Levodopa


Description

Levodopa is a prodrug of dopamine that is administered to patients with Parkinson's due to its ability to cross the blood-brain barrier[Label]. Levodopa can be metabolised to dopamine on either side of the blood-brain barrier and so it is generally a...

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Pharmacology

Indication

Levodopa on its own is formulated as an oral inhalation powder indicated for intermittent treatment... Read more

Pharmacodynamic

Levodopa is able to cross the blood-brain barrier while dopamine is not[FDA Label, Read more

Mechanism of action

Levodopa by various routes crosses the blood brain barrier, is decarboxylated to form dopamine[Label... Read more

Absorption

Orally inhaled levodopa reaches a peak concentration in 0.5 hours with a bioavailability than is 70%... Read more

Protein binding

Levodopa binding to plasma proteins is negligible[ Read more

Volume of distribution

168L for orally inhaled levodopa[Label].

Clearance

Intravenously administered levodopa is cleared at a rate of 14.2mL/min/kg in elderly patients and 23... Read more

Half life

2.3 hours for orally inhaled levodopa[FDA Label]. Oral levodopa has a half life of 50 minutes but wh... Read more

Route of elimination

After 48 hours, 0.17% of an orally administered dose is recovered in stool, 0.28% is exhaled, and 78... Read more

Toxicity

There is no readily available data for the use of levodopa in pregnancy[Label]. Rabbits treated with... Read more


Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Anxiety US
Varying Reports
Falling US
Varying Reports
Extrapyramidal disorder US
Varying Reports
Ataxia US
Varying Reports
Leg Pain US
Varying Reports
Weight Loss US
Varying Reports
Weight Gain US
Varying Reports
Edema US
Varying Reports
Trismus US
Varying Reports
Blepharospasm US
Varying Reports
Euphoria US
Varying Reports
Disorientation US
Varying Reports
Memory Impairment US
Varying Reports
Decreased mental acuity US
Varying Reports
Nervousness US
Varying Reports
Gait abnormalities US
Varying Reports
Fatigue US
Varying Reports
Myocardial Infarction US
Varying Reports
Abdominal Pain US
Varying Reports
Distress US
Varying Reports
Heartburn US
Varying Reports
Hiccups US
Varying Reports
Bruxism US
Varying Reports
Burning sensation of the tongue US
Varying Reports
Sialorrhea US
Varying Reports
Flatulence US
Varying Reports
Gastrointestinal pain US
Varying Reports
Dysphagia US
Varying Reports
Faintness US
Varying Reports
Bizarre breathing patterns US
Varying Reports
Malaise US
Varying Reports
Hoarseness US
Varying Reports
Sense of stimulation US
Varying Reports
Hot Flashes US
Varying Reports
Decreased serum potassium US
Varying Reports
Decreased white blood cell count US
Varying Reports
Increased uric acid US
Varying Reports
Increased serum creatinine US
Varying Reports
Increased glucose in urine US
Varying Reports
Increased protein in urine US
Varying Reports
Increased tremor US
Varying Reports
Numbness US
Varying Reports
Muscle twitching US
Varying Reports
Activation of latent Horner's syndrome US
Varying Reports
Peripheral neuropathy US
Varying Reports
Pharyngeal pain US
Varying Reports
Cough US
Varying Reports
Malignant Melanoma US
Varying Reports
Flushing US
Varying Reports
Oculogyric crises US
Varying Reports

Contraindications

  • Route:
    • Oral
  • Regions: US
  • Patient Conditions:
      • Name: History of Numerous Skin Cancers
      • Drugbank Id: DBCOND0070189
  • Route:
    • Oral
  • Regions: US
  • Patient Conditions:
      • Name: Skin Lesion
      • Drugbank Id: DBCOND0037061
  • Recommended Actions:
    • Discontinue MAO inhibitors, except for selective MAO-B inhibitors, at least two weeks prior to levodopa therapy.
  • Regions: US
  • With Categories Coadmin:
      • Name: Monoamine Oxidase Inhibitors
      • Drugbank Id: DBCAT001004
      • Mesh Id: D008996
  • Regions: US
  • Patient Conditions:
      • Name: Narrow-angle glaucoma
      • Drugbank Id: DBCOND0095646

Food Interactions

    Information currently not available.

