Abstract:
:Motor fluctuations are a common problem in the long-term management of Parkinson's disease (PD), resulting in disability and impaired quality of life. The relatively short serum half-life (approximately 90 min) of oral levodopa/carbidopa and its erratic absorption due to delayed and inconsistent gastric emptying (a non-motor feature of PD) are thought to be important factors in the development of motor fluctuations. Continuous infusion of levodopa/carbidopa directly into the small intestine of PD patients results in marked reduction of motor fluctuations by reducing plasma levodopa variability by an order of magnitude over oral therapy. Previously, the use of long-term intraduodenal infusion of levodopa/carbidopa was limited by the relatively large volumes of infusate necessitated by the low solvency of levodopa. The development of a micronized levodopa (20 mg/ml) and carbidopa (5 mg/ml) suspension utilizing a methylcellulose gel provides the high levodopa concentration and physical and chemical stability necessary for long-term enteral therapy. Clinical evidence indicates that a marked reduction of motor fluctuations and dyskinesias can be achieved and maintained by intraduodenal administration of this suspension. This article reviews the published data describing the efficacy and safety of duodenal levodopa, and discusses its current and potential role in meeting the needs of PD patients.
journal_name
Expert Opin Pharmacotherjournal_title
Expert opinion on pharmacotherapyauthors
Samanta J,Hauser RAdoi
10.1517/14656566.8.5.657subject
Has Abstractpub_date
2007-04-01 00:00:00pages
657-64issue
5eissn
1465-6566issn
1744-7666journal_volume
8pub_type
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journal_title:Expert opinion on pharmacotherapy
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journal_title:Expert opinion on pharmacotherapy
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journal_title:Expert opinion on pharmacotherapy
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journal_title:Expert opinion on pharmacotherapy
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journal_title:Expert opinion on pharmacotherapy
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