As we do not yet have any long-term experience of subcutaneous L-dopa (January 2024), this is a preliminary answer and should be taken with a pinch of salt… One aspect is which you tolerate better – L-dopa or apomorphine – assuming you have experience of both. Apomorphine is, of course, a dopamine agonist, so experience of such agents may be a factor. Side effects can differ between the two substances. Skin-related side effects appear to differ, with more inflammation/lumps associated with apomorphine and more infections associated with L-dopa. Another aspect is that with apomorphine pump therapy, you almost always need L-dopa tablets as well – this is not, of course, necessary with the L-dopa pump, but it can be combined with a dopamine agonist in tablet form. The L-dopa pump is intended for round-the-clock use – this is a new feature compared with previous pumps, but all pumps can be used round the clock if required. The new L-dopa pump is slightly larger than the apomorphine pump, but I believe the weight is similar; however, I do not yet have any exact figures on this. /Dag Nyholm
