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Drug-drug interactions with levodopa modulating treatment responses in Parkinson's disease

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Abstract

Optimum treatment responses in patients with Parkinson's disease are typically achieved through drug interactions that aim at increasing levodopa availability, targeting the drug to the brain, while smoothing its concentrationtime profile. Inhibitors of amino acid decarboxylase, catechol-O-methyltransferase, and monoamine oxidases are all used for that purpose but to assure maximum levodopa effectiveness and safety, doses and timing of these drugs with respect to comedication have to be individualised. Moreover, a number of frequently used drugs to treat comorbidity have a potential to modify levodopa pharmacokinetics and particularly bioavailability. These drugs may trigger avoidable fluctuations of motor function in these patients if not handled appropriately. Other combinations should be avoided because they are associated with unacceptable risks.

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Authors and Affiliations

  1. Dept. of Internal Medicine VI, Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany

    Walter E. Haefeli MD

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Haefeli, W.E. Drug-drug interactions with levodopa modulating treatment responses in Parkinson's disease. J Neurol 254 (Suppl 4), IV29–IV36 (2007). https://doi.org/10.1007/s00415-007-4006-x

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