What is the use of Istradefylline (Adenosine A2A receptor antagonist)?

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Last updated: February 23, 2025View editorial policy

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From the FDA Drug Label

NOURIANZ is an adenosine receptor antagonist indicated as adjunctive treatment to levodopa/carbidopa in adult patients with Parkinson's disease (PD) experiencing "off" episodes (1). The use of Istradefylline (Adenosine A2A receptor antagonist) is as an adjunctive treatment to levodopa/carbidopa in adult patients with Parkinson's disease (PD) experiencing "off" episodes 1.

  • Key Indication: Parkinson's disease (PD)
  • Specific Use: Adjunctive treatment to levodopa/carbidopa for "off" episodes

From the Research

Istradefylline is a medication used as an add-on treatment for Parkinson's disease in patients experiencing "off" episodes while on levodopa/carbidopa therapy, and it is typically prescribed at a dose of 20 mg or 40 mg once daily, taken orally with or without food, as evidenced by a pooled analysis of 8 phase 2b/3 trials 2. The unique mechanism of action of Istradefylline, as an adenosine A2A receptor antagonist, helps to reduce "off" time in Parkinson's patients by enhancing the effects of dopamine in the brain. This can lead to improved motor function and reduced periods of reduced mobility or increased stiffness. Some key points to consider when using Istradefylline include:

  • Common side effects may include dyskinesia (involuntary movements), dizziness, and constipation, as reported in a study published in the Journal of Parkinson's disease 2.
  • It's essential to note that Istradefylline is not a replacement for levodopa/carbidopa but rather a complementary treatment, as stated in a study published in The mental health clinician 3.
  • Patients should continue their regular Parkinson's medications as prescribed and inform their healthcare provider of any changes in symptoms or new side effects.
  • The effectiveness of Istradefylline may vary among individuals, and it may take several weeks to notice significant improvements in motor symptoms, as suggested by a real-world analysis of Japanese prescription data 4.
  • Istradefylline has been shown to slow the progression of levodopa dose escalation in patients with Parkinson's disease, which may help reduce the occurrence or severity of levodopa-induced complications in long-term treatment, as evidenced by a study published in PloS one 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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