Skip to main content
NCBI home page
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1991 Apr;31(4):413–417. doi: 10.1111/j.1365-2125.1991.tb05555.x

The influence of protein containing meals on the pharmacokinetics of levodopa in healthy volunteers.

D R Robertson 1, I Higginson 1, B S Macklin 1, A G Renwick 1, D G Waller 1, C F George 1
PMCID: PMC1368327  PMID: 2049250

Abstract

1. The pharmacokinetics of levodopa and paracetamol after single oral doses have been investigated in eight healthy young volunteers in the fasted state and following isocaloric meals containing either 10.5 g or 30.5 g of protein. 2. The initial peak and maximum plasma drug concentrations and the times at which these occurred were not affected by food. 3. The mean area under the plasma concentration-time curve (AUC) for paracetamol following an overnight fast did not differ significantly from that observed following the low and high protein meals. 4. By contrast, the AUC for levodopa following the low protein meal (193.9 +/- 15.7 micrograms ml-1 min) was significantly lower compared with administration in the fasted state (216.5 +/- 26.1 micrograms ml-1 min). However, there were no significant differences in the kinetics of levodopa between the fasting state and following the high protein meal. 5. There was no evidence that consumption of a meal containing 30.5 g of protein impaired either the rate or extent of absorption of levodopa. Therefore the reported beneficial effects of a low protein diet in the treatment of patients with Parkinson's disease probably result from reduced competition for levodopa transport across the blood-brain barrier.

Full text

PDF
413

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baruzzi A., Contin M., Riva R., Procaccianti G., Albani F., Tonello C., Zoni E., Martinelli P. Influence of meal ingestion time on pharmacokinetics of orally administered levodopa in parkinsonian patients. Clin Neuropharmacol. 1987 Dec;10(6):527–537. doi: 10.1097/00002826-198712000-00004. [DOI] [PubMed] [Google Scholar]
  2. Carter J. H., Nutt J. G., Woodward W. R., Hatcher L. F., Trotman T. L. Amount and distribution of dietary protein affects clinical response to levodopa in Parkinson's disease. Neurology. 1989 Apr;39(4):552–556. doi: 10.1212/wnl.39.4.552. [DOI] [PubMed] [Google Scholar]
  3. Fabbrini G., Mouradian M. M., Juncos J. L., Schlegel J., Mohr E., Chase T. N. Motor fluctuations in Parkinson's disease: central pathophysiological mechanisms, Part I. Ann Neurol. 1988 Sep;24(3):366–371. doi: 10.1002/ana.410240303. [DOI] [PubMed] [Google Scholar]
  4. Frankel J. P., Kempster P. A., Bovingdon M., Webster R., Lees A. J., Stern G. M. The effects of oral protein on the absorption of intraduodenal levodopa and motor performance. J Neurol Neurosurg Psychiatry. 1989 Sep;52(9):1063–1067. doi: 10.1136/jnnp.52.9.1063. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gillespie N. G., Mena I., Cotzias G. C., Bell M. A. Diets affecting treatment of parkinsonism with levodopa. J Am Diet Assoc. 1973 May;62(5):525–528. [PubMed] [Google Scholar]
  6. Juncos J. L., Fabbrini G., Mouradian M. M., Serrati C., Chase T. N. Dietary influences on the antiparkinsonian response to levodopa. Arch Neurol. 1987 Oct;44(10):1003–1005. doi: 10.1001/archneur.1987.00520220009006. [DOI] [PubMed] [Google Scholar]
  7. Leenders K. L., Poewe W. H., Palmer A. J., Brenton D. P., Frackowiak R. S. Inhibition of L-[18F]fluorodopa uptake into human brain by amino acids demonstrated by positron emission tomography. Ann Neurol. 1986 Aug;20(2):258–262. doi: 10.1002/ana.410200212. [DOI] [PubMed] [Google Scholar]
  8. Marsden C. D., Parkes J. D. "On-off" effects in patients with Parkinson's disease on chronic levodopa therapy. Lancet. 1976 Feb 7;1(7954):292–296. doi: 10.1016/s0140-6736(76)91416-1. [DOI] [PubMed] [Google Scholar]
  9. Mena I., Cotzias G. C. Protein intake and treatment of Parkinson's disease with levodopa. N Engl J Med. 1975 Jan 23;292(4):181–184. doi: 10.1056/NEJM197501232920404. [DOI] [PubMed] [Google Scholar]
  10. Minami H., McCallum R. W. The physiology and pathophysiology of gastric emptying in humans. Gastroenterology. 1984 Jun;86(6):1592–1610. [PubMed] [Google Scholar]
  11. Nutt J. G., Woodward W. R., Hammerstad J. P., Carter J. H., Anderson J. L. The "on-off" phenomenon in Parkinson's disease. Relation to levodopa absorption and transport. N Engl J Med. 1984 Feb 23;310(8):483–488. doi: 10.1056/NEJM198402233100802. [DOI] [PubMed] [Google Scholar]
  12. Pincus J. H., Barry K. M. Plasma levels of amino acids correlate with motor fluctuations in parkinsonism. Arch Neurol. 1987 Oct;44(10):1006–1009. doi: 10.1001/archneur.1987.00520220012007. [DOI] [PubMed] [Google Scholar]
  13. Rivera-Calimlim L., Dujovne C. A., Morgan J. P., Lasagna L., Bianchine J. R. Absorption and metabolism of L-dopa by the human stomach. Eur J Clin Invest. 1971 May;1(5):313–320. doi: 10.1111/j.1365-2362.1971.tb00637.x. [DOI] [PubMed] [Google Scholar]
  14. Robertson D. R., Renwick A. G., Wood N. D., Cross N., Macklin B. S., Fleming J. S., Waller D. G., George C. F. The influence of levodopa on gastric emptying in man. Br J Clin Pharmacol. 1990 Jan;29(1):47–53. doi: 10.1111/j.1365-2125.1990.tb03601.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Robertson D. R., Wood N. D., Everest H., Monks K., Waller D. G., Renwick A. G., George C. F. The effect of age on the pharmacokinetics of levodopa administered alone and in the presence of carbidopa. Br J Clin Pharmacol. 1989 Jul;28(1):61–69. doi: 10.1111/j.1365-2125.1989.tb03506.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Tsui J. K., Ross S., Poulin K., Douglas J., Postnikoff D., Calne S., Woodward W., Calne D. B. The effect of dietary protein on the efficacy of L-dopa: a double-blind study. Neurology. 1989 Apr;39(4):549–552. doi: 10.1212/wnl.39.4.549. [DOI] [PubMed] [Google Scholar]
  17. Wade D. N., Mearrick P. T., Morris J. L. Active transport of L-dopa in the intestine. Nature. 1973 Apr 13;242(5398):463–465. doi: 10.1038/242463a0. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES