Gocovri is a brand-name prescription drug. It’s approved to treat dyskinesia (uncontrolled, involuntary movements) in adults with Parkinson’s disease (PD).

Specifically, Gocovri is approved for this use in adults who also take a drug called levodopa. (Levodopa is a PD drug that works by increasing levels of the brain chemical dopamine.) The adults can be taking levodopa either by itself or in addition to other medications that also affect dopamine.

Gocovri contains the active drug amantadine. It belongs to a class of drugs known as anti-Parkinson’s agents. (A class of drugs is a group of medications that work in same way.)

Gocovri comes as extended-release capsules that are taken by mouth once daily, usually at bedtime. It’s available in two strengths: 68.5 milligrams (mg) and 137 mg.

Effectiveness

In clinical studies, Gocovri was effective in treating dyskinesia in people with PD. For information about the drug’s effectiveness, see the “Gocovri uses” section below.

Gocovri is available only as a brand-name medication. It’s not currently available in generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

However, amantadine, the active drug in Gocovri, is available as a generic medication. But generic amantadine medications come in different forms and strengths than Gocovri comes in.

Gocovri can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Gocovri. These lists don’t include all possible side effects.

For more information on the possible side effects of Gocovri, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Gocovri, you can do so through MedWatch.

Mild side effects

Mild side effects of Gocovri can include:*

  • dry mouth
  • constipation
  • nausea and vomiting
  • decreased appetite
  • trouble sleeping
  • confusion
  • headache
  • blurred vision
  • dry eyes
  • muscle spasms
  • cough
  • mottled skin, which may go away when Gocovri is stopped

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Gocovri. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Gocovri’s patient information.

Serious side effects

Serious side effects from Gocovri aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Anxiety. Symptoms can include:
    • irritability
    • restlessness
    • racing thoughts
  • Urinary tract infection (UTI). Symptoms can include:
    • burning sensation or pain when urinating
    • nausea and vomiting
    • fever
  • Benign prostatic hyperplasia (BPH), a condition in which your prostate is enlarged. Symptoms can include:
    • trouble starting to urinate
    • frequent urination
  • Joint swelling. Symptoms can include:
    • pain in your joints
    • joint stiffness
    • redness or warmth around a joint
  • Peripheral edema (swelling in your arms, hands, feet, or legs). Symptoms can include:
    • swollen, stretched skin in areas with swelling
    • skin that stays dented when it’s gently pressed on
    • weight gain
  • Dystonia (involuntary muscle contractions). Symptoms can include:
    • twitching of your eyelids
    • muscle cramps
    • trouble speaking
    • twisting of your muscles
  • Allergic reaction.*
  • Excessive sleepiness.*
  • Hallucinations (having sensations that aren’t real).*
  • Dizziness.*
  • Increased risk of falling.*
  • Trouble controlling impulses,* such as spending money, gambling, or binge eating.
  • Depression.*
  • Suicidal thoughts or behaviors.*

* These serious side effects are explained in more detail below in “Side effect details.”

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Gocovri. But it’s not known how often allergic reaction happens in people using Gocovri.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Gocovri. But call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Excessive sleepiness

Excessive sleepiness has been reported in some people taking Gocovri. In addition, people using the drug have fallen asleep while doing activities such as eating or driving. And with Gocovri, it’s possible to fall asleep without first having drowsiness or other warning signs.

In clinical trials, 4% of people taking Gocovri felt tired or sleepy. In comparison, 1% of people taking a placebo felt tired or sleepy. (A placebo is a treatment with no active drug.)

If you feel abnormally tired or you’re falling asleep during activities while taking Gocovri, talk with your doctor right away. They may recommend that you take a medication other than Gocovri. This is because these side effects could possibly be dangerous for you and others around you.

Hallucinations

It’s possible to have hallucinations while you’re taking Gocovri. With hallucinations, you have sensations of sounds, sights, smells, tastes, or touches that your mind thinks are real. But these sensations aren’t real.

Both auditory (sounds) and visual (sights) hallucinations have been reported with Gocovri use. In addition, illusions,* delusions,† and paranoia‡ have been reported with Gocovri use. For example, in clinical trials:

  • 25% of people taking Gocovri had one of these side effects
  • 3% of people taking a placebo (treatment with no active drug) had one of these side effects

People with psychosis or other major psychotic disorders, such as schizophrenia, have a higher risk of hallucinations with Gocovri. Because of this risk, people with these conditions typically shouldn’t take Gocovri.

While you’re taking Gocovri, if you have any sensations that can’t be explained, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.

* With illusions, your senses are distorted.
† With delusions, you believe certain ideas that aren’t true.
‡ With paranoia, you have fear or distrust that’s not rational.

Dizziness

Dizziness is a common side effect of Gocovri. And in some cases, this side effect can increase your risk of falling.

In clinical trials, dizziness occurred in:

  • 16% of people taking Gocovri
  • 1% of people taking a placebo (treatment with no active drug)

In addition, some people taking Gocovri have orthostatic hypotension, which can lead to dizziness. With orthostatic hypotension, your blood pressure drops when you stand up. Orthostatic hypotension can make you feel dizzy or faint, which also increases your risk of falling.

In clinical trials, orthostatic hypotension occurred in:

  • 13% of people taking Gocovri
  • 1% of people taking a placebo

If you feel dizzy while you’re taking Gocovri, call with your doctor right away. They may recommend ways to help reduce this side effect. Or in some cases, they may recommend that you take a medication other than Gocovri.

Fall risk

Falling is one of the most common side effects of Gocovri. People taking the drug may fall because of other side effects of Gocovri, such as dizziness, fainting, tiredness, and trouble walking.

In clinical studies:

  • 13% of people taking Gocovri had a fall
  • 7% of people taking a placebo (treatment with no active drug) had a fall

Falls can be dangerous. In some cases, they can cause serious injuries, including bone fractures or bleeding.

If you feel that you’re at risk of falling because you’re having certain side effects of Gocovri, call your doctor. Also, let your doctor know right away if you have any falls while you’re taking the drug. In some cases, your doctor may recommend that you stop taking Gocovri.

Trouble controlling impulses

It’s possible to have trouble controlling certain impulses or urges while you’re taking Gocovri. Examples can include urges to:

  • spend money
  • gamble
  • binge eat

Using medications that affect the brain chemical dopamine, including Gocovri, can sometimes cause these intense, uncontrollable urges. It’s not known exactly how often people taking Gocovri in clinical studies had these urges.

While taking Gocovri, if you begin acting in strange ways, develop odd behaviors, or have uncontrollable urges, call your doctor right away. It’s also important to have family members or other people close to you watch for these behaviors. It might be difficult for you to notice the behaviors by yourself, so it’s helpful to have other people monitor for them.

Depression and suicide

Depression and suicidal thoughts or behaviors have been reported in people taking Gocovri. For example, in clinical studies:

  • 6% of people taking Gocovri felt depressed
  • 1% of people taking a placebo (treatment with no active drug) felt depressed
  • 2% of people taking Gocovri either had suicidal thoughts or attempted suicide
  • 0% of people taking a placebo either had suicidal thoughts or attempted suicide

Because of this risk, it’s important to let your doctor know if you have any symptoms of depression while you’re taking Gocovri. These symptoms can include:

  • tiredness
  • feelings of guilt or helplessness
  • trouble sleeping or sleeping too much
  • irritability
  • loss of interest in activities that you used to enjoy
  • changes in appetite
  • suicidal thoughts or behaviors

Call your doctor and seek help right away if you have new or worsening depression while you’re taking Gocovri. But if you have thoughts of hurting yourself, call 911 or your local emergency number.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

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The Gocovri dosage your doctor prescribes will depend on other medical conditions you may have. It will also depend on how your body tolerates the drug.

Typically, your doctor will start you on a low dosage of Gocovri. Then they’ll adjust your dosage over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Gocovri comes as extended-release capsules that are taken by mouth. It’s available in two strengths: 68.5 milligrams (mg) and 137 mg.

Dosage for dyskinesia in people with Parkinson’s disease

Gocovri is approved to treat dyskinesia (uncontrolled, involuntary movements) in adults with Parkinson’s disease (PD). The usual starting dosage of Gocovri is 137 mg taken once daily at bedtime.

If you don’t have severe or bothersome side effects after 1 week of Gocovri treatment, your doctor may increase your dosage. Typically, they’ll increase your dosage to 274 mg (two 137-mg capsules) once daily.

Note: For more information about dyskinesia related to PD, see the “Gocovri uses” section below.

What if I miss a dose?

If you miss a dose of Gocovri, it’s best to just skip the missed dose and take your next dose as usual. Don’t try to make up for the missed dose by taking more medication than usual at your next dose.

However, if you miss several doses of Gocovri, it’s important to let your doctor know right away. This is because Gocovri can cause serious side effects if it’s not tapered off correctly. (When a drug is tapered off, your dosage is slowly decreased until you’re not taking the drug any longer.)

If you’ve missed several doses of Gocovri, your doctor may want to monitor you for side effects. For information about these side effects, see the “Gocovri withdrawal and dependence” section below.

And to help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Gocovri is meant to be used as a long-term treatment. If you and your doctor determine that Gocovri is safe and effective for you, you’ll likely take it long term.

Other drugs are available that can treat movement disorders such as dyskinesia related to Parkinson’s disease (PD). Some may be a better fit for you than others. If you’re interested in finding an alternative to Gocovri, talk with your doctor. They can tell you about other medications that may work well for you.

Examples of other drugs that may be used to treat movement disorders related to PD include:

  • medications other than Gocovri that contain the drug amantadine, such as Osmolex ER
  • valbenazine (Ingrezza), which is only used for a condition called tardive dyskinesia (TD)
  • istradefylline (Nourianz)
  • carbidopa/levodopa ER (Rytary)
  • carbidopa/levodopa that’s given as a continuous infusion* (LCIG)

* With a continuous infusion of carbidopa/levodopa, a pump slowly sends the drug into your intestine without interruption.

You may wonder how Gocovri compares with other medications that are prescribed for similar uses. Here we look at how Gocovri and Osmolex ER are alike and different.

Ingredients

Both Gocovri and Osmolex ER contain the same active drug: amantadine. This drug belongs to a class of medications called anti-Parkinson’s agents. (A class of medications is a group of drugs that work in the same way.)

Uses

Gocovri is approved to treat dyskinesia (uncontrolled, involuntary movements) in adults with Parkinson’s disease (PD).

Specifically, Gocovri is approved for use in adults who also take a drug called levodopa. (Levodopa is a PD drug that works by increasing levels of the brain chemical dopamine.) The adults can be taking levodopa either by itself or in addition to other medication that also affects dopamine.

Osmolex ER is also approved to treat PD. In addition, it’s approved for use in adults with extrapyramidal symptoms (movement disorders caused by certain drugs).

Drug forms and administration

Gocovri comes as extended-release capsules that are taken by mouth once daily, usually at bedtime.

Osmolex ER comes as extended-release tablets that are taken by mouth once daily. But unlike Gocovri, Osmolex ER is usually taken in the morning.

Side effects and risks

Gocovri and Osmolex ER both contain amantadine. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Gocovri, with Osmolex ER, or with both drugs (when taken individually).

  • Can occur with Gocovri:
    • dry eyes and blurred vision
    • muscle spasms
  • Can occur with Osmolex ER:*
    • dry nose
    • diarrhea
  • Can occur with both Gocovri and Osmolex ER:*
    • nausea and vomiting
    • decreased appetite
    • trouble sleeping
    • confusion
    • dry mouth
    • constipation
    • headache

* These side effects were seen in clinical trials of immediate-release amantadine. Clinical trials of Osmolex ER, which contains extended-release amantadine, didn’t report side effects. However, it’s thought that Osmolex ER could cause the same side effect as immediate-release amantadine causes.

Serious side effects

These lists contain examples of serious side effects that can occur with Gocovri, with Osmolex ER, or with both drugs (when taken individually).

* These side effects were seen in clinical trials of immediate-release amantadine. Clinical trials of Osmolex ER, which contains extended-release amantadine, didn’t report side effects. However, it’s thought that Osmolex ER could cause the same side effect as immediate-release amantadine causes.

Effectiveness

These drugs haven’t been directly compared in clinical studies. But studies have found Gocovri to be effective for use in people with PD.

Clinical trials of Osmolex ER weren’t done in people with PD. But clinical trials of immediate-release amantadine have shown that it’s effective in people with PD. And Osmolex ER, which contains extended-release amantadine, is thought to be effective based on these studies.

