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Dopaminergic drugs

 
, medical expert
Last reviewed: 08.07.2025
 
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Levodopa. Dioxyphenylalanine (DOPA or DOPA) is a biogenic substance formed in the body from tyrosine and is a precursor of dopamine, which in turn is converted into norepinephrine and then into adrenaline. Levodopa is well absorbed when taken orally, with the maximum concentration in the blood plasma being created after 1-2 hours. It is excreted largely by the kidneys, less with feces.

The drug is administered orally during or after meals. The initial dose is usually 0.25 g, every 2-3 days the dose is increased by 0.25 g to a daily dose of 3 g.

The drug reduces psychomotor and emotional reactions.

Studies have shown that levodopa, by restoring the activity of the sympathetic nervous system, promotes a more rapid disappearance of heart failure symptoms and accelerates reparative processes. After a course of levodopa treatment, dopamine excretion increased by 3.4 times, and norepinephrine excretion by 65%, which indicates a significant increase in the intensity of biosynthesis of both dopamine and norepinephrine. At the same time, adrenaline excretion remained unchanged. Accordingly, the norepinephrine/adrenaline ratio increases by 1.5 times.

Levodopa stimulates the synthesis of norepinephrine, thereby promoting a more rapid disappearance of the symptoms of heart failure. Identical patterns are observed in a number of complications of pregnancy and childbirth - the norepinephrine/adrenaline ratio is disrupted and therefore the use of levodopa is effective in terms of preventing weakness of labor.

In experiments on rats, mice and rabbits, no embryofetotoxic or teratogenic effect was found; even in doses of 75-150-300 mg/kg, the drug administered to rats on days 6-15 of pregnancy did not have a harmful effect on the fetus.

Levodopa is successfully used in doses of 0.25-2 g/day in the complex therapy of miscarriage.

When using the drug, various side effects are possible in the form of dyspeptic phenomena (nausea, vomiting, loss of appetite), orthostatic hypotension, arrhythmia, headache, involuntary movements, anxiety, tachycardia.

Release form: capsules and tablets of 0.25 and 0.5 g in packages of 100 and 1000 pieces.

Methyldopa (methyldopum, dopegyt). A precursor of the "false" adrenergic mediator alpha-methylnoradrenaline, a dopa-decarboxylase inhibitor, methyldopa, like clonidine, inhibits synaptic impulses and causes a decrease in arterial pressure. Hypotension is accompanied by a slowing of heart contractions, a decrease in cardiac output and peripheral resistance.

Methyldopa is used as a hypotensive agent that reduces peripheral vascular resistance and is effective in hypertension. The drug does not have a stronger hypotensive effect than sympatholytics, but is better tolerated and causes fewer side effects. Therefore, it is increasingly used in the treatment of arterial hypertension during pregnancy, childbirth, and the postpartum period, without having a negative effect on the mother's body, the condition of the fetus, and the newborn. It is not yet entirely clear whether methyldopa crosses the placental barrier, but its use in the last trimester of pregnancy has not revealed fetoembryotoxic or teratogenic effects.

Methyldopa is prescribed orally in the form of 0.25 g tablets. Usually they start with 0.25-0.5 g per day, then the dose is increased to 0.75-1 g, and if the effect is insufficient, to 1.5-2 g per day.

It should be taken into account that the effect of methyldopa is short-lived and after discontinuing the drug, blood pressure rises again.

Release form: tablets of 0.25 g in a package of 50 pieces.

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