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Support for your patients on NOURIANZ

Patient access
NOURIANZ Co-pay Assistance

For eligible commercially insured patients. See below for a general program overview; additional terms and conditions apply. See for additional information.

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Call 1-833-KKCARES (1-833-552-2737)


The information provided by the case manager or nurse to your patients is for informational purposes only and does not constitute medical advice. It is not intended to replace a discussion between you and your patient. All decisions regarding patient care must be made by a patient’s healthcare provider considering the unique characteristics of each patient.

Co-pay card program

Eligible patients may pay as little as $20 per month for each prescription of NOURIANZ

Commercial insurance

Kyowa Kirin offers co-pay assistance for eligible commercially insured patients. Review the co-pay assistance terms and conditions to determine if your patients with commercial insurance qualify.a,b

Government insurance

In most cases, Kyowa Kirin doesn't offer a program for government- or military-insured patients.c A case manager may be able to refer them to independent charitable foundations and/or inform them about federal plan selections.

No insurance

Kyowa Kirin offers a patient assistance program for eligible uninsured patients. Download the application form to review the terms and conditions and determine if your patients without insurance qualify.c

aPatients must be US residents with an active primary commercial plan; patients with federal or state government insurance such as Medicare, Medicaid, and Tricare are not eligible for co-pay assistance. Other terms and conditions may apply.

bCommercially insured patients do not need to participate in Kyowa Kirin Cares to be eligible for co-pay assistance.

cPatients must be US residents with no active medical or pharmacy benefit insurance and an annual gross income ≤400% of the federal poverty level, confirmed by electronic income verification response or documented proof of income.

Complete co-pay card terms and conditions

How can your patients get NOURIANZ?

NOURIANZ Prescription

Patients bring their prescription to a CVS pharmacy or Walgreens pharmacy, or you can e-prescribe directly to a CVS or Walgreens.


NOURIANZ will be shipped directly to their home, or they can choose to pick up their prescription at the pharmacy.*

*Timing of process to be determined by the Pharmacy.



NOURIANZ (istradefylline) is an adenosine receptor antagonist indicated as adjunctive treatment to levodopa/carbidopa in adult patients with Parkinson’s disease (PD) experiencing “off” episodes.

Important Safety Information

Warnings and Precautions

Dyskinesia: NOURIANZ in combination with levodopa may cause dyskinesia or exacerbate pre-existing dyskinesia. In clinical trials, 1% of patients treated with either NOURIANZ 20 mg or 40 mg discontinued treatment because of dyskinesia, compared to 0% for placebo.

Hallucinations / Psychotic Behavior: Because of the potential risk of exacerbating psychosis, patients with a major psychotic disorder should not be treated with NOURIANZ. Consider dosage reduction or discontinuation if a patient develops hallucinations or psychotic behaviors while taking NOURIANZ.

Impulse Control / Compulsive Behaviors: Patients treated with NOURIANZ and one or more medication(s) for the treatment of Parkinson’s disease (including levodopa) may experience intense urges to gamble, increased sexual urges, intense urges to spend money, binge or compulsive eating, and/or other intense urges, and the inability to control these urges. In clinical trials, 1 patient treated with NOURIANZ 40 mg was reported to have impulse control disorder, compared to no patient on NOURIANZ 20 mg or placebo.

Drug Interactions

The maximum recommended dosage in patients taking strong CYP3A4 inhibitors is 20 mg once daily. Avoid use of NOURIANZ with strong CYP3A4 inducers.

Specific Populations

Pregnancy: Based on animal data, may cause fetal harm.

Hepatic impairment: The maximum recommended dosage of NOURIANZ in patients with moderate hepatic impairment is 20 mg once daily. Avoid use in patients with severe hepatic impairment.

Adverse Reactions

The most common adverse reactions with an incidence ≥5% and occurring more frequently than with placebo were dyskinesia (15%, 17%, and 8%), dizziness (3%, 6%, and 4%), constipation (5%, 6%, and 3%), nausea (4%, 6%, and 5%), hallucination (2%, 6%, and 3%), and insomnia (1%, 6%, and 4%) for NOURIANZ 20 mg, 40 mg, and placebo, respectively.

You are encouraged to report suspected adverse reactions to Kyowa Kirin, Inc. at 1-844-768-3544 or FDA at
1-800-FDA-1088 or

Please see full Prescribing Information for NOURIANZ.

Reference: 1. NOURIANZ [package insert]. Kyowa Kirin, Inc., Bedminster, NJ, USA.

