Improved high-performance liquid chromatographic analysis with double detection system for L-dopa, its metabolites and carbidopa in plasma of parkinsonian patients under L-dopa therapy.

An analytical method is described for measuring L-3,4-dihydroxyphenylalanine (L-DOPA), 3-O-methyl-DOPA, dihydroxyphenylacetic acid, free catecholamines and the peripheral DOPA decarboxylase inhibitor, carbidopa, in plasma samples of Parkinsonian patients by using high-performance liquid chromatography. A sample preparation method is presented for the isolation of the catecholamines and L-DOPA with its metabolites. Catecholamines are extracted by weak cation exchange on small columns and subsequent adsorption on alumina. L-DOPA, 3-O-methyl-DOPA, dihydroxyphenylacetic acid and carbidopa contained in the column effluents are directly injected in the chromatographic system. The eluates are separated on a reversed-phase column, monitored by both a coulometric electrochemical detector and a fluorescence detector, connected in series. Chromatographic peaks were identified on the basis of their retentions and response ratios of the two detectors. Two examples are presented of therapeutic drug monitoring in Parkinsonian patients treated with oral doses and continuous intravenous infusion of L-DOPA.