Interactions

Type in a drug name to check for interaction with Levodopa

The risk or severity of serotonin syndrome can be increased when Levodopa is combined with 2,5-Dimethoxy-4-ethylamphetamine.
The risk or severity of adverse effects can be increased when Levodopa is combined with 2,5-Dimethoxy-4-ethylthioamphetamine.
The risk or severity of adverse effects can be increased when Levodopa is combined with 4-Bromo-2,5-dimethoxyamphetamine.
The risk or severity of adverse effects can be increased when Levodopa is combined with 4-Methoxyamphetamine.
The risk or severity of adverse effects can be increased when Levodopa is combined with 5-methoxy-N,N-dimethyltryptamine.
The risk or severity of adverse effects can be increased when Levodopa is combined with 7-Nitroindazole.
The risk or severity of adverse effects can be increased when Levodopa is combined with 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline.
The risk or severity of hypotension and orthostatic hypotension can be increased when Acebutolol is combined with Levodopa.
The risk or severity of adverse effects can be increased when Levodopa is combined with Acepromazine.
The risk or severity of adverse effects can be increased when Levodopa is combined with Aceprometazine.
The risk or severity of adverse effects can be increased when Acetazolamide is combined with Levodopa.
The risk or severity of adverse effects can be increased when Acetophenazine is combined with Levodopa.
The risk or severity of adverse effects can be increased when Levodopa is combined with Acetylglycinamide chloral hydrate.
The absorption of Levodopa can be decreased when combined with Aclidinium.
The risk or severity of adverse effects can be increased when Adinazolam is combined with Levodopa.
The risk or severity of adverse effects can be increased when Levodopa is combined with Adipiplon.
The risk or severity of adverse effects can be increased when Levodopa is combined with Agomelatine.
The risk or severity of adverse effects can be increased when Ajulemic acid is combined with Levodopa.
The risk or severity of adverse effects can be increased when Levodopa is combined with Alaproclate.
The risk or severity of adverse effects can be increased when Levodopa is combined with Alcuronium.

References

  • 1 . Djamshidian A, Poewe W: Apomorphine and levodopa in Parkinson's disease: Two revolutionary drugs from the 1950's. Parkinsonism Relat Disord. 2016 Dec;33 Suppl 1:S9-S12. doi: 10.1016/j.parkreldis.2016.12.004. Epub 2016 Dec 22. [PubMed: 28012951]
  • 2 . Meiser J, Weindl D, Hiller K: Complexity of dopamine metabolism. Cell Commun Signal. 2013 May 17;11(1):34. doi: 10.1186/1478-811X-11-34. [PubMed: 23683503]
  • 3 . Elroby SA, Makki MS, Sobahi TR, Hilal RH: Toward the understanding of the metabolism of levodopa I. DFT investigation of the equilibrium geometries, acid-base properties and levodopa-water complexes. Int J Mol Sci. 2012;13(4):4321-39. doi: 10.3390/ijms13044321. Epub 2012 Apr 2. [PubMed: 22605980]
  • 4 . Robertson DR, Wood ND, Everest H, Monks K, Waller DG, Renwick AG, George CF: The effect of age on the pharmacokinetics of levodopa administered alone and in the presence of carbidopa. Br J Clin Pharmacol. 1989 Jul;28(1):61-9. [PubMed: 2775615]
  • 5 . Abrams WB, Coutinho CB, Leon AS, Spiegel HE: Absorption and metabolism of levodopa. JAMA. 1971 Dec 27;218(13):1912-4. [PubMed: 5171067]
  • 6 . Fanali G, Rampoldi V, di Masi A, Bolli A, Lopiano L, Ascenzi P, Fasano M: Binding of anti-Parkinson's disease drugs to human serum albumin is allosterically modulated. IUBMB Life. 2010 May;62(5):371-6. doi: 10.1002/iub.317. [PubMed: 20225277]
  • 7 . FDA Approved Drug Products: Sinemet [Link]
  • 8 . Sinemet FDA Label [File]

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