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COVID-19 Update: INBRIJA® (levodopa inhalation powder) continues to be available through a dedicated specialty pharmacy network. INBRIJA® (levodopa inhalation powder) continues to be available through a dedicated specialty pharmacy network. Since the initial outbreak of COVID-19, Acorda has been closely monitoring our supply chain for potential impact to the supply of our medicines. See more >

Training Resources and Nurse Educators

Training Your Patients To Use INBRIJA

Get Your Patients Started

Your patients may need several tries to become familiar with the inhalation process. In addition to the training resources provided, encourage your patients 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.

Watch the demonstration video

Be sure to watch the demonstration video, which gives step-by-step guidance on the correct dose and administration of INBRIJA.

This video is available on the patient website (, and also in the INBRIJA Start Kits provided to new patients. Demonstration Video Cards are also provided to offices via your Acorda representative.

Demonstrate how to use INBRIJA

It is important for patients to understand how to correctly use INBRIJA prior to first use. Demonstration Kits have been provided to offices to help demonstrate for the patient how to properly administer the product.

Should you need a Demonstration Kit or replacement items, reach out to your Acorda representative.

Provide them with Helpful Hints

Before your patients use INBRIJA, remind them that using INBRIJA may take some getting used to, and to keep the following Helpful Hints in mind when getting started:

  • It is quite common to cough when breathing in. Advise patients to try to refrain from coughing. Some patients have found that sipping liquid before and after breathing in INBRIJA helps with cough
  • If your patients feel like they might cough, recommend that they hold their breath for a few seconds, wait until the feeling goes away, take a sip of liquid, then breathe in again with the same capsule
  • Your patients may need several tries to become familiar with the inhalation process. It's important that they not be discouraged based on their first few tries. 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.

For additional information,
download the Helpful Hints Brochure.

Nurse Educators Available to Your Patients

Patients starting INBRIJA will be contacted by Prescription Support Services and offered the opportunity to speak with a Nurse Educator who will reinforce how to use INBRIJA.


INBRIJA® Indication

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

Important Safety Information

  • Contraindication: nonselective MAOIs (e.g., phenelzine, tranylcypromine) due to hypertension risk. Discontinue their use at least 2 weeks prior to initiating INBRIJA.
  • Not recommended in patients with asthma/COPD/other chronic lung disease due to bronchospasm risk.
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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.