Vyalev® is a 24-hour continuous dopamine replacement therapy delivered via a small wearable pump.

A new treatment now available on the PBS for Australians living with advanced Parkinson’s.

What is it?

Vyalev® is a 24-hour continuous dopamine replacement therapy delivered via a small wearable pump designed for people with advanced Parkinson’s who experience motor fluctuations. Vyalev replaces oral levodopa/carbidopa with a liquid formulation infused under the skin (subcutaneous) through a device called the Vyafuser™ pump to help manage those unpredictable “off” periods when symptoms return despite regular oral medication.

Vyalev® may be suitable for people who:

  • Experience frequent “off” time or dyskinesia despite oral meds.
  • Want a non-surgical alternative to other device assisted therapies like Duodopa or DBS.
  • Are looking for more consistent symptom control, especially overnight or early morning.

It’s now listed on the PBS, making it affordable and accessible for Australians following advocacy by Parkinson’s Australia.

How does it work?

  • The pump delivers foslevodopa and foscarbidopa, which convert into levodopa and carbidopa in the body… the gold standard for Parkinson’s symptom relief.
  • Medication is infused 24/7, bypassing the digestive system for more stable dopamine levels.
  • You wear the pump in a belt, vest, or pouch. A small cannula (tube) sits under the skin to deliver the medication.
  • You still take your other medications, just not your levodopa oral therapy anymore.

FAQs

Pump hygiene & maintenance

  • Daily cleaning of hands and skin before handling the pump is essential.
  • Rotate infusion sites to avoid skin irritation or pooling (when medication collects under the skin, causing swelling or nodules).
  • Pooling can be managed by changing the site and ensuring proper cannula placement.
  • Replace the syringe, tubing, and cannula as directed, typically every 24–72 hours.
  • Do not shower with the pump on, disconnect temporarily and reconnect within an hour.

FAQs

Do I stop all my other medications?

No. You can still take all your adjunct therapies (e.g. COMT). You only need to stop taking oral c/l.

Can I exercise with Vyalev?

Yes. Many users report improved mobility and stamina. The pump is portable and designed to move with you. Your clinician can adjust your infusion rate for higher activity periods.

Can I be intimate while wearing the pump?

Yes. The pump is discreet and can be worn in a belt or vest. Just ensure the infusion site is secure and comfortable. Open communication with your partner and care team is key.

Can I travel or go through airports?

Yes. Vyalev is safe for travel, including airport security. Carry documentation from your doctor and keep medication cool. The solution can be unrefrigerated for up to 28 days once opened (kept out of sunlight and under 30C degrees).

Can I shower with it?

No. Disconnect the pump before showering, bathing, or swimming. Reconnect within an hour to avoid interruption in therapy.

What are common side effects?

Most side effects are mild and manageable, including:

  • Skin reactions at the infusion site (redness, swelling, nodules)
  • Dyskinesia
  • Hallucinations or sleepiness in some cases.

Remember, these are similar to oral levodopa and can often be managed by adjusting the dose.

What if I get pooling?

Pooling refers to medication collecting under the skin, causing swelling or bumps. If this happens:

  • Change the infusion site
  • Use a new cannula
  • Notify your care team if it persists.

Don’t let side effects put you off! Vyalev has helped many Australians regain independence, mobility, and quality of life. Listen to Paula’s story here below.

Key Statistics

  1. Vyalev increases “on” time without troublesome dyskinesia by an average of 2.72 hours per day. Compared to oral carbidopa/levodopa, Vyalev showed a statistically significant improvement in motor symptom control during waking hours.
  2. Vyalev reduces “off” time by an average of 3.5 hours per day over one year. In a 52-week open-label trial, patients experienced a 59% reduction in daily “off” time, improving overall quality of life.
  3. Infusion site reaction rates dropped significantly with improved education, hygiene and site rotation strategies.
  4. Vyalev is the first and only 24-hour subcutaneous levodopa infusion therapy approved in Australia. It offers a non-surgical alternative for continuous dopamine delivery, now PBS-listed for eligible patients with advanced Parkinson’s.

How do I access it?

It’s advisable to explore all available pathways to find the support that best suits your individual needs. Look to:

  • getting a GP referral to someone with VYALEV experience
  • your state-based Parkinson’s organisation for advice on local services to access
  • private health to see what is covered in relation to consultations and expenses
  • DVA, NDIS or My Aged Care plan supports.

Infosheet under review

References

  • AbbVie. (2024). VYALEV™ Efficacy & Clinical Trial Results. Retrieved from https://www.vyalevhcp.com/efficacy
  • Parkinson's News Today. (2025, April 10). Vyalev has good long-term safety profile in Parkinson's. Retrieved from https://parkinsonsnewstoday.com/news/aan-2025-vyalev-good-long-term-safety-profile-parkinsons
  • VA Pharmacy Benefits Management Services. (2025, March). Foscarbidopa and Foslevodopa (Vyalev) in Parkinson's Disease: National Drug Mini-monograph. Retrieved from https://www.va.gov/formularyadvisor
  • Therapeutic Goods Administration. (2024, October). Australian Public Assessment Report for Vyalev. Retrieved from https://www.tga.gov.au
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