Neupro Special Precautions

Talk to the doctor, pharmacist or nurse before using Neