A new extended-release medication is giving Parkinson's patients significantly more predictable symptom control throughout the day. In an ongoing clinical trial, people who switched to Crexont, a newer formulation of levodopa and carbidopa, experienced an average increase of more than three hours of "good on time" (periods when symptoms are well-controlled without problematic involuntary movements) within just six weeks, while their "off time" (when symptoms aren't well-managed between doses) decreased by more than three hours on average.

What Makes Parkinson's Symptoms Fluctuate Throughout the Day?

Parkinson's disease develops when brain cells that produce dopamine, a crucial signaling molecule, begin to die. Dopamine helps control movement, so when levels drop, people experience tremors, stiffness, and difficulty with coordination. Levodopa, the standard treatment, gives the brain raw material to make more dopamine. However, as Parkinson's progresses, the medication's effects wear off more quickly between doses, creating unpredictable periods of poor symptom control.

Over time, long-term levodopa use can also trigger dyskinesia, involuntary jerking movements that make daily activities even more challenging. This is why researchers have been working to develop formulations that maintain steadier medication levels in the body throughout the day.

How Does Crexont Deliver Better Symptom Control?

Crexont is an extended-release formulation designed to release levodopa and carbidopa slowly and consistently, maintaining more stable medication levels in the bloodstream. This approach helps reduce the dramatic ups and downs that patients experience with instant-release formulations. The medication was approved by the FDA in 2024 and is now being studied in real-world settings to confirm its benefits.

The ELEVATE-PD trial, an ongoing Phase 4 study conducted by researchers at Amneal Pharmaceuticals, evaluated 111 participants who switched from other levodopa-based therapies to Crexont. Most had previously been taking instant-release levodopa plus carbidopa, while some were already on other extended-release options like Rytary. Participants underwent a five-week dose adjustment period, then received their optimal dose for approximately one year.

What Were the Key Improvements Patients Experienced?

• Extended "Good On" Time: Patients gained more than three hours of daily symptom control on average, with longer continuous periods of stable movement and reduced involuntary movements.
• Reduced "Off" Time: Daily periods of poor symptom control decreased by more than three hours on average, giving patients more predictable functioning throughout the day.
• Fewer Motor Fluctuations: Patients experienced fewer unpredictable swings between good and poor symptom control, making daily activities more manageable and less stressful.
• Simplified Dosing Schedule: Crexont requires fewer daily doses than instant-release formulations, reducing medication timing complexity and the need to carefully coordinate meals with medication intake.

These improvements held steady across all patient groups, regardless of which levodopa-based therapy they had been taking before switching. Standard measures of motor symptom severity also showed meaningful improvement, and the safety profile matched what researchers already knew about Crexont.

"Crexont substantially increased good on time, reduced off time, and improved motor function in Parkinson's patients across all therapy groups, confirming that switching patients from other levodopa-based therapies to Crexont offers meaningful improvements in symptom control through the day," the researchers stated.

Research Team, ELEVATE-PD Trial, Amneal Pharmaceuticals

Why Does This Matter for Daily Life?

For people living with Parkinson's, the difference between three hours of good symptom control and three hours of poor control is enormous. Those extra hours of predictable functioning mean more time to work, spend time with family, exercise, or simply enjoy activities without worrying about sudden tremors or stiffness. The longer continuous periods of stability also reduce the mental burden of constantly monitoring when the next dose will kick in.

Patient testimonials in the trial data highlight these real-world benefits. One participant reported feeling "on" for most of the day after switching, while another noted improvements in balance, reduced foot freezing that had plagued them for months, and the ability to march without shuffling. A third patient emphasized how much better their brain felt within just a few weeks of starting the medication.

How to Discuss Medication Switching With Your Neurologist

• Track Your Current Symptoms: Keep a detailed log of when your "on" and "off" times occur, how long they last, and what activities are most affected. This information helps your neurologist understand whether a medication switch might benefit you.
• Ask About Your Specific Situation: Crexont may not be right for everyone. Discuss your current medication regimen, any side effects you're experiencing, and your treatment goals with your neurologist to determine if switching is appropriate.
• Understand the Adjustment Period: If you do switch, expect a five-week dose adjustment phase where your neurologist fine-tunes your dose. Some patients experience temporary side effects like nausea or brain fog during this period, but these often resolve quickly.
• Plan for Long-term Monitoring: Extended-release medications require ongoing programming and adjustment. Work with your neurologist to establish a schedule for regular check-ins to optimize your dose over time.

The ELEVATE-PD trial is ongoing, and researchers continue to gather data on long-term outcomes. However, the interim results presented at the American Academy of Neurology annual meeting suggest that for many Parkinson's patients struggling with medication fluctuations, switching to an extended-release formulation like Crexont could meaningfully improve daily functioning and quality of life.

If you or a loved one has Parkinson's and is experiencing increasing "off time" or medication side effects, this research provides evidence-based information to discuss with your healthcare team. The goal of Parkinson's treatment is not just to manage symptoms, but to help people maintain independence and enjoy their daily lives, and these new findings suggest that extended-release formulations are delivering on that promise.