Influence of the dopamine agonist alpha-dihydroergocryptine on the pharmacokinetics of levodopa in patients with Parkinson's disease

Clin Neuropharmacol. 2001 Jul-Aug;24(4):235-8. doi: 10.1097/00002826-200107000-00008.

Abstract

This study investigated whether chronic coadministration of alpha-dihydroergocryptine (DHEC) altered the plasma pharmacokinetics of individualized treatments with levodopa in 12 patients with Parkinson's disease. Steady-state pharmacokinetics of plasma levodopa (L-Dopa) under combined treatment were compared with those under treatment with L-Dopa alone. There was no evidence of increased exposure to L-Dopa caused by concomitant treatment with DHEC. In contrast, additional treatment with DHEC reduced the overall exposure to L-Dopa (17.5% reduction in area under the curve; 95% CI: 23%-6%). This effect was small but statistically significant for the area under the plasma concentration-time curve, whereas tmax (time of maximum plasma concentration) and peak-to-trough fluctuation were not affected. Cmax (maximum plasma concentration), on average, was reduced to a similar extent (-14.5%; 95% CI: 38% to -17%), albeit not significantly. The magnitude of the interaction does not suggest changing the current clinical practice of up-titrating DHEC and subsequently adapting L-Dopa to the individual needs of patients.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Antiparkinson Agents / blood
  • Antiparkinson Agents / pharmacokinetics*
  • Area Under Curve
  • Confidence Intervals
  • Dihydroergocryptine / pharmacokinetics*
  • Dihydroergocryptine / therapeutic use
  • Dopamine Agonists / pharmacokinetics*
  • Dopamine Agonists / therapeutic use
  • Drug Interactions
  • Drug Therapy, Combination
  • Female
  • Humans
  • Levodopa / blood
  • Levodopa / pharmacokinetics*
  • Male
  • Middle Aged
  • Parkinson Disease / blood*
  • Parkinson Disease / drug therapy

Substances

  • Antiparkinson Agents
  • Dopamine Agonists
  • Levodopa
  • Dihydroergocryptine