Session Information
Date: Monday, September 23, 2019
Session Title: Neuropharmacology
Session Time: 1:45pm-3:15pm
Location: Les Muses Terrace, Level 3
Objective: The aim of this study is to evaluate the pharmacokinetics of levodopa in patients with Parkinson’s disease (PD) who underwent gastrointestinal surgery.
Background: Levodopa is the most potent medication for PD and is mainly absorbed in the duodenum and the proximal jejunum. The pharmacokinetics of levodopa is affected by several factors, such as gastric emptying, gastric acid secretion, and protein intake. We reported that stomach structure is related to levodopa absorption, but there were few reports describing the pharmacokinetics of levodopa in PD patients who underwent gastrointestinal surgery.
Method: We measured the concentrations of levodopa in two cases who underwent different gastrointestinal surgery.
Results: Case 1 is a 76-year-old male PD patient, who was diagnosed with hypopharyngeal and esophageal cancer at an age of 73 years. He underwent esophagectomy with free the jejunal autograft and gastric tube reconstruction. Plasma levodopa concentration showed time to peak concentration (Tmax) after food intake was shorter than that without food intake (1.5h vs 1.0h). Food was considered to affect the absorption of levodopa in case 1. Case 2 is a 84-year-old male PD patient, who was diagnosed with gastric cancer at an age of 82 years. He underwent total gastrectomy with Roux-en-Y gastric bypass. The reconstruction procedures were as follows: the jejunum was separated from the duodenum and connected to the remaining end of the esophagus, and the remaining duodenum was connected farther down the jejunum from where the esophagus and jejunum were attached. Plasma levodopa concentration achieved peak within one hour both after food intake and without food intake (Tmax 0.75h vs 1.0h). Case 2 was considered showing rapid absorption of levodopa with little influence of food intake.
Conclusion: Our results might suggest that the operative methods affect the pharmacokinetics of levodopa in PD patients who underwent gastrointestinal surgery.
To cite this abstract in AMA style:
N. Miyaue, M. Nomoto, H. Yabe, Y. Yamanishi, S. Tada, R. Ando, M. Kubo, M. Nagai. Effect of gastrointestinal surgery on the pharmacokinetics of levodopa in Parkinson’s disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/effect-of-gastrointestinal-surgery-on-the-pharmacokinetics-of-levodopa-in-parkinsons-disease/. Accessed June 15, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-gastrointestinal-surgery-on-the-pharmacokinetics-of-levodopa-in-parkinsons-disease/