Costs

Gocovri generally costs more than Osmolex ER costs. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Gocovri and Osmolex ER are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Like Osmolex ER (discussed above), the drug Nourianz has uses similar to those of Gocovri. Here’s a comparison of how Gocovri and Nourianz are alike and different.

Ingredients

Gocovri contains the active drug amantadine. It belongs to a class of drugs called anti-Parkinson’s agents. (A class of drugs is a group of medications that work in same way.)

Nourianz, on the other hand, contains the active drug istradefylline. It also belongs to the class of drugs called anti-Parkinson’s agents.

Uses

Gocovri is approved to treat dyskinesia (uncontrolled, involuntary movements) in adults with Parkinson’s disease (PD).

Specifically, Gocovri is approved for use in adults who also take a drug called levodopa. (Levodopa is a PD drug that works by increasing levels of the brain chemical dopamine.) The adults can be taking levodopa either by itself or in addition to other medication that also affects dopamine.

Nourianz is approved for use in adults with PD as an add-on treatment to therapy with carbidopa/levodopa (Sinemet). Specifically, Nourianz is approved for use in adults who are having “off episodes” with their treatment. (During “off” episodes, the effect of carbidopa/levodopa wears off too quickly after each dose is given, or it’s just not working as well as it should.)

Drug forms and administration

Gocovri comes as extended-release capsules that are taken by mouth once daily, usually at bedtime.

Nourianz comes as film-coated tablets that are taken by mouth, typically once daily.

Side effects and risks

Gocovri and Nourianz are both anti-Parkinson’s agents. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Gocovri, with Nourianz, or with both drugs (when taken individually).

  • Can occur with Gocovri:
    • dry mouth
    • vomiting
    • confusion
    • headache
    • dry eyes or blurred vision
    • muscle spasms
  • Can occur with Nourianz:
    • diarrhea
    • rash
  • Can occur with both Gocovri and Nourianz:
    • constipation
    • nausea
    • trouble sleeping
    • decreased appetite

Serious side effects

These lists contain examples of serious side effects that can occur with Gocovri, with Nourianz, or with both drugs (when taken individually).

Effectiveness

These drugs haven’t been directly compared in clinical studies. But separate studies have found both Gocovri and Nourianz to be effective for use in people with PD.

Costs

Gocovri generally costs more than Nourianz costs. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Gocovri and Nourianz are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

You should take Gocovri according to your doctor’s or healthcare provider’s instructions. Gocovri comes as capsules that are taken by mouth.

When to take

Gocovri can cause some people to feel very tired or drowsy. Because of this, it’s usually recommended that you take the drug at bedtime. (For more information on tiredness caused by Gocovri, see the “Gocovri side effects” section above.)

And to help make sure that you don’t miss a dose, try setting a reminder. This could include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work too.

Taking Gocovri with food

Gocovri can be taken with or without food. But keep in mind that some foods may interact with Gocovri. For information about these possible interactions, see the “Gocovri interactions” section below.

Can Gocovri be crushed, split, or chewed?

Gocovri capsules should be swallowed whole. They shouldn’t be crushed, split, or chewed.

However, if you have trouble swallowing Gocovri capsules whole, you can open a capsule and sprinkle its contents out on a small amount of soft food. Examples of these foods include applesauce and pudding. Then this food should be swallowed whole right away. Don’t chew it or save it to take at a later time.

The Food and Drug Administration (FDA) approves prescription drugs such as Gocovri to treat certain conditions.

Gocovri for dyskinesia in people with Parkinson’s disease

Gocovri is FDA-approved to treat dyskinesia (uncontrolled, involuntary movements) in adults with Parkinson’s disease (PD).

Specifically, Gocovri is approved for use in adults who also take a drug called levodopa. (Levodopa is a PD drug that works by increasing levels of the brain chemical dopamine.) The adults can be taking levodopa either by itself or in addition to other medication that also affects dopamine.

PD affects your nervous system. In early stages of this disease, you may have tremors or stiffness. But in later stages of PD, other symptoms, such as dementia, can develop.

Effectiveness of Gocovri in people with Parkinson’s disease

Two clinical trials looked at people with dyskinesia related to PD. Some people were given Gocovri, while other people were given a placebo (treatment with no active drug).

