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Levo-DOPA (L-DOPA) is a precursor of dopamine. Dopamine itself does not cross the blood-brain barrier and so is not effective as a drug. L-DOPA does enter the brain and is converted to dopamine in the striatum.
L-DOPA is usually given in conjunction with an inhibitor of dopamine decarboxylase. The inhibitor does not cross the blood-brain barrier hence the side-effects of peripheral dopamine production, such as nausea, are reduced while the central actions of L-DOPA are augmented.
NICE states that it is not possible to identify a universal first-choice drug therapy for people with early Parkinson's disease (PD). A possible initial first-choice therapy is levodopa therapy (2)
Levodopa, with a peripheral inhibitor of the aromatic L-amino acid decarboxylase such as carbidopa, is the most effective symptomatic treatment for PD; however, as PD progresses, oral medication inadequately controls symptoms due to an increasingly narrowing therapeutic window (3).
Foslevodopa/foscarbidopa, is a formulation of LD/CD phosphate prodrugs (3)
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