Principles of personalized medicine and modern pharmaceutical technologies to optimize levodopa therapy of Parkinson's disease

Abstract

Levodopa (3-hydroxy-L-tyrosine, the levorotatory isomerof 3,4-dihydroxyphenylalanine) is a biological precursor of the neurotransmitter dopamine and has been the "gold standard" in the treatment of Parkinsons disease for over 50 years. The widespread use of levodopa in clinical practice has not only provided neurologists with unique data from many years of symptomatic replacement therapy for a severe neurodegenerative disease but has also clearly identified several serious problems associated with levodopa absorption and metabolism. This article discusses the modern approaches to personalized medicine, which aim to overcome the numerous difficulties in managing patients with Parkinsons disease and long-term levodopa use. A major focus is the review of strategies for selecting the optimal levodopa dosage regimen in specific patients and the main innovative dosage forms of this drug that improve its pharmacokinetics.

Keywords

• parkinson's disease
• levodopa
• dyskinesia
• motor fluctuations
• pharmacokinetics
• therapeutic drug monitoring