Drug General Information (ID: DDI6AYGOL1)
Drug Name			Levodopa		Drug Info		Ferrous gluconate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Dopaminergic Antiparkinsonism Agents				Iron Supplement
Structure

Mechanism of Levodopa-Ferrous gluconate Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Levodopa				Ferrous gluconate
Mechanism		Binds to polyvalent cations				Polyvalent cations
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Ferrous gluconate due to formation of complexes caused by Levodopa

Recommended Action
Management		Until more information is available, patients receiving levodopa and/or carbidopa in combination with iron-containing products should be advised to separate the times of administration by as much as possible. Patients should be monitored for reduced efficacy of levodopa, and the dosage adjusted as necessary.

References
1	Campbell NR, Hasinoff B "Ferrous sulfate reduces levodopa bioavailability: chelation as a possible mechanism." Clin Pharmacol Ther 45 (1989): 220-5. [PMID: 2920496]
2	Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5. [PMID: 2054263]
3	Campbell NR, Rankine D, Goodridge AE, Hasinoff BB, Kara M "Sinemet-ferrous sulphate interaction in patients with Parkinson's disease." Br J Clin Pharmacol 30 (1990): 599-605. [PMID: 2291872]
4	Greene RJ, Hall AD, Hider RC "The interaction of orally administered iron with levodopa and methyldopa therapy." J Pharm Pharmacol 42 (1990): 502-4. [PMID: 1980293]