Gasper’s story: Strength, family, and moving forward

Image of Gasper, real CREXONT patient.

Gasper has always believed in the value of hard work. For over 40 years, he ran his own automotive business, often putting in long days and seven-day work weeks. “I was a hustler,” he says with a smile. “I worked hard, and I enjoyed it.” That drive never left him, not after selling the business or being diagnosed with Parkinson’s disease in the summer of 2022.

Gasper’s days look a little different after his diagnosis, but his determination to make every day count and his love for his family is strong. He starts most mornings with either going to church or a combination of physical, occupational, or speech therapy. He keeps himself busy, not just for his own wellbeing, but because it brings him joy to stay connected with others in his community.

“I do best in a crowd,” he says. “And my family makes sure I stay busy.” That family includes three siblings, two grandchildren, and two children including his daughter, Dr Jill Giordano Farmer, DO, who is also his Movement Disorder Specialist. The line between family and clinical care can be delicate, but Dr Farmer manages it with empathy and purpose.

“She’s amazing,” Gasper says proudly. “She thinks I can’t take care of myself, but I always tell her I can, as long as I listen to her.”

Dr Farmer plays a unique dual role, combining clinical experience with an intimate understanding of her father’s personality, habits, and needs. “It’s not just about prescribing medication,” she says. “It’s about walking alongside someone you love through every stage. I’m his doctor, but I’m also his daughter, and I want to help make each day a little easier for him.”

She’s the one who first noticed early signs of Parkinson’s. At first, it was thought to be a “trick knee,” but Dr Farmer noticed changes in his voice, posture, and sleep. Eventually, the diagnosis became clear. “I didn’t look it up,” Gasper says. “I read the pamphlets the doctor gave me and listened to my daughter.”

Dr Farmer’s approach was never to overwhelm him with information. Instead, she met him where he was, offering resources only when he was ready. “A lot of this was buffered by my late wife,” Gasper reflects. “She’d filter the info before I was ready to hear it.”

He began treatment gradually, trying different approaches like immediate-release carbidopa/levodopa with his care team, while also staying consistent with exercise, therapy, and family support.

As his Parkinson’s progressed, Gasper began struggling and had difficulty maintaining his medication routine. That’s when Dr Farmer introduced him to CREXONT® (carbidopa and levodopa) extended-release capsules, 70 mg/280 mg three times per day.

With this new treatment in place, Gasper found more consistency in his days, and felt more alert and less fatigued. He jokes that he’s “not too good” with his phone, so he keeps his pills out where he can see them to help remember to take them.

With CREXONT, Gasper feels more like himself again; present, capable, and connected to the life he cherishes. What matters most to Gasper is feeling present and capable of doing the things he loves, like spending time with his grandchildren, one of whom reminds him of his late wife, attending church, and looking forward to his upcoming 80th birthday celebration in Aruba with the entire family. CREXONT has helped him reclaim those moments by offering more consistency in his days.

“If I can help somebody even an inch and make their life better, I hit a home run. That’s it,” he says of sharing his story with Parkinson’s and his experience taking CREXONT.

For Dr Farmer, the experience of being both physician and daughter has only deepened her passion for helping others. “When you have a successful outcome in treatment, you want to give hope. That there are options. That you’re not alone.”

She often tells her own patients about Gasper’s experience, not to prescribe a one-size-fits-all solution, but to make the path forward feel a little more real and less intimidating. “When doctors are asked, ‘What would you do for your own family?’ this is what I chose for mine,” says Dr Farmer.

Gasper doesn’t like to talk much about his diagnosis outside the family, not because he’s ashamed, but because he doesn’t want people to look at him differently. Still, he chooses to share his story with the hope that it might help someone else feel just a little more understood.

“I don’t know what the future holds,” he says honestly. “But I’m working on it now. And I’m lucky to have people beside me.”

Gasper’s experience with CREXONT is his own and may not reflect the experience of every patient. For some patients, CREXONT may cause falling asleep during daily activities. Side effects may include nausea and anxiety. Individual results will vary. Talk to your patients to see if CREXONT is right for them. Only an HCP should assess each patient’s condition and advise them on treatment options.


IMPORTANT SAFETY INFORMATION

Indications and Usage

CREXONT® (carbidopa and levodopa) extended-release capsules for oral use is indicated for the treatment of Parkinson’s disease, post-encephalitic parkinsonism, and parkinsonism that may follow carbon monoxide intoxication or manganese intoxication in adults.

Dosage and Administration

  • Levodopa-naïve patients: Starting dose is 35 mg carbidopa/140 mg levodopa taken orally twice daily for the first three days; thereafter, dosage may be increased gradually as needed
  • For patients converting to CREXONT from immediate-release carbidopa/levodopa, dosages are not substitutable on a 1:1 basis. See full prescribing information Section 2.2 for instructions
  • For patients converting from Rytary® (carbidopa and levodopa) extended-release capsules, initiate CREXONT on an approximately 1:1 mg basis using the levodopa component for conversion
  • CREXONT may be taken up to four times daily. The maximum recommended daily dosage is 525 mg carbidopa/2100 mg levodopa
  • CREXONT may be taken with or without food. Capsules should not be chewed, divided or crushed
  • CREXONT should not be taken with alcohol

Contraindications

Nonselective MAO inhibitors.

Warnings and Precautions

  • CREXONT may cause falling asleep during activities of daily living, somnolence or dizziness. Patients should avoid activities that require alertness such as driving and operating machinery until they know how CREXONT affects them
  • It is important to avoid sudden discontinuation or rapid dose reduction to reduce the risk of withdrawal symptoms such as high fever or confusion. Patients who are discontinuing CREXONT should taper off with healthcare provider guidance
  • Consider dose reductions or stopping CREXONT in patients with hallucinations or impulse control disorders (e.g., gambling, sexual urges, or uncontrolled spending)
  • Consider dose reduction in patients with dyskinesia
  • Patients with a major psychotic disorder should not be treated with CREXONT
  • Monitor patients with a history of cardiovascular disease for cardiac function
  • Monitor patients with a history of peptic ulcer for upper GI hemorrhage
  • Monitor patients with glaucoma for increased intraocular pressure

Adverse Reactions

The most common adverse reactions (incidence ≥ 3% and greater than immediate-release CD/LD) are nausea and anxiety.

Drug Interactions

Iron salts and dopamine D2 antagonists, including metoclopramide, may reduce the effectiveness of CREXONT.

Use in Specific Populations

Pregnancy: Based on animal data, CREXONT may cause fetal harm. There are no adequate data on the developmental risk associated with the use of CREXONT in pregnant women.
Breastfeeding: The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for CREXONT.
Geriatric patients: There were no differences in safety outcomes between patients less than 65 years of age, 65-75 years of age, or 75 years and older.

To report SUSPECTED ADVERSE REACTIONS, contact Amneal Specialty, a division of Amneal Pharmaceuticals, LLC at 1‑877‑835‑5472 or the FDA at 1‑800‑FDA‑1088 or www.fda.gov/medwatch.

Please see full Prescribing Information for CREXONT.

Content is for guidance only. Please use clinical judgment when prescribing CREXONT. Dosage is individualized for each patient.