Hydrosoluble fiber (Plantago ovata husk) and levodopa I: Experimental study of the pharmacokinetic interaction

Fiber therapy could be used in patients with Parkinson disease to reduce the symptoms of gastrointestinal disorders; however, it could interact with levodopa reducing its effectiveness. In this experimental study we have investigated whether the presence of Plantago ovata husk (water-soluble fiber) modifies in rabbits the bioavailability and other pharmacokinetic parameters of levodopa (20 mg/kg) when administered by the oral route at the same time. We have also studied whether pharmacokinetic modifications are fiber-dose dependent (100 and 400 mg/kg). The extent of levodopa absorbed when administering 100 mg/kg of fiber (AUC = 43.4 μg min ml− 1) is approximately the same as when levodopa is administered alone (AUC = 47.1 μg min ml− 1); however, Cmax is lower (1.04 versus 1.43 μg ml− 1). Results obtained indicate that fiber at the higher dose increases the extent of levodopa absorbed (AUC = 62.2 μg min ml− 1), being the value of Cmax similar (1.46 μg ml− 1). The value of tmax increases from 10 min when levodopa is administered alone to 20 min when the animals receive fiber. On the other hand, since certain time on, levodopa concentrations are always higher in the groups that receive fiber: 60 min with 100 mg/kg fiber and 20 min with 400 mg/kg fiber. Fiber also increases the mean residence time (MRT). P. ovata husk administration with levodopa could be beneficial, not only in patients with constipation, due to: lower adverse reactions (lower values of Cmax) and longer and more stable effects (higher final concentrations and more time in the body).