Neupro Dosage/Direction for Use

Patients Not Taking Levodopa: Early Stage of Parkinson's Disease: Start by using one Neupro 2 mg/24 h patch daily. From the second week, the daily dose will be increased by 2 mg, on a weekly basis, until reaching the right (maintenance) dose. For most patients, the right dose is between 6 mg and 8 mg per day (reached within 3 to 4 weeks).
The maximum dose is 8 mg per day.
Patients Taking Levodopa: Advanced Stage of Parkinson's Disease: Sart by using one Neupro 4 mg/24 h patch daily. From the second week, the daily dose will be increased by 2 mg, on a weekly basis, until reaching the right (maintenance) dose. For most patients, the right dose is between 8 mg and 16 mg per day (reached within 3 to 7 weeks).
The maximum dose is 16 mg per day.
If Neupro has to be discontinued, see Treatment Discontinuation.
Treatment Discontinuation: Do not stop Neupro suddenly without talking to the doctor. A sudden stop could cause development of neuroleptic malignant syndrome which may represent a major health risk. The symptoms include: Akinesia (loss of muscle movement), rigid muscles, fever, unstable blood pressure, tachycardia (increased heart rate), confusion, depressed level of consciousness (e.g. coma).
The daily dose of Neupro should be reduced gradually by 2 mg every other day.
For further questions on the use of this medicine, ask the doctor, pharmacist or nurse.
Administration: Neupro is applied once a day. For higher doses, multiple patches must be applied. The patch should be applied at approximately the same time every day. The patch remains on the skin for 24 hrs and will then be replaced by a new one at a different site of application. Changing of the patch should also be done at around the same time everyday. Do not cut the Neupro patches into pieces.
The patch should be applied to clean, dry, healthy skin on the shoulder, upper arm, belly, thigh, hip, flank (at the side, between the ribs and hip).
Reapplication to the same site within 14 days should be avoided. Neupro should not be placed on skin that is red, irritated or damaged.
To prevent the patch becoming loose or falling off: Do not put the patch in an area where it can be rubbed by tight clothing.
Do not use creams, oils, lotions, powders or other skin products on the area of skin under or near the patch.
In case of sticking the patch in a hairy area of skin, shave the area at least 3 days before sticking the patch.
If the patch falls off, a new patch should be applied for the rest of the day, then replace the patch at the same time as usual.
Note: Bathing, showering and exercising should not affect how Neupro works. Nevertheless, check that the patch has not fallen off afterwards.
Avoid external heat (for example excessive sunlight, saunas, hot baths heating pads or hot-water bottles) on the area of the patch.
If the patch has irritated the skin, keep that area protected from direct sunlight, as it may cause changes in the colour of the skin.
How to Use the Patch: Each patch is packed in a separate sachet. Stick Neupro onto the skin as soon as the sachet has been opened and the release liner has been removed.
To open the sachet, hold the two sides of the sachet. Peel apart the foil and open the sachet.
Take the patch out of the sachet.
The sticky side of the patch is covered by a transparent release liner. Hold the patch in both hands with the release liner facing the patient.
Bend the patch in half so that the S-shaped break in the liner opens.
Peel off one side of the release liner. Do not touch the sticky side of the patch with fingers.
Hold the other half of the rigid release liner and put the sticky surface of the patch onto the skin. Press the sticky side of the patch firmly into place.
Fold back the other half of the patch and remove the other side of the release liner.
Press the patch down firmly with the palm of hand for about 20 to 30 seconds to make sure the patch is touching the skin and the edges stick well.
Wash hands with soap and water immediately after handling the patch.
Removing the Patch: Slowly and carefully peel off the used patch.
Gently washing the area with warm water and mild soap should remove any adhesive that stays on the skin after removing the patch. A small amount of baby oil can also be used to remove any adhesive that would not wash off.
Do not use alcohol or other dissolving liquids such as nail polish remover as these may irritate the skin.
Choose a new area of skin where a new patch will be applied, then follow the instructions as mentioned.
If the patch was not changed at the usual time, change it as soon as it was remembered: Remove the old patch and use a new one. If sticking a new patch after removing the old one is forgotten, use a new patch as soon as it was remembered.
In both cases, on the following day, use a new patch at the usual time. Do not use a double dose to make up for a forgotten dose.