title: Mucuna pruriens in Parkinson Disease: A Kinetic-Dynamic Comparison With Levodopa Standard Formulations.
abstract: OBJECTIVE
  We compared levodopa (LD) kinetic-dynamic profile of a dose of LD/aromatic amino acid decarboxylase peripheral inhibitors versus a nominally equivalent dose of a commercial Mucuna pruriens (Mucuna) seeds extract in 2 patients with Parkinson disease chronically taking LD standard combined with self-prescribed Mucuna.
  
  
  METHODS
  Patients were challenged with a fasting morning dose of 100 mg LD/25 mg carbidopa (patient 1) or benserazide (patient 2) versus 100 mg LD from Mucuna capsules in 2 different sessions, after a 12-hour standard LD formulations' washout. They underwent kinetic-dynamic LD monitoring based on LD dose intake and simultaneous serial assessments of plasma drug concentrations and motor test performances. Quantitative analysis of LD in Mucuna capsules was also performed.
  
  
  RESULTS
  Levodopa bioavailability was markedly lower after Mucuna administration compared with LD standard formulations: in patient 1, peak plasma LD concentration (Cmax) decreased from 2.0 to 1.0 mg/L and the area under the plasma concentration time curve from 137 to 33.6 mg/L per minute; in patient 2, Cmax was 0.7 mg/L after LD/benserazide and nearly undetectable after Mucuna. In patient 1, impaired LD bioavailability from Mucuna resulted in reduced duration and overall extent of drug response compared with LD/carbidopa. In patient 2, no significant subacute LD motor response was observed in either condition. Quantitative analysis of Mucuna formulation confirmed the 100 mg LD content for the utilized capsules.
  
  
  CONCLUSIONS
  Our results show an impaired LD bioavailability from Mucuna preparation, as expected by the lacking aromatic amino acid decarboxylase inhibitors coadministration, which might explain the suggested lower dyskinetic potential of Mucuna compared with standard LD formulations.
authors.affiliation: *IRCCS-ISNB Institute of Neurological Sciences of Bologna; †Department of Biomedical and Neuromotor Sciences, University of Bologna; ‡Department of Pharmacy and Biotechnology, University of Bologna; §Neurology Unit, St Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Contin
authors.forename: Giovanna
authors.initials: G
authors.lastname: Lopane
authors.forename: Andrea
authors.initials: A
authors.lastname: Passini
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Poli
authors.forename: Carmelina
authors.initials: C
authors.lastname: Iannello
authors.forename: Maria
authors.initials: M
authors.lastname: Guarino
mesh_terms: D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology; D001545:Benserazide / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D001682:Biological Availability; D002214:Capsules; D002230:Carbidopa / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D004359:Drug Therapy, Combination; D005260:Female; D041743:Herb-Drug Interactions; D006801:Humans; D007980:Levodopa / Q000493:pharmacokinetics* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000187:drug effects; D031299:Mucuna / Q000737:chemistry*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000378:metabolism; D008517:Phytotherapy / Q000379:methods*; D010936:Plant Extracts / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D012639:Seeds / Q000737:chemistry
chemical_list: D000978:Antiparkinson Agents; D002214:Capsules; D010936:Plant Extracts; D007980:Levodopa; D001545:Benserazide; D002230:Carbidopa