A Patch for Early-Stage ParkinsonsBy: NEAL HERMANOWICZ, MD PHILLIP AND CAROL TRAUB PARKINSON’S CENTER EISENHOWER MEDICAL CENTER
After years of development, a patch for treating symptoms of Parkinson’s disease has been approved by the Food and Drug Administration (FDA) and is now available in pharmacies. Neupro®, a once-a-day skin patch, contains the medication rotigotine. Rotigotine belongs to a category of medications known as dopamine agonists, drugs that mimic the action of dopamine in the brain. Other examples of dopamine agonists include Requip® (ropinirole), Mirapex® (pramipexole) and Parlodel® (bromocriptine).
The patch is currently approved by the FDA for early and mild symptoms of Parkinson’s. Unlike both Mirapex and Requip, the Neupro patch is not approved as an adjunct to other medications. For example, either Requip or Mirapex is sometimes added when a patient is having an inadequate response to the medication levodopa. Although testing of Neupro as an adjunct will begin soon, it does not yet have FDA approval specifically for this purpose, although some physicians may advise patients to use it in this manner.
Neupro appears to be similar to Mirapex or Requip in how well it works and also in terms of side effects. The main advantage of using the Neupro patch is to alleviate the need to swallow pills, which can be a significant problem for Parkinson’s patients. It is unlikely that patients taking levodopa will be able to substitute it with Neupro. However, it is conceivable that someone with relatively mild symptoms using only Mirapex or only Requip could replace these medications with the Neupro patch. Patients using the patch should change the patch daily and vary the location of application to avoid skin irritation.
While the Neupro patch is one new alternative, it is also expected that Requip will soon be released as a once-a-day pill. More medications for Parkinson’s are under development and will likely find their way to the pharmacy within the next year or two.