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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

<http://www.ncbi.nlm.nih.gov/PubMed/>

janet paterson
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