In these studies, the Unified Dyskinesia Rating Scale (UDysRS) was used to assess people’s dyskinesia. On this scale, lower scores indicate less severe dyskinesia than higher scores indicate.

After 12 weeks of treatment, the following results were seen in these studies.

  • In the first study, UDysRS scores were lowered, on average, by:
    • 15.9 points in people taking Gocovri
    • 8 points in people taking the placebo
  • In the second study, UDysRS scores were lowered, on average, by:
    • 20.7 points in people taking Gocovri
    • 6.3 points in people taking the placebo

In both of these studies, people taking Gocovri reported a significant increase in “on episodes.” The people also reported a significant decrease in “off episodes.” (During “on episodes,” your PD symptoms are well controlled with treatment. And during “off episodes,” the effect of your PD treatment wears off too quickly after each dose is given, or it’s just not working as well as it should.)

After 12 weeks of treatment, the following results were seen.

  • In the first study, “on episodes” were increased by an average of:
    • 3.6 hours in people taking Gocovri
    • 0.8 hours in people taking the placebo
  • In the second study, “on episodes” were increased by an average of:
    • 4 hours in people taking Gocovri
    • 2.1 hours in people taking the placebo

Gocovri and children

It’s not known whether Gocovri is safe or effective for use in children. Because of this, the drug is only approved for use in adults.

Gocovri is approved treat dyskinesia (uncontrolled, involuntary movements) in adults with Parkinson’s disease (PD). Specifically, Gocovri is approved for this use in adults who are taking a drug called levodopa.

Examples of medications that contain the drug levodopa include:

  • carbidopa/levodopa (Sinemet)
  • carbidopa/levodopa ER (Rytary)
  • carbidopa/entacapone/levodopa (Stalevo)

Levodopa is used to treat symptoms of PD. It works by increasing levels of the brain chemical dopamine. But sometimes levodopa can cause people to have dyskinesia. This can happen because the drug wears off too quickly after a dose is taken.

Gocovri works in addition to levodopa to further increase your dopamine levels. By doing this, Gocovri helps to decrease the time it takes for levodopa to wear off.

Gocovri should always be used with levodopa. For some people, Gocovri and levodopa may be taken along with other drugs that also affect dopamine levels.

If you have questions about using Gocovri with other drugs, talk with your doctor.

It’s recommended that you don’t drink alcohol while you’re taking Gocovri. This is because alcohol can cause some of the same side effects as Gocovri causes. And it can also worsen certain side effects of the drug.

Examples of Gocovri’s side effects that can be increased with alcohol use include:

Gocovri can also cause some people to have trouble controlling certain urges. This can lead to an increase in risky behaviors, such as gambling and spending excessive amounts of money. Alcohol can also inhibit your ability to control certain impulses. So consuming alcohol while you’re taking Gocovri could increase this risk even more.

For more information on trouble controlling impulses with Gocovri, see the “Gocovri side effects” section above.

If you drink alcohol, talk with your doctor before taking Gocovri. They can recommend whether it’s safe for you to continue drinking while you’re taking Gocovri.

Gocovri can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Gocovri and other medications

Below are lists of medications that can interact with Gocovri. These lists don’t contain all the drugs that may interact with Gocovri.

Before taking Gocovri, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Gocovri and other anticholinergic drugs

Gocovri can cause side effects similar to those caused by anticholinergic drugs. (Anticholinergics are a group of medications that are used to treat a variety of conditions.) Taking Gocovri with anticholinergics can worsen those side effects.

Examples of side effects that are commonly caused by anticholinergics include:

Examples of anticholinergic drugs that can cause significant side effects that may be worsened with Gocovri include:

  • dicyclomine (Bentyl)
  • benztropine (Cogentin)
  • tolterodine (Detrol)
  • scopolamine (Transderm Scop)
  • oxybutynin (Ditropan XL)

Before starting any new medications, ask your doctor or pharmacist about possible interactions with Gocovri. Your doctor or pharmacist will recommend whether it’s safe for you to take the medications together.