References: 1. Hickey P, Stacy M. Available and emerging treatments for Parkinson’s disease: a review. Drug Des Devel Ther. 2011;5:241-254. 2. The voice of the patient: Parkinson’s disease. Silver Spring, MD: US Food and Drug Administration; April 2016. Accessed June 11, 2019. 3. Parkinson’s Foundation. Statistics. Accessed May 5, 2019. 4. Stocchi F, Antonini A, Barone P, et al. Early DEtection of wEaring off in Parkinson disease: the DEEP study. Parkinsonism Relat Disord. 2014;20(2):204-211. 5. NOURIANZ [package insert]. Kyowa Kirin, Inc., Bedminster, NJ, USA.

References: 1. NOURIANZ [package insert]. Kyowa Kirin, Inc., Bedminster, NJ, USA. 2. Kalia LV, Brotchie JM, Fox SH. Novel nondopaminergic targets for motor features of Parkinson's disease: review of recent trials. Mov Disord. 2013;28(2):131-144. 3. Morelli M, Di Paolo T, Wardas J, Calon F, Xiao D, Schwarzschild MA. Role of adenosine A2A receptors in parkinsonian motor impairment and L-DOPA-induced motor complications. Prog Neurobiol. 2007;83(5):293-309. 4. Mishina M, Ishiwata K, Naganawa M, et al. Adenosine A2A receptors measured with [11C]TMSX PET in the striata of Parkinson's disease patients. PLoS One. 2011;6(2):e17338. doi:10.1371/journal.pone.0017338. 5. Varani K, Vincenzi F, Tosi A, et al. A2A adenosine receptor overexpression and functionality, as well as TNF-α levels, correlate with motor symptoms in Parkinson’s disease. FASEB J. 2010;24(2):587-598. doi:10.1096/fj.09-141044. 6. Brooks DJ. Dopamine agonists: their role in the treatment of Parkinson’s disease [editorial]. J Neurol Neurosurg Psychiatry. 2000;68(6):685-689. 7. Brichta L, Greengard P, Flajolet M. Advances in the pharmacological treatment of Parkinson’s disease: targeting neurotransmitter systems. Trends Neurosci. 2013;36(9):543-554. 8. Ishibashi K, Miura Y, Wagatsuma K, Toyohara J, Ishiwata K, Ishii K. Occupancy of adenosine A2A receptors by istradefylline in patients with Parkinson’s disease using 11C-preladenant PET. Neuropharmacology. 2018;143:106-112. 9. Ossola B, Schendzielorz N, Chen SH, et al. Amantadine protects dopamine neurons by a dual action: reducing activation of microglia and inducing expression of GDNF in astroglia. Neuropharmacology. 2011;61(4):574-582. 10. Kaakkola S, Wurtman RJ. Effects of COMT inhibitors on striatal dopamine metabolism: a microdialysis study. Brain Res. 1992;587(2):241-249. 11. Kong P, Zhang B, Lei P, et al. Neuroprotection of MAO-B inhibitor and dopamine agonist in Parkinson disease. Int J Clin Exp Med. 2015;8(1):431-439. 12. GOCOVRI® (amantadine) [Prescribing Information]. Emeryville, CA: Adamas Pharma LLC; 2017. 13. Gerlach M, Double K, Arzberger T, Leblhuber F, Tatschner T, Riederer P. Dopamine receptor agonists in current clinical use: comparative dopamine receptor binding profiles defined in the human striatum. J Neural Transm (Vienna). 2003;110(10):1119-1127. 14. Rubí B, Maechler P. Minireview: new roles for peripheral dopamine on metabolic control and tumor growth: let's seek the balance. Endocrinology. 2010;151(12):5570-5581. doi:10.1210/en.2010-0745. 15. Jenner P. Istradefylline, a novel adenosine A2A receptor antagonist, for the treatment of Parkinson's disease. Expert Opin Investig Drugs. 2005;14(6):729-738.

References: 1. NOURIANZ [package insert]. Kyowa Kirin, Inc., Bedminster, NJ, USA. 2. Data on file. Kyowa Kirin Pharmaceutical Development, Inc., Princeton, NJ.

References: 1. Data on file. Kyowa Kirin Pharmaceutical Development, Inc., Princeton, NJ. 2. NOURIANZ [package insert]. Kyowa Kirin, Inc., Bedminster, NJ, USA.

Reference: 1. NOURIANZ [package insert]. Kyowa Kirin, Inc., Bedminster, NJ, USA.