Lack of a Pharmacokinetic Interaction at Steady State Between Ropinirole and L‐Dopa in Patients with Parkinson's Disease

Taylor, Anne C.; Beerahee, A; Citerone, David R.; Cyronak, Matthew J.; Leigh, T. J.; Fitzpatrick, K; López‐Gil, Arturo; Vakil, S. D.; Burns, Eileen; Lennox, Graham

doi:10.1592/phco.19.3.150.30927

Cited by 13 publications

(11 citation statements)

References 15 publications

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“…The accuracy values of processed ropinirole samples (30.0, 4500.0 pg/ml; n = 6) were 1.7% and −5.4%, respectively, when kept at room temperature for 24 h. Table 1 provides its mean pharmacokinetic parameters and range. Ropinirole had approximately linear pharmacokinetics when given as a single dose, and was eliminated with a half-life of approximately 6 h. Peak plasma concentrations of ropinirole were reached within 0.74-2 h. These findings are in agreement with the previously reported pharmacokinetic parameters of ropinirole [6][7][8][9]. Although the mean AUC inf and C max of ropinirole were 16.2% and 8.9% greater respectively in the Madopar phase than in the placebo phase, the other pharmacokinetic parameters were not significantly different between the two phases.…”

Section: Validation Of the Methodssupporting

confidence: 91%

“…Research about the disposition and metabolic fate of ropinirole has been carried out in animals and humans [5]. Previous work has examined the pharmacokinetics of ropinirole in Caucasian [6][7][8] and has observed the lack of a pharmacokinetic interaction between ropinirole and levodopa plus carbidopa at steady state in Caucasian patients with PD [9]. However the effects of Madopar on the pharmacokinetics of ropinirole in Asians have not yet been examined.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of Madopar on the pharmacokinetics of ropinirole in healthy Chinese volunteers

Wen

Jia

Luo

et al. 2007

Journal of Pharmaceutical and Biomedical Analysis

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Section: Validation Of the Methodssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The effect of Madopar on the pharmacokinetics of ropinirole in healthy Chinese volunteers

Wen

Jia

Luo

et al. 2007

Journal of Pharmaceutical and Biomedical Analysis

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“…Low (1.5 mg/d) and high (4.5 mg/d) pramipexole doses administered concomitantly with levodopa did not alter levodopa bioavailability in a double‐blind, placebo‐controlled trial 19 . There was no pharmacokinetic interaction reported under coadministration of ropinirole and levodopa in PD patients not previously treated with dopamine agonists 20 …”

Section: Discussionmentioning

confidence: 93%

Lack of Pharmacokinetic Interactions Between Transdermal Rotigotine and Oral Levodopa/Carbidopa

Braun

Cawello

Andreas

et al. 2009

The Journal of Clinical Pharma

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This open-label phase I trial assessed potential pharmacokinetic interactions between oral levodopa/carbidopa and transdermal rotigotine treatment at steady state. Twenty-four participants with idiopathic restless legs syndrome (12 per group) received levodopa/carbidopa (100 mg/25 mg bid) and rotigotine (initial dose 2 mg/24 h for 3 days, followed by 4 mg/24 h) in a randomized sequence as monotherapy and in combination during hospitalization for 13 days. Primary pharmacokinetic parameters were AUC(ss) and C(max,ss) of levodopa, carbidopa, and rotigotine at steady state. Mean concentration-time profiles of the 3 agents were similar during monotherapy and combination treatment. The point estimate for the ratio of geometric means (combined vs monotherapy) for AUC(ss) and C(max,ss) for levodopa (0.98 and 1.04), carbidopa (1.03 and 1.06), and unconjugated rotigotine (1.02 and 0.98) was near unity. All 90% confidence intervals were within the acceptance range for bioequivalence (0.8, 1.25). The most frequently documented adverse events were application site reactions (itching and reddening at application site) and headache. Most adverse events were mild to moderate in intensity, but 2 were of severe intensity (headache and extrasystoles); no serious adverse events occurred. The data presented indicate that rotigotine and levodopa/carbidopa can be coadministered without pharmacokinetic interactions between the compounds.

