Drug Interactions in Parkinson’s Disease: Safety of Pharmacotherapy for Arterial Hypertension

BACKGROUND: Parkinson’s disease (PD) is a progressive neurodegenerative disorder of the central nervous system, observed in patients aged older than 50 years. In this study, we review interactions between therapies used in PD and selected antihypertensive agents. Moreover, in view of the lack of evidence-based recommendations regarding the pharmacotherapy of arterial hypertension in PD patients, we propose effective and safe therapeutic algorithms for these two coexisting conditions. METHOD: We used the “Drug interactions” database affiliated with the Ministry of Health, which allows for the identification of interactions between compared active compounds. The database is updated on a monthly basis and all data are consistent with current legislation. For information about interactions, we additionally added data from the British National Formulary, a joint publication of the British Medical Association and the Royal Pharmaceutical Society of Great Britain. In this analysis, we also used data from Micromedex(®), Cerner Multum™, Wolters Kluwer™, Lexicomp(®) and Stockley’s(®). We analysed the potential interactions between antihypertensive and anti-parkinsonian agents included in respective guidelines on the pharmacotherapy of these conditions. RESULTS: Our analysis revealed the lack of clinically relevant interactions between preparations of levodopa and benserazide (used for the treatment of PD) and angiotensin-converting enzyme inhibitors, antagonists of AT(1) receptor for angiotensin II or antagonists of β-adrenoreceptors (β-adrenolytics). CONCLUSION: To avoid major drug-to-drug interactions, patients receiving preparations of levodopa and benserazide should be prescribed angiotensin-converting enzyme inhibitors, antagonists of AT(1) receptor for angiotensin II, or antagonists of β-adrenoreceptors (β-adrenolytics) as the first-line agents of antihypertensive treatment.