Gocovri and drugs that affect urinary pH

Gocovri’s removal from your body depends very much on the acidity of your urine. That’s why taking medications that alter your body’s pH balance can change your level of Gocovri. Based on the acidity of your urine, your level of Gocovri may either be too high or too low.

Examples of medications that can alter your body’s pH balance include:

  • sodium bicarbonate (Brioschi)
  • potassium citrate (Urocit-K)
  • hydrochlorothiazide (Microzide, others)
  • acetazolamide

Before starting any new medications, ask your doctor or pharmacist about possible interactions with Gocovri. Your doctor or pharmacist will recommend whether it’s safe for you to take the medications together.

Gocovri and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Gocovri. However, you should still check with your doctor or pharmacist before using any of these products while taking Gocovri.

Gocovri and foods

There aren’t any foods that have been specifically reported to interact with Gocovri. If you have any questions about eating certain foods with Gocovri, talk with your doctor.

Gocovri and vaccines

It’s recommended that you don’t get live vaccines, including the live influenza (flu) vaccine, while you’re taking Gocovri. (Live vaccines contain a live but weakened form of certain viruses.)

This is because amantadine, the active drug in Gocovri, can act like an antiviral in your body. By working as an antiviral, amantadine won’t allow your body to respond to the live vaccines like usual. This means you won’t develop immunity to the condition you’re being vaccinated for as you normally would with the vaccine.

However, keep in mind that inactivated vaccines, including the inactivated flu vaccine, are safe to have while you’re using Gocovri. (The inactivated vaccines don’t contain any live virus.)

If you have questions about the vaccines that are safe for you to have, talk with your doctor or pharmacist.

As with all medications, the cost of Gocovri can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Gocovri, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Gocovri, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Gocovri, or if you need help understanding your insurance coverage, help is available.

Adamas Pharmaceuticals, Inc., the manufacturer of Gocovri, offers several programs to help lower the cost of the drug. For more information and to find out if you’re eligible for support, call 844-GOCOVRI (844-462-6874) or visit the drug website.

Generic version

Gocovri isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

However, amantadine, the active drug in Gocovri, is available as a generic medication. But generic amantadine medications come in different forms and strengths than Gocovri comes in.

Gocovri is approved to treat dyskinesia (uncontrolled, involuntary movements) in adults with Parkinson’s disease (PD). It’s not known exactly how the drug works, but it’s thought to help reduce dyskinesia by affecting the brain chemical dopamine.

Gocovri is approved for this use in adults who are also taking a drug called levodopa. Levodopa, which is used to treat PD, works by increasing levels of dopamine in your brain. But sometimes levodopa can cause people to have dyskinesia. This can happen because the drug wears off too quickly after a dose is taken.

Gocovri works in addition to levodopa to further increase your dopamine levels. By doing this, Gocovri helps to decrease the time it takes for levodopa to wear off. And this may help reduce dyskinesia in people with PD.

How long does it take to work?

Gocovri begins to work within a few hours after you’ve taken the medication. But how quickly Gocovri starts to treat dyskinesia will vary from person to person.

It’s not known whether it’s safe to use Gocovri during pregnancy.

However, during animal studies, negative effects were seen in developing fetuses exposed to amantadine. (Amantadine is the active drug in Gocovri.) Examples of some of these negative effects include:

  • decreased birth weight
  • skeletal malformations

Keep in mind that animal studies don’t always predict what will happen in humans. However, because of this possible risk, it’s important to talk with your doctor before taking Gocovri during pregnancy. They can recommend whether it’s safe for you to use Gocovri if you’re pregnant or are planning to become pregnant.

It’s not known if Gocovri is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Gocovri.

For more information about taking Gocovri during pregnancy, see the “Gocovri and pregnancy” section above.

It’s not known if it’s safe to breastfeed while you’re using Gocovri. Amantadine, the active drug in Gocovri, is passed into human breast milk. But it’s not known how much drug passes into the milk, or whether the drug affects children who are breastfed.

If you’re breastfeeding or planning to breastfeed, talk with your doctor. They can recommend whether it’s safe for you to take Gocovri.

Here are answers to some frequently asked questions about Gocovri.

Do I need to avoid alcohol while I’m taking Gocovri?

Yes, it’s recommended that you don’t drink alcohol while you’re taking Gocovri. This is because alcohol can cause some of the same side effects that Gocovri causes. In addition, drinking alcohol can worsen certain side effects of Gocovri.

