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Effects of levodopa on the renin‐aldosterone system
Author(s) -
Katz Fred H.,
Hoehn Margaret M.
Publication year - 1977
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt1977214388
Subject(s) - aldosterone , fludrocortisone , plasma renin activity , levodopa , orthostatic vital signs , medicine , endocrinology , renin–angiotensin system , natriuresis , blood pressure , hydrocortisone , parkinson's disease , disease
Plasma renin activity and plasma aldosterone, supine and erect, and urinary aldosterone levels were measured in 18 patients on normal sodium diets and in 11 patients on low sodium diets, all of whom also were on long‐term levodopa therapy. Of the 230 hormone measurements, 185 were normal, 11 were high, and 34 were low. Most of the low levels were in 3 patients who had recently received fludrocortisone for orthostatic hypotension, and the renin‐aldosterone systems might have been suppressed by it. In another phase of this study, 4 subjects were maintained on a constant diet for 6 wk, while the effect of gradualty increasing dosages of levodopa on mineral balance and renin‐aldosterone was determined. In 3 of the 4 patients there was a mild natriuretic effect of levodopa (previously demonstrated for acute levodopa therapy). There were no significant consistent changes in renin or aldosterone levels while levodopa was being administered. These studies indicate that levodopa does not usualty suppress the elements of the renin‐aldosterone system and that such a mechanism is unlikely to be the cause of orthostatic hypotension during the course of levodopa therapy. Since levodopa may induce natriuresis, in this situation unchanged levels of renin and aldosterone may, however, represent an inappropriately low set of this hormonal system.