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Review
. 2024;14(7):1353-1368.
doi: 10.3233/JPD-240036.

Molecular Variability in Levodopa Absorption and Clinical Implications for the Management of Parkinson's Disease

Ana Luisa Pedrosa de Menezes  1 , Bastiaan R Bloem  2 , Milan Beckers  2 , Capucine Piat  1 , Eduardo E Benarroch  1 , Rodolfo Savica  1
Affiliations
Review

Molecular Variability in Levodopa Absorption and Clinical Implications for the Management of Parkinson's Disease

Ana Luisa Pedrosa de Menezes et al. J Parkinsons Dis. 2024.

Abstract

Levodopa is the most widely used medication for the symptomatic treatment of Parkinson's disease and, despite being an "old" drug, is still considered the gold standard for offering symptomatic relief. The pharmacokinetic and pharmacodynamics of levodopa have been studied extensively. Our review explores the molecular mechanisms that affect the absorption of this drug, focusing on the large intra- and interindividual variability of absorption that is commonly encountered in daily clinical practice, and on the interaction with other medications. In addition, we will explore the clinical implications of levodopa absorption variability and address current and future strategies for researchers and clinicians.

Keywords: Levodopa; Parkinson’s disease; absorption; molecular pathway; transport.

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Conflict of interest statement

B.R.B. and R.S. are Editorial Board members of this journal, but were not involved in the peer-review process of this article nor they had access to any information regarding its peer review.

Figures

Fig. 1
Fig. 1
Overview on the molecular pathway of levodopa in the small intestine.
Fig. 2
Fig. 2
Overview on the molecular pathway of levodopa in the brain.
Fig. 3
Fig. 3
Elements that have a possible interference with Levodopa absorption.
Fig. 4
Fig. 4
Main transporters involved in Levodopa absorption and their genetic characteristics.
See this image and copyright information in PMC

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