Table 2.

On-demand treatment options for motor-fluctuations

Pharmacological class	Route of administration, available dose	Daily dose, mg	Mechanism of action	Time to On	Safety	Ease of use
Dopaminergic drugs
Apomorphine APL-1302277	Pen injector, for SC 1 mg	1–6 (pen injector), 30	Nonergoline D1-, D2-receptor dopamine agonist	SC: within 10–15 min after the injection with benefit lasting for 45–60 min SL: within 30 min after the administration, with benefit lasting for 90 min	All: nausea, vomiting, orthostatic hypotension, somnolence, and dyskinesia Subcutaneous: skin lesions/nodules Sublingual: lip swelling, oral mucosal erythema, and oropharyngeal swelling	On-demand, 1–5/6 times/day (SL form marketed only in US) SC: difficulties assembling the device and performing the injection, during Off-time SL: soluble bilayer Film placed under the tong
	SL (not sublingual), 30 mg	× 5 (SL)
CVT-301	Oral inhalation, 84 mg (in two 2 sequential inhalations)	5 dose/day	DA precursor	Within 30 min after the injection with benefit lasting for 60 min	Cough, upper respiratory tract infection, and sputum discoloration	On-demand, 1–5 times/day (available US and Europe) Two sequential inhalations using a plastic inhaler
L-dopa	L-dopa/benserazide, 100/25 mg, dispersible tablets	1–5	DA precursor/dopa decarboxylase inhibitor	NA	As for Levodopa (Table 1)	On-demand, 1–5 time/day, tablet, water dispersible

SL sublingual, SC subcutaneous, NA not available