Examples of Gocovri’s side effects that can be increased with alcohol use include:

For more information about drinking alcohol while taking Gocovri, see the “Gocovri and Alcohol” section above.

Can I use Gocovri if I have severe kidney problems?

No, it’s recommended that you don’t use Gocovri if you have severe kidney problems. This is because Gocovri is mostly removed from your body by your kidneys. And if your kidneys aren’t working properly, the drug may build up in your body and cause issues.

If you have kidney problems, talk with your doctor about whether it’s safe for you to use Gocovri. Your doctor may recommend a dosage of Gocovri for you that’s lower than the usual dosage. Or they may recommend that you use an alternative drug for your condition.

Is it safe to drive while I’m taking Gocovri?

Possibly. But keep in mind that both excessive sleepiness and falling asleep while driving have been reported in people taking Gocovri. And sometimes people taking the drug can fall asleep without first having drowsiness or other warning signs. This means that driving and doing certain other activities that require your full attention might be dangerous while you’re taking Gocovri.

Before driving while taking Gocovri, it’s important that you know how the medication affects you. See how Gocovri makes you feel over a prolonged period of time. Then talk with your doctor about whether it’s safe for you to drive while taking this drug.

Should I avoid certain vaccines during my Gocovri treatment?

Yes, it’s recommended that you don’t get live vaccines, including the live influenza (flu) vaccine, while you’re taking Gocovri. (Live vaccines contain a live but weakened form of certain viruses.)

This is because amantadine, the active drug in Gocovri, can act like an antiviral in your body. By working as an antiviral, amantadine won’t allow your body to respond to the live vaccines like usual. This means you won’t develop immunity to the condition you’re being vaccinated for as you normally would with the vaccine.

However, keep in mind that inactivated vaccines, including the inactivated flu vaccine, are safe to have while you’re using Gocovri. (The inactivated vaccines don’t contain any live virus.)

If you have questions about the vaccines that are safe for you to have, talk with your doctor or pharmacist.

If Gocovri isn’t working for me, should I stop taking it?

No, you shouldn’t stop taking Gocovri without first talking with your doctor. It’s important to note that stopping Gocovri too quickly can cause serious side effects. These side effects include:

  • fever
  • confusion
  • rigid muscles

For more information about how abruptly stopping Gocovri could affect you, see the “Gocovri withdrawal and dependence” section below.

If you need to stop taking Gocovri or you feel that your Gocovri dose needs to be changed, talk with your doctor. Be sure to do this before making any changes to your Gocovri dosage schedule. If you need to stop Gocovri treatment, your doctor will recommend a plan for you to slowly and safely taper off of the medication.

Will Gocovri cure Parkinson’s disease dyskinesia?

No, unfortunately Gocovri doesn’t cure dyskinesia (uncontrollable, involuntary movements) related to Parkinson’s disease (PD). However, the drug may help reduce your dyskinesia.

For more information about Gocovri’s effectiveness for this condition, see the “Gocovri Uses” section above.

This drug comes with several precautions. Before taking Gocovri, talk with your doctor about your health history. Gocovri may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Kidney problems. It’s recommended that you don’t take Gocovri if you have severe kidney problems. Talk with your doctor about any history of kidney problems before taking this drug. They can recommend whether it’s safe for you to take Gocovri.
  • Sleep disorder. Gocovri can cause both excessive sleepiness and falling asleep during activities. These side effects can be worse in people with a history of sleep problems. Talk with your doctor about any history of sleep problems before taking this drug. They can recommend whether it’s safe for you to take Gocovri.
  • Alcohol use. Drinking alcohol can worsen certain side effects of Gocovri. If you drink alcohol, talk with your doctor before taking Gocovri. They can recommend if it’s safe for you to continue drinking while you’re taking this drug.
  • Uncontrollable impulses. Unusual urges such as binge eating, gambling, and compulsive shopping have been reported in people taking Gocovri. If you have a history of uncontrollable impulses, taking Gocovri could make them worse for you. Before starting Gocovri, talk with your doctor about any history of uncontrollable urges. They can recommend whether it’s safe for you to take Gocovri.
  • Depression and thoughts of suicide. Gocovri can cause depression and thoughts of suicide in some people. If you have history of these conditions, you may have an increased risk of these side effects while using Gocovri. Talk with your doctor about any history of depression or suicidal thoughts or behaviors before taking this drug. They can recommend whether it’s safe for you to take Gocovri.
  • Major psychotic disorder. Gocovri can cause or worsen hallucinations (having sensations that aren’t real). This risk is higher in people with psychosis or a major psychotic disorder, such as schizophrenia. Because of this risk, it’s recommended that people with history of psychosis or a major psychotic disorder avoid taking this drug.
  • Allergic reaction. If you’ve had an allergic reaction to Gocovri or any of its ingredients, you shouldn’t take Gocovri. Ask your doctor about other medications that may be better options for you. If you’re unsure about your medication allergies, talk with your doctor.
  • Pregnancy. It’s not known whether it’s safe to use Gocovri in pregnancy. For more information, please see the “Gocovri and pregnancy” section above.
  • Breastfeeding. It’s not known whether it’s safe to use Gocovri while breastfeeding. For more information, please see the “Gocovri and breastfeeding” section above.

