Pump delivered therapy can help some people ease their Parkinson’s symptoms, especially when a type of medications begins to wear off and symptoms worsen or reappear.

A longtime dream for many living with Parkinson’s disease has been to reduce the number of daily pills or injections needed to manage symptoms. The more the disease progresses, the trickier it can become to manage symptoms.

Pump infusion therapy is becoming a new way to manage certain medications, particularly those to help with OFF episodes when Parkinson’s symptoms may reappear or get worse if a medication is wearing off.

Since October 2024, the Food and Drug Administration (FDA) has approved for the first time 2 new devices that can be continuously worn on the body and offer a steady stream of Parkinson’s medications into your bloodstream. Think of these like insulin pumps for people with diabetes, who use these small wearable devices to get their needed insulin continuously throughout the day and night.

This type of technology can make it more manageable in the face of changing Parkinson’s symptoms, possibly reducing the amount of medications or injections needed to manage symptoms and the disease overall.

Pump delivery uses the same medications commonly prescribed in pill form, which may help treat Parkson’s symptoms for those with advanced stages of the disease.

There are two main types of pump infusion, for a total of three devices currently available:

  • Duopa: Delivers a gel form of the medications levodopa and carbidopa directly into the small intestine through a surgically implanted tube. It bypasses stomach emptying issues that can affect oral medications, providing more consistent levodopa levels. This system has been available since FDA approval in 2015.
  • Onapgo: A subcutaneous infusion system that offers continuous dopamine receptor stimulation, potentially leading to more predictable symptom improvement. It delivers an infusion of apomorphine, a dopamine agonist. This has been available since FDA approval in February 2025.
  • Vyalev: A subcutaneous infusion device that provides a continuous supply of carbidopa and levodopa, smoothing out “off” times and improving symptom management. This has been available since FDA approval in October 2024.

Symptoms of Parkinson’s, like tremors, trouble moving, and stiffness, are caused by your brain not having enough dopamine, a chemical the brain normally has.

Because your brain can’t be given more dopamine directly, levodopa works to add more dopamine through the brain’s natural process. Your brain converts levodopa to dopamine when it passes through.

Carbidopa is mixed with levodopa to stop your body from breaking down levodopa too soon. It also helps to prevent nausea, a side effect caused by levodopa.

These devices are digitally programmed to release medication in the correct amounts. As prescribed by your doctor, you’ll only have to change the cassette or syringe once or twice a day.

Research shows that pump therapy for Parkinson’s disease is an effective treatment, especially as it helps improve symptoms that are tied to “OFF” episodes.

Unlike pills, pump-delivered therapy can help provide a constant flow of medication. They generally bypass the stomach, so the medication is not delayed as it might be in pill form. Onapgo and Vyalev avoid gastrointestinal complications, while Duopa is released into the small intestine.

The continuous flow of medication can help with fluctuation and unpredictable symptoms if and when the oral medication might otherwise wear off.

Studies show that pump-delivered therapy is effective. It’s considered a good option for people in the later stages of Parkinson’s who may no longer be getting the same symptom relief from taking pills.

Access barriers

While pump therapy for Parkinson’s is bcoming more commonplace, it’s still inaccessable to many people with the disease. Researchers recognize the barriers to this type of therapy, but acknowledge that as more people and clinicans become familiar with it, the more effective it may be for the Parkinson’s community.

Any surgical or pump-delivery medical device may have possible side effects risks. For the available pumps, these can include:

  • for the surgically-implanted pump tube, risks may include infections at the surgical site or possible tube blockages or leaks
  • bruising, redness, or nodules at the wearable pump’s infusion site
  • headache
  • insomnia
  • nausea
  • daytime sleepiness
  • dizziness
  • uncontrollable muscle movments (dyskinesia)

You can discuss possible side effects and risks with your healthcare team.

Pump-delivered therapy still has some limits, as it’s relatively new. This may not be an option for everyone. However, it does show promise in helping some people with Parkinson’s to give them longer spans between symptoms.

You can discuss these new treatment options with your healthcare team to best understand how they work, what medications are offered in each device, and whether pump infusion therapy might be an option to consider.