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December 27, 1971

Cardiovascular Effects of Levodopa

Author Affiliations

From the Clinical Pharmacology Program and the departments of medicine and pharmacology, Emory University School of Medicine, Atlanta. Dr. Whitsett is now with the University of Oklahoma School of Medicine, Oklahoma City.

JAMA. 1971;218(13):1921-1923. doi:10.1001/jama.1971.03190260037010

The cardiovascular side effects of levodopa are potentially dangerous. It is important, therefore, that physicians understand the mechanisms involved in their production so that if treatment is indicated, a rational approach may be instituted. Investigations in the dog have shown that the acute cardiovascular actions of levodopa are primarily due to dopamine which is released into the circulation by decarboxylation of the amino acid.1

Cardiovascular Actions of Dopamine  The actions of dopamine are complex because the amine acts on three different receptors: β-adrenergic receptors to stimulate the heart,2 α-adrenergic receptors to cause vasoconstriction,2,3 and dopaminergic receptors to cause renal3,4 and mesenteric5 vasodilation (Fig 1).When dopamine hydrochloride is infused intravenously at rates of 2.6μg to 7.1μg/kg/min to normal subjects, cardiac output increases, heart rate is not significantly altered, total peripheral resistance decreases, and renal blood flow and sodium excretion increase.4 When higher rates of infusion