Clinician reference tool — not medical advice. This is a clinical decision-aid intended for healthcare professionals: it gives deterministic suggestions to think with, not a diagnosis or a prescription. If you’re a patient, you’re welcome to look around — but please review anything here with your own doctor; it isn’t a substitute for personalized medical care.
Clinician reference tool — not a prescriber, not medical advice. Deterministic suggestions to think with, grounded in current Parkinson's disease guidelines and pivotal trials; the treating clinician’s judgement, current product monographs, and live provincial coverage are always required. Runs entirely in your browser — no data is collected.

Evidence: Soileau MJ 2022 · sources last checked 2026-07-22

Parkinson's disease management selector

Pick the age band, cognition, predominant symptom, functional impact and disease stage to get ranked management suggestions — from initial oral therapy through advanced / device-aided options — across the Health Canada-approved formulary, with the guideline reasoning and references behind each.

Guideline lens

Clinical profile

Age band

Cognitive status

Predominant symptom

Functional impact

Disease stage

Motor complications & cautions

Wearing-off and dyskinesia steer the adjunct choice; dementia, psychosis, ICD risk, sleepiness and orthostatic hypotension down-rank or route out dopamine agonists (and anticholinergics).

Safety & guideline notes

  • • Per the Canadian Guideline for Parkinson Disease, 2nd ed. (2019): levodopa is the most effective drug for motor symptoms and is first-line when they affect quality of life; dopamine agonists and MAO-B inhibitors are options for milder / earlier disease, used cautiously in older or cognitively impaired patients.
  • • This tool assumes a confirmed diagnosis of idiopathic Parkinson's disease. If the diagnosis is uncertain, or atypical / secondary parkinsonism is suspected (early falls, prominent early autonomic failure, poor levodopa response, rapid progression), refer to a movement-disorder specialist before treatment.
  • • Coverage: most oral PD medications are covered under provincial formularies (e.g. ODB, often as Limited Use); device-aided therapies (DBS, Duodopa, Vyalev) require special authorization and specialist initiation — confirm against the live provincial formulary.

Select the clinical profile to begin.

e.g. Age > 70 + Significant impact + Early, or Advanced + Wearing-off to see the device-aided pathway.

References

  1. [1]Grimes D, et al. Canadian Guideline for Parkinson Disease, 2nd edition. CMAJ 2019;191:E989. link
  2. [2]NICE NG71 — Parkinson's disease in adults (2017). link
  3. [3]Pringsheim T, et al. Dopaminergic therapy for motor symptoms in early Parkinson disease — practice guideline summary (American Academy of Neurology, 2021). Neurology 2021;97:942. link
  4. [4]PD MED Collaborative Group. Long-term effectiveness of levodopa, dopamine agonists, and MAO-B inhibitors in early Parkinson's disease (PD MED): a large, open-label, pragmatic randomised trial. Lancet 2014;384:1196. link
  5. [5]Health Canada — Drug Product Database & product monographs (levodopa/carbidopa, Stalevo, pramipexole, ropinirole, rotigotine, rasagiline, selegiline, safinamide/Onstryv, entacapone, amantadine, anticholinergics, Duodopa, Vyalev, Movapo). link
  6. [6]Fox SH, et al. International Parkinson and Movement Disorder Society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson's disease. Mov Disord 2018;33:1248. link
  7. [7]Schuepbach WMM, et al. Neurostimulation for Parkinson's disease with early motor complications (EARLYSTIM). NEJM 2013;368:610. link
  8. [8]Olanow CW, et al. Continuous intrajejunal infusion of levodopa-carbidopa intestinal gel for patients with advanced Parkinson's disease: a randomised, controlled, double-blind, double-dummy study. Lancet Neurol 2014;13:141. link
  9. [9]Soileau MJ, et al. Safety and efficacy of continuous subcutaneous foslevodopa-foscarbidopa in patients with advanced Parkinson's disease: a randomised, double-blind, active-controlled, phase 3 trial. Lancet Neurol 2022;21:1099. link
  10. [10]Katzenschlager R, et al. Apomorphine subcutaneous infusion in patients with Parkinson's disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomised, placebo-controlled trial. Lancet Neurol 2018;17:749. link