Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-06-05T04:48:08.203Z Has data issue: false hasContentIssue false

Continuous Drug Delivery with Levodopa/Carbidopa Infusion: Review and First Data of a Dutch Cohort

Published online by Cambridge University Press:  07 November 2014

Extract

A duodenal levodopa (L-dopa) and carbidopa infusion has been developed to stabilize plasma levels of L-dopa, in order to reduce existing motor response fluctuations. Stable plasma levels have been shown to reduce these fluctuations significantly. A constant duodenal infusion with an L-dopa solution can improve response fluctuations, however L-dopa has very poor solubility. Only in an acidic environment can L-dopa be dissolved in large volumes. To supply 1 day of infusion with the conventional L-dopa solution, ∼4–5 liters are necessary, an inconvenience to most patients. With L-dopa/carbidopa infusion, L-dopa and carbidopa are concentrated in a water-based gel-like suspension to 20 mg/mL, which has reduced the infusion volumes to <100 mL/day.

Type
Expert Roundtable Supplement
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Nyholm, D. The rationale for continuous dopaminergic stimulation in advanced Parkinson's disease. Parkinsonism Rel Disord. 2007;13:1317.CrossRefGoogle ScholarPubMed
2.Nutt, JG. Continuous dopaminergic stimulation: is it the answer to the motor complications of levodopa? Mov Disord. 2007;22:19.CrossRefGoogle Scholar
3.Nilsson, D, Nyholm, D, Aquilonius, SM. Duodenal levodopa infusion in Parkinson's disease – long-term experience. Acta Neurol Scand. 2001;104:343348.CrossRefGoogle ScholarPubMed
4.Nilsson, D, Hansson, LE, Johansson, K, et al.Long-term intraduodenal infusion of a water based levodopa-carbidopa dispersion in very advanced Parkinson's disease. Acta Neurol Scand. 1998;97:175–83.CrossRefGoogle ScholarPubMed
5.Antonini, A, Isaias, IU, Canesi, Met al.Duodenal levodopa infusion for advanced Parkinson's disease: 12-month treatment outcome. Mov Disord. 2007;22:11451149.CrossRefGoogle ScholarPubMed
6.Nyholm, D, Nilsson Remahl, AIM, Dizdar, N, et al.Duodenal levodopa infusionmonotherapy vs oral polypharmacy in advanced Parkinson disease. Neurology. 2005;64:216223.CrossRefGoogle ScholarPubMed
7.Schrag, A, Selai, C, Jahanshahi, M, Quinn, NP. The EQ-5D--a generic quality of life measure-is a useful instrument to measure quality of life in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry. 2000;69:6773.CrossRefGoogle ScholarPubMed
8.Gancher, ST, Woodward, WR, Nutt, JG. Apomorphine tolerance in Parkinson's disease: lack of a dose effect. Clin Neuropharmacol. 1996;19:5964.CrossRefGoogle ScholarPubMed