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PRESCRIBING INBRIJA®

How to Prescribe

ORALLY INHALED LEVODOPAINBRIJA—For Use As Needed When PD Symptoms Start To Return in Patients Treated With CD/LD

1. INBRIJA Prescription

Select an option for prescribing INBRIJA
Introducing a simple process for ePrescribing INBRIJA. Save and print these instructions.
  • Find and select Pacific LTC Pharmacy in your EMR by using the NPI, NCPDP or Fax numbers below.
    NCPDP: 5664417
    NPI: 1871002485
    Fax: (661) 253-5022

    Include patient's current mobile phone number*. *You may receive a phone call from an INBRIJA patient support specialist if additional information is required to initiate prior authorization.

  • Tell your patients to expect a text
    Patients will receive a text or phone call from an (844) number within 1-2 hours from sending the eRx to complete enrollment and confirm next steps including prescription fulfillment. *Standard text and data rates may apply
Complete the Prescription Request Form
  • Download and fill out a Prescription Request Form
  • Fax completed form to 1-855-886-2484

If you do not have access to a fax machine, call us at 1-888-887-3447.

INBRIJA is now covered on most commercial plans. Commercial patients are eligible for a $0 initial prescription of INBRIJA. Use our Interactive Formulary Tool to check plans now.

2. Train Your Patient

Your patients may need several tries to become familiar with the inhalation process. Encourage them to try a few times, and to call the Nurse Educators for additional training and answers to any questions about how to use the inhaler. Your patients may contact them at 1-888-887-3447.

What Happens Next

Encourage your patient to add INBRIJA's Prescription Support Services phone number, 1-888-887-3447, to their phone contacts so they recognize the caller identity when they call.

Prescription Support Services will support your patient by:

  • Determining coverage and eligibility for patient support programs including:
    • Co-Pay Mitigation
    • $0 Initial Prescription for eligible patients
    • Patient Assistance Programs and Medicare Extra Help
  • Arranging a one-on-one training session with an INBRIJA Nurse Educator to:
    • Review appropriate use of INBRIJA
    • Train on how-to-use and clean the device along with other helpful tips
    • Schedule follow-up calls to provide ongoing support, answer questions and provide additional training
  • Ensuring your patients receive a Start Kit with helpful resources, including the following:

    Helpful Hints Brochure

    Provide your patients with Helpful Hints on how to use INBRIJA to get started.

    Download here

    Demonstration Video

    This demonstration video instructs patients on the correct use of INBRIJA.

Should you have any questions,
 please call Prescription Support Services:
1-888-887-3447
Request Samples Interactive
Formulary Tool
Next: TRAINING RESOURCES AND NURSE EDUCATORS

INBRIJA® Indication

Intermittent treatment of OFF episodes in patients with PD treated with CD/LD.

Important Safety Information

Contraindicated in patients taking or who have recently taken (within 2 weeks) nonselective monoamine oxidase (MAO) inhibitors (e.g., phenelzine and tranylcypromine) due to hypertension risk. Discontinue use of nonselective MAO inhibitors at least 2 weeks prior to initiating INBRIJA.

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Indication

INBRIJA is indicated for intermittent treatment of OFF episodes in patients with Parkinson’s disease (PD) treated with carbidopa/levodopa.

Important Safety Information

  • INBRIJA is contraindicated in patients taking or who have recently taken (within 2 weeks) nonselective monoamine oxidase (MAO) inhibitors (e.g., phenelzine and tranylcypromine) due to risk of hypertension. Discontinue use of nonselective MAO inhibitors at least 2 weeks prior to initiating INBRIJA.
  • Patients treated with levodopa, the active ingredient in INBRIJA, have reported falling asleep during activities of daily living, including operation of motor vehicles, which sometimes resulted in accidents. Many patients reported somnolence but some reported no warning signs (sleep attack). This may occur more than a year after initiating treatment. Reassess patients for drowsiness/sleepiness including occurrence during specific activities. Advise patients of potential for drowsiness and ask about factors that may increase this risk (e.g., sedating medications, sleep disorders).
    • Consider discontinuing INBRIJA in patients who report significant daytime sleepiness or falling asleep during activities that require active participation. If continuing INBRIJA, advise patients not to drive and to avoid activities that may result in harm. There is insufficient information that dose reduction will eliminate episodes of falling asleep during activities of daily living.
  • Neuroleptic malignant syndrome-like symptoms (e.g., elevated temperature, muscular rigidity, altered consciousness, autonomic instability) have been reported with rapid dose reduction, withdrawal of, or changes in dopaminergic therapy.
  • Hallucinations (with or without confusion, insomnia, and excessive dreaming) may occur and may respond to reducing levodopa therapy. Abnormal thinking and behavior may present with paranoid ideation, delusions, hallucinations, confusion, psychotic-like behavior, disorientation, aggressive behavior, agitation, and delirium.
  • INBRIJA should ordinarily not be used in patients with major psychotic disorder due to risk of exacerbating psychosis. Dopamine antagonists used to treat psychosis may exacerbate symptoms of PD and may decrease INBRIJA efficacy.
  • Patients on medications that increase central dopaminergic tone such as INBRIJA can experience intense urges to gamble or spend money, increased sexual urges, binge eating, and/or other intense urges, and inability to control them. In some cases, these urges stopped with dose reduction or medication discontinuation. Since some patients may not recognize these behaviors as abnormal, ask patients or their caregivers about development of new or increased urges and consider stopping INBRIJA if this occurs.
  • INBRIJA may cause or exacerbate dyskinesias. If troublesome dyskinesias occur, consider stopping INBRIJA or adjusting other PD medications.
  • INBRIJA is not recommended in patients with asthma, COPD, or other chronic underlying lung disease because of the risk of bronchospasm.
  • Monitor patients with glaucoma for increased intraocular pressure.
  • Abnormalities in laboratory tests may include elevations of liver function tests (e.g., alkaline phosphatase, AST, ALT, lactic dehydrogenase, bilirubin), blood urea nitrogen, hemolytic anemia, and positive direct antibody test. Increased levels of catecholamines and their metabolites in plasma and urine may result in false-positive results suggesting pheochromocytoma.
  • The most common adverse reactions (≥ 5% and > placebo) were cough (15% vs 2%), upper respiratory tract infection (6% vs 3%), nausea (5% vs 3%), and sputum discolored (5% vs 0%).
  • Use of selective MAO-B inhibitors with INBRIJA may be associated with orthostatic hypotension. Monitor patients taking these drugs concurrently.
  • Dopamine D2 receptor antagonists (e.g., phenothiazines, butyrophenones, risperidone, metoclopramide) and isoniazid may reduce levodopa efficacy; monitor for worsening symptoms.
  • Iron salts or multivitamins with iron salts may reduce levodopa bioavailability.
  • INBRIJA should be used during pregnancy/nursing only if potential benefit justifies potential risk. There are no adequate data on INBRIJA in pregnant women or breastfed infants. Animal data shows carbidopa/levodopa is developmentally toxic (including teratogenicity). Levodopa may affect milk production, interfering with lactation. Levodopa has been detected in human milk.
  • Safety and effectiveness in pediatric patients have not been established.
  • Geriatric patients (n=56) experienced more of the following adverse reactions than patients <65 (n=58): cough (25% vs 5%), upper respiratory tract infection (11% vs 2%), nausea (7% vs 3%), vomiting (4% vs 2%), pain in extremities (4% vs 0%), and discolored nasal discharge (4% vs 0%).

Please see the Full Prescribing Information.