Note: For more information about the potential negative effects of Gocovri, see the “Gocovri side effects” section above.

Using more than the recommended dosage of Gocovri can lead to serious side effects. Do not use more Gocovri than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

You shouldn’t stop taking Gocovri without first talking with your doctor. Stopping Gocovri too quickly can cause serious side effects and withdrawal. (Withdrawal occurs when you stop taking a drug that your body has become dependent upon. With dependence, your body needs the drug in order to feel normal.)

Side effects that can occur when abruptly stopping Gocovri include:

  • fever
  • confusion
  • rigid muscles

Abruptly stopping Gocovri can also worsen Parkinson’s disease (PD) symptoms, which Gocovri is used to treat. This can possibly lead to depression, slurred speech, agitation, or hallucinations (having sensations that aren’t real).

If you’re planning to stop taking Gocovri, it’s recommended that you slowly decrease your dose over a few days to weeks. Doing so can help decrease your risk of serious side effects.

If your doctor recommends that you stop taking Gocovri, they’ll make a plan for you to slowly taper off of the drug.

When you get Gocovri from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Gocovri capsules should be stored at room temperature (68°F to 77°F/20°C to 25°C). For short periods of time, the capsules can be stored at temperatures ranging from 59°F to 86°F (15°C to 30°C).

Gocovri should be kept in a tightly sealed container. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Gocovri and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Gocovri is indicated to treat dyskinesia in adults with Parkinson’s disease (PD) who are using therapy with levodopa, either by itself or with additional dopaminergic agents.

Administration

Gocovri is an extended-release capsule that should be swallowed whole by mouth, once daily. It should be not crushed, chewed, or divided.

However, for people with swallowing issues, Gocovri capsules can be opened and their contents sprinkled out onto a small amount of soft food, such as applesauce or pudding. This resulting mixture should be swallowed whole immediately. It should not be stored for later use.

Mechanism of action

The exact mechanism of how amantadine works to treat dyskinesia in people with PD is not known. However, it is thought that amantadine has direct and indirect effects on dopamine neurons, as well as activity as a weak uncompetitive NMDA receptor antagonist.

Pharmacokinetics and metabolism

Amantadine reaches steady state in approximately 4 days after initiation. The steady-state half-life is approximately 16 hours. Amantadine is excreted primarily through the urine, unchanged by way of glomerular filtration and tubular secretion.

Contraindications

Gocovri is contraindicated in people with end stage renal disease (CrCl of less than 15 mL/min).

Misuse, withdrawal, and dependence

It is recommended that Gocovri be tapered off in people who have taken it for at least 4 weeks. If Gocovri is not tapered appropriately, symptoms resembling neuroleptic malignant syndrome (NMS) can result. These symptoms can include fever, muscle rigidity, and altered consciousness.

Abrupt discontinuation of Gocovri can also cause delirium, agitation, hallucinations, and an increase in symptoms of PD.

Storage

Gocovri capsules should be stored at room temperature (68°F to 77°F/20°C to 25°C) in a tightly sealed container. For short periods of time, the drug can be stored at temperatures ranging from 59°F to 86°F (15°C to 30°C).

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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