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Lack of a pharmacokinetic interaction at steady state between ropinirole and
L-dopa in patients with Parkinson's disease.

STUDY OBJECTIVE: To assess the interaction between therapeutic dosages of
ropinirole and L-dopa plus a decarboxylase inhibitor administered at steady
state in patients with Parkinson's disease. DESIGN. Open, 6-week, overlap
trial with random allocation. PATIENTS: Thirty patients with Parkinson's
disease not previously treated with dopamine agonists, of whom 28 produced
evaluable pharmacokinetic data for ropinirole and 23 for L-dopa.
INTERVENTION: Group A (14 patients) received L-dopa for weeks 1-5 and
ropinirole in increasing increments for weeks 2-6; group B (16) received
ropinirole for weeks 1-5 and L-dopa for weeks 5 and 6. MEASUREMENTS AND MAIN
RESULTS: Primary end points were AUC0-8 and Cmax for ropinirole, and AUC0-8,
AUC0-infinity and Cmax for L-dopa. Secondary end points were Tmax for
ropinirole, and Tmax and half-life for L-dopa. Coadministration with L-dopa
at steady state did not affect rate or extent of availability of ropinirole:
point estimates of the geometric mean ratio for ropinirole plus L-dopa
compared with ropinirole alone for both Cmax and AUC0-8 approximated to
unity. The small (16%) increase in peak concentrations of L-dopa on
administration with ropinirole is unlikely to be of clinical consequence, as
peak concentrations of L-dopa are typically highly variable. CONCLUSION:
There are no pharmacokinetic grounds for adjusting dosages of either
ropinirole or L-dopa when given in combination.

Pharmacotherapy 1999 Feb;19(2):150-6
Taylor AC, Beerahee A, Citerone DR, Cyronak MJ, Leigh TJ, Fitzpatrick KL,
Lopez-Gil A, Vakil SD, Burns E, Lennox G
SmithKline Beecham Pharmaceuticals, Welwyn, Herts, UK.
PMID: 10030765, UI: 99153836

janet paterson
52 now / 41 dx / 37 onset
613 256 8340 po box 171 almonte ontario canada K0A 1A0
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