L-Dopa prodrugs: an overview of trends for improving parkinson's disease treatment

A Di Stefano, P Sozio… - Current …, 2011 - ingentaconnect.com
A Di Stefano, P Sozio, L Serafina Cerasa, A Iannitelli
Current pharmaceutical design, 2011ingentaconnect.com
L-Dopa is the mainstay of Parkinson's disease therapy; this drug is usually administered
orally, but it is extensively metabolized in the gastrointestinal tract, so that relatively little
arrives in the bloodstream as intact L-Dopa. The peripheral conversion of L-Dopa by amino
acid decarboxylase to dopamine is responsible for the typical gastrointestinal and
cardiovascular side effects. To minimize the conversion to dopamine outside the central
nervous system, L-Dopa is usually given in combination with peripheral inhibitors of amino …
L-Dopa is the mainstay of Parkinson's disease therapy; this drug is usually administered orally, but it is extensively metabolized in the gastrointestinal tract, so that relatively little arrives in the bloodstream as intact L-Dopa. The peripheral conversion of L-Dopa by amino acid decarboxylase to dopamine is responsible for the typical gastrointestinal and cardiovascular side effects. To minimize the conversion to dopamine outside the central nervous system, L-Dopa is usually given in combination with peripheral inhibitors of amino acid decarboxylase. In spite of that, other central nervous side effects such as dyskinesia, on-off phenomenon and end-of-dose deterioration still remain. The main factors responsible for the poor bioavailability are the drug's physical-chemical properties: low water and lipid solubility, resulting in unfavorable partition, and the high susceptibility to chemical and enzymatic degradation. Starting from these considerations the prodrug approach has been applied to L-Dopa in order to overcome its metabolism problems and to improve its bioavailability. The goal of this paper is to provide the reader with a critical overview on L-Dopa prodrugs here classified according to the nature of the main chemical modification on L-Dopa backbone that led to the formation of the desired derivative.
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