Advise Saving Nourianz as a Last Resort for Parkinson's

Nourianz (NUR-ee-anz, istradefylline) will be the first "adenosine antagonist" for Parkinson's disease.

It's touted as a NON-dopaminergic add-on for "off" episodes...when scheduled carbidopa/levodopa wears off between doses and symptoms (tremor, etc) return, especially as Parkinson's progresses.

But once-daily Nourianz doesn't seem to reduce "off" time more than dopaminergic add-ons...such as COMT inhibitors (entacapone, etc), dopamine agonists (pramipexole, etc), or MAO-B inhibitors (rasagiline, etc).

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