Objective: To evaluate the possible effect of combined intake of levodopa/carbidopa and trimethoprim/sulfamethoxazole on the duration of ON/OFF periods in a PD patient.

Background: Drug interactions, MEDLINE, PubMED was searched. No data, indicating any possible interaction between levodopa/carbidopa and trimethoprim/sulfamethoxazole was found. A PD patient with positive family history for PD was prescribed biseptol (trimethoprim/sulfamethoxazole) 480 mg/d for 10 days because of acute bronchitis. During the period of biseptol intake patient noticed a significant increase in duration of ON periods from 1.5 h up to 2.0-2.5 h. After biseptol discontinuation duration of ON periods returned to 1.5 h.

Methods: A 12 weeks-long drug challenge trial was started with the aim to establish the efficacy of biseptol in increasing the duration of Levodopa ON. Treatment schedule consisted of three 2 week periods of combined settled-dose antiParkinsonian treatment with biseptol 480 mg/d BID with alternating three 2 week periods of the same antiParkinsonian drug regimen without biseptol. Patient completed Hauser ON/OFF diary.

Results: During the three combined treatment periods a statistically significant increase by 35 min (p<0.01) per ON period was observed. The total stay in ON period per day increased by 105 min (p<0.01). During the first period results were not statistically significant (p<0.25), during the second and third combined treatment periods the increase in ON period duration was statistically significant, p 0.003 and p 0.0005

1

Time	Three cycles with biseptol		Three cycles without biseptol
	On-state, min	Off-state, min	On-state, min	Off-state, min
Median per day, min	460,36	522,86	355,36	624,79
Median per intake , min	153,45	174,29	118,45	207,26

Time spent in ON period (per intake) was statistically significantly greater by 35 min (p<0.001) during three cycles combined treatment with biseptol.“. Time to ON onset didn’t change during combined treatment. No adverse events (exception: right clavicule fracture) were recorded during the whole trial, laboratory safety analysis obtained before and after the trial were normal.

Conclusions: Pharmacokinetic and pharmacodynamic interactions between levodopa/carbidopa and trimethoprim/sulfamethoxazole should be checked in the population of sporadic PD patients as well as in the group of genetic variants (mendelian AD type of inheritance) of PD.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/biseptol-a-new-antiparkinsonian-agent/