Levodopa in Patients with a History of Melanoma

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Parkinson Diseases Manual By Lianna Marie

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Levodopa is an intermediary metabolite in the synthesis of melanin. For this reason, there has been long-standing concern that this medication might potentially promote the growth of melanoma. While melanoma obviously occurs in patients on levodopa therapy, there is no evidence that the incidence differs from that in the general population (96-99), other than that there seems to be a higher risk for melanoma in patients with PD, even without levodopa treatment (100). In studies of patients with melanoma, levodopa exposure is rare (101). Thus, although the package insert warns that levodopa should not be used in patients with melanoma or suspicious skin lesions (102-105), there is no clinical evidence to support this admonition (106-109). Nonetheless, in patients with PD and a history of melanoma, it would seem prudent to both defer levodopa therapy until other medications prove inadequate and to monitor closely for recurrent melanoma.

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