Delivery Methods for Parkinson’s Medications

When managing Parkinson’s, the way your medication is delivered can be just as important as the medicine itself. The delivery method is tailored to your needs and your body’s ability to absorb and use the medication. Here’s a breakdown of the main routes used in Australia:

  1. Traditional Oral Delivery: Oral medications are the most common and widely used method. Tablets and capsules are taken by mouth and are usually the first line of treatment. Medications such as carbidopa/levodopa, dopamine agonists, MAO-B inhibitors, COMT inhibitors, anticholinergics, and amantadine are delivered this way. For many, oral administration is straightforward and effective. However, fluctuations in blood levels due to competition from protein or poor timing can sometimes lead to variations in symptom control.
  2. Transdermal Delivery: For some, a transdermal patch offers an alternative. This method involves applying a patch (for example, the rotigotine patch) to the skin, which allows the medication to be absorbed steadily over time. This can be particularly helpful if you experience difficulties with swallowing or if you need a more consistent dose throughout the day.
  3. Injectable and Infusion-Based Delivery: When oral or transdermal routes are not sufficient—perhaps due to absorption issues, swallowing difficulties, or advanced symptoms—alternative methods come into play.
    • Subcutaneous Injections: Some medications, notably apomorphine, can be administered via injection. This is often used to manage “off” periods where symptoms return suddenly.
    • Continuous Subcutaneous Infusions: For a more consistent delivery, treatments such as continuous subcutaneous infusion of apomorphine provide a steady stream of medication. This method helps reduce the fluctuations in drug levels that can lead to motor complications.
    • Intestinal (Duodenal) Infusions: Levodopa can also be delivered as a continuous intestinal gel infusion. This involves a surgically placed tube that administers medication directly into the small intestine, offering a more predictable absorption rate, ideal for advanced Parkinson’s when timing and dosing are critical.
  4. Device-Assisted Therapies: While not a “delivery” method in the traditional sense, device-assisted therapies are an important part of the treatment landscape when medications on their own no longer provide adequate symptom control.
    • Deep Brain Stimulation (DBS): DBS is a surgical intervention where electrodes are implanted into specific areas of the brain to modulate activity and improve motor symptoms. Although DBS does not deliver medication, it is considered when optimised pharmacological treatments no longer achieve the desired outcomes.
    • Emerging Delivery Technologies: Research into new drug delivery technologies is ongoing. For example, continuous subcutaneous levodopa infusion is an area of development aimed at providing the smoothest possible dopamine replacement therapy with fewer motor fluctuations.

 Tailoring Your Treatment

Every person with Parkinson’s is unique, and your treatment plan is adjusted to suit your motor and non-motor symptoms. Your neurologist and Parkinson’s Nurse Specialist will consider factors such as symptom severity, lifestyle needs, and any difficulties with side effects or traditional delivery methods when recommending the most appropriate option. Whether you’re managing mild symptoms with oral medications or require more advanced delivery systems like infusion therapies, the goal is always to maintain a high quality of life and as much independence as possible.

For many living with young onset Parkinson’s in Australia, understanding these options and discussing them with your care team can be a key factor in finding a treatment plan that really works for you.

References

Michael J. Fox Foundation for Parkinson’s Research. (n.d.). Medications for Parkinson’s. Retrieved from https://www.michaeljfox.org/

National Institute for Health and Care Excellence. (2017). Parkinson’s disease in adults: Diagnosis and management (NICE guideline NG71). Retrieved from https://www.nice.org.uk/guidance/ng71

Mouchaileh, N., & Cameron, J. (2025). Device-assisted therapies for Parkinson disease. Australian Prescriber, 48(1), 10–17. https://doi.org/10.18773/austprescr.2025.003

Waller et al. (2021) The initial diagnosis and management of Parkinson’s disease. AJGP Vol. 50, Issue 11.

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