Ropinirole
Antiparkinsonism Preps · Dopamine agonist, dopaminergic agent
Indications
Monotherapy or as an adjunct to levodopa in idiopathic Parkinson's disease. Symptomatic treatment of moderate to severe idiopathic restless legs syndrome.
Dosage
Adults: Parkinson's disease: Week 1: 0.25 mg three times daily with meals. Week 2: 0.5 mg three times daily. Week 3: 0.75 mg three times daily. Week 4: 1 mg three times daily. If necessary, continue to titrate in wkly increments of up to 3 mg daily. Symptom control may be seen at 3 - 9 mg daily; max 24 mg daily. Idiopathic restless legs syndrome: Initially 0.25 mg once daily at bed time for 2 days. If well tolerated, increase to 0.5 mg once daily for remainder of wk 1. Increase if necessary by 0.5 mg per wk to usual dose of 2 mg once daily; max 4 mg once daily. Children: Not recommended.
Adverse Effects
GI upset, nausea, abdominal pain, somnolence, leg oedema, nervousness, dizziness, fatigue, syncope, hypotension, bradycardia, dyskinesias, hallucinations, confusion. Rarely, sudden onset of sleep (warn patient).
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Severe renal or severe hepatic impairment. Precautions: Moderate hepatic impairment, severe cardiovascular disease; monitor BP. History of psychiatric disorders. Change in smoking habit. Risk of sudden sleep onset; warn patient. Monitor for impulse control disorders incl pathological gambling, hypersexuality, compulsive spending or eating. Haemodialysis. Withdraw gradually. Elderly.
Interactions
Ciprofloxacin, enoxacin, fluvoxamine, HRT, starting or stopping smoking, neuroleptics, sulpiride, metoclopramide, antipsychotics, antihypertensives, antiarrhythmics, other inhibitors of CYP1A2, vit K antagonists.
Advice to Patient
Take with or without meals. To reduce occurrence of nausea or GI upset, take with meals. Do not chew or crush or divide tablets, swallow whole. Contact prescriber if there is difficulty in walking, change in gait, pain or burning on urination, pus or blood in urine, chest pain, palpitations, chest tightness, unusual cough, increased sleepiness, hallucinations, confusion, lack of sleep, unusual dreams, loss of memory, increased urge for any activity. Do not take any new medication especially those that cause drowsiness without consulting prescriber. Avoid alcohol during therapy. Change position slowly from sitting or lying to standing, avoid quick moves. Have regular skin examination by a dermatologist.
Pharmacokinetics
Absorption: Immediate release: Rapid. Metabolism: Extensively hepatic; first-pass effect. Bioavailability: Absolute: 45%-55%. Half-life elimination: Approx. 6 hrs. Time to peak: Immediate release: Approx. 1-2 hrs; Extended release: 6-10 hrs; Tmax increased by 2.5-3 hrs when taken with a high-fat meal. Excretion: Urine (<10% as unchanged drug, 60% as metabolites).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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