Levodopa methyl-ester/carbidopa effervescent tablets (CNP-1512) are currently approved for rescue therapy in PD in Italy (Chiesi Farmaceutici). Outside of Italy, the drug (V1512) is owned by Vernalis Pharmaceuticals. This preparation is approximately 250 times more soluble in water and can thus be easily dissolved and orally administered. Studies comparing the drug with standard levodopa preparations demonstrate a faster onset of action (by a mean of 8.5 minutes) and a longer total duration of action (mean 15 minutes longer) with fewer dose failures. A large 39-center European trial compared levodopa methyl-ester with standard levodopa in patients already on levodopa who were experiencing at least two hours of "off" time. At 12 weeks, subjects on levodopa methyl-ester tended to have less off time than levodopa (-39.4 vs. +3.4 minutes, P = 0.07). No unexpected adverse events have been noted. Phase III North American and European studies are planned (4).
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