Kynmobi

Initiation Criteria:

For the acute, intermittent treatment of patients with Parkinson’s disease (PD), who meet all of the following criteria: 

¹Optimal treatment is defined as receiving maximally tolerated dose of a levodopa-based therapy (e.g., levodopa/carbidopa or levodopa/benserazide) AND at least one of the following:

• a DA (e.g., pramipexole, bromocriptine, pramipexole, ropinirole, rotigotine) for at least 4 weeks OR
• a MAO-B inhibitor (e.g., rasagiline, selegiline) OR
• amantadine. 

²Case-by-case consideration may be provided for patients receiving optional PD treatment with levodopa and derivatives AND a catechol-O-methyltransferase (COMT) inhibitor and who have a documented contraindication/intolerance to a DA, MAO-B inhibitor, and amantadine. 

Renewal Criteria:
Renewals will be considered in patients who continue to benefit from therapy and who do not develop unacceptable toxicities or intolerances while on APO SL.³

³Treatment should be discontinued in patients who do not demonstrate an improvement of at least 3.25 points in the Movement Disorders Society Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS Part III) score measured within 30 to 60 minutes after a titrated dose is administered. Assessments should occur within 1 year after APO SL has been titrated to a stable and tolerated dose. 

Exclusion criteria:
Concomitant use with 5-hydroxytryptamine type 3 (5HT3) antagonists (e.g., ondansetron, granisetron, palonosetron).