Medically reviewed by Sarim Mir, MD, board-certified neurologist at Mir Neurology. Published July 2026.
For people living with advanced Parkinson’s disease, one of the hardest challenges is “motor fluctuations” — times when medication wears off and movement symptoms return. An FDA-approved therapy called Vyalev (foscarbidopa and foslevodopa) takes a different approach: delivering Parkinson’s medication continuously, around the clock, through a small under-the-skin pump. Here’s what it is, who it may help, and how to find out if it’s an option for you.
What Vyalev is
Vyalev is a 24-hour continuous subcutaneous (under-the-skin) infusion of two well-established Parkinson’s medications — carbidopa and levodopa, in a form designed for steady delivery. It was FDA-approved in October 2024 as the first and only subcutaneous 24-hour levodopa-based infusion for treating motor fluctuations in adults with advanced Parkinson’s disease. The medication is delivered by a small wearable pump, similar in concept to an insulin pump.
The problem it aims to solve
In earlier Parkinson’s, oral levodopa works well and steadily. As the disease advances, its effect can become uneven — patients cycle between “on” time (good symptom control) and “off” time (symptoms return), and may also experience troublesome involuntary movements (dyskinesia). Because Vyalev is delivered continuously rather than in scattered oral doses, it’s designed to keep medication levels steadier throughout the day and night.
What the research showed
In clinical trials, people using Vyalev gained meaningfully more “on” time without troublesome dyskinesia — roughly a few additional hours per day compared with oral medication — along with reduced “off” time. For someone whose day is shaped by medication timing, that added steady function can be significant. As always, individual results vary.
Things to consider
Vyalev isn’t right for everyone, and it involves a device worn continuously. The most common side effects reported in trials were infusion-site reactions (redness, swelling, pain, or infection), along with hallucinations and dyskinesia. Some patients in trials stopped treatment because of infusion-site issues. That’s why careful evaluation, training, and follow-up with a neurologist are essential parts of this therapy.
Who might be a candidate?
Vyalev is intended for adults with advanced Parkinson’s disease experiencing motor fluctuations that aren’t well controlled with oral medication. Determining whether it fits your situation requires a specialist evaluation of your symptoms, current treatment, and overall health. Learn about our Parkinson’s disease care and what a movement disorder evaluation involves.
How to find out if it’s right for you
If you or a loved one has advanced Parkinson’s and struggles with medication wearing off, a conversation with a movement disorder specialist is the place to start. Our team can assess your current treatment and discuss whether newer options like Vyalev are appropriate. To schedule in Hagerstown or Cumberland, book an evaluation or call (301) 797-7600.
Source: AbbVie. “U.S. FDA Approves VYALEV (foscarbidopa and foslevodopa) for Adults Living with Advanced Parkinson’s Disease,” October 17, 2024. This article is for education and is not medical advice; treatment decisions should be made with your physician.
Frequently asked questions
What is Vyalev?
Vyalev (foscarbidopa/foslevodopa) is an FDA-approved 24-hour continuous under-the-skin infusion of levodopa-based medication for motor fluctuations in adults with advanced Parkinson’s disease, delivered by a small wearable pump.
How is it different from Parkinson’s pills?
Instead of scattered oral doses, Vyalev delivers medication continuously to keep levels steadier, which is designed to reduce “off” time and increase good “on” time.
What are the main side effects?
The most common are infusion-site reactions (redness, swelling, pain, or infection), along with hallucinations and dyskinesia. Careful monitoring with your neurologist is important.
Who is a candidate for Vyalev?
Adults with advanced Parkinson’s whose motor fluctuations aren’t well controlled by oral medication. A movement disorder specialist evaluation determines whether it’s appropriate.
Need to talk to a neurologist about this?
Mir Neurology offers same-week appointments in Hagerstown & Cumberland, MD. No referral needed for most plans.
