “off” time that occurs between medication doses, first thing in the morning, or suddenly and unpredictably. In clinical trials, Inbrija started working, in some people, within 10 minutes and lasted, on average, an hour.

Cons and Complications

Inbrija is not a replacement for daily scheduled Parkinson’s treatments. It is an add-on, on-demand medication for “off” time. While most may find the inhaler easy to use, some might experience challenges or discomfort with this method of drug delivery. Trials did not test Inbrija in people with asthma or COPD (chronic obstructive pulmonary disease), so safety and benefits in those who live with these conditions is unclear.

The most common potential side effects of Inbrija include nausea, cough, upper respiratory infection, or changes in saliva or spit color.

The medical information contained in this article is for general information purposes only. The Michael J. Fox Foundation for Parkinson's Research has a policy of refraining from advocating, endorsing or promoting any drug therapy, course of treatment, or specific company or institution. It is crucial that care and treatment decisions related to Parkinson's disease and any other medical condition be made in consultation with a physician or other qualified medical professional.

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