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“…32 A study evaluating the pharmacokinetic interaction of ropinirole and levodopa demonstrated that their co-administration does not affect the bioavailability of ropinirole and may cause an average increase of only 16% in the maximum steady-state concentration of levodopa (see Table 3). 37 However, the study also noted that peak concentrations of levodopa are highly variable and, in some individuals, may increase up to 47% when administered with ropinirole. 37 Yet, in various clinical trials of dopamine agonists, the dose of levodopa was reduced by approximately 20% in patients with a positive clinical response to the adjunctive therapy, demonstrating that pharmacodynamic interactions may be of greater clinical significance (see Table 3).…”

Section: Frontiers In Neuropharmacotherapy Part IImentioning

confidence: 91%

“…37 However, the study also noted that peak concentrations of levodopa are highly variable and, in some individuals, may increase up to 47% when administered with ropinirole. 37 Yet, in various clinical trials of dopamine agonists, the dose of levodopa was reduced by approximately 20% in patients with a positive clinical response to the adjunctive therapy, demonstrating that pharmacodynamic interactions may be of greater clinical significance (see Table 3). 32,[38][39] …”

Section: Frontiers In Neuropharmacotherapy Part IImentioning

confidence: 91%

Frontiers in Neuropharmacotherapy Part II: Multiple Sclerosis and Parkinson’s Disease

Chappell

Cohen

2002

Journal of Pharmacy Practice

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Disease-modifying agents such as -interferons and glatiramer acetate have a significant impact on slowing the course of relapsing-remitting multiple sclerosis (MS). Therapeutic guidelines recommend initiating therapy with 1 of the 3 agents shortly after diagnosis of clinically definite MS, but there is insufficient data to specifically select one of the therapies. New research helps differentiate the therapies based on their induction of neutralizing antibodies, optimal dosing, and monitoring strategies. New treatments for secondary progressive MS are also emerging with evidence for the use of interferon -1b and the approval of mitoxantrone. Future therapies for MS include oral glatiramer acetate and combination therapy. Levodopa continues to be the standard of care for the treatment of Parkinson's disease, but the approval of newer therapies that spare the use of levodopa and improve safety profiles are changing the management of the disease. Dopamine agonists such as bromocriptine and pergolide have been used to manage complications of levodopa therapy in patients with advanced disease, but new research supports the use of the more selective dopamine agonists, pramipexole and ropinirole, as monotherapy in early Parkinson's disease. The combination of a catechol-O-methyltransferase (COMT) inhibitor with levodopa provides a new therapeutic option for treating patients with motor complications in advanced disease. KEY WORDS: Multiple sclerosis, Parkinson's disease, pharmacotherapy.R ESEARCH DURING the "Decade of the Brain" provided significant advances in the treatment of many neurological diseases. In "Frontiers in Neuropharmacotherapy, Part I," 1 new studies evaluating the safety and efficacy of recently approved drugs for Alzheimer's disease and epilepsy were reviewed. In Part II of this review, studies evaluating the role of new therapies in the medical management of multiple sclerosis (MS) and Parkinson's disease will be discussed. MULTIPLE SCLEROSISAdvances in the treatment of multiple sclerosis epitomize changes in neurology over the past decade. Interferon (IFN) β-1b, approved by the FDA in 1993, was one of the earliest neurologic therapies approved in the Decade of the Brain, and was the first breakthrough for the treatment of MS. The approval of 2 additional agents, IFN β-1a and glatiramer acetate, followed in 1996. Clinical trials have shown that these disease-modifying agents have a favorable impact on the clinical course of relapsing-remitting MS (RRMS), and there is a growing consensus that treatment with one of these agents should be started when a definitive diagnosis is made. 2 However, the optimal dose and route of administration, duration of benefit, mechanism of action, and use in types of MS other than the relapsing-remitting form remain unclear for these therapies. Furthermore, while JOURNAL OF PHARMACY PRACTICE 2002. 15;3:221-240

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Lack of a Pharmacokinetic Interaction at Steady State Between Ropinirole and L‐Dopa in Patients with Parkinson's Disease

Abstract: There are no pharmacokinetic grounds for adjusting dosages of either ropinirole or L-dopa when given in combination.

Cited by 13 publications

References 15 publications

The effect of Madopar on the pharmacokinetics of ropinirole in healthy Chinese volunteers

The effect of Madopar on the pharmacokinetics of ropinirole in healthy Chinese volunteers

Lack of Pharmacokinetic Interactions Between Transdermal Rotigotine and Oral Levodopa/Carbidopa

Frontiers in Neuropharmacotherapy Part II: Multiple Sclerosis and Parkinson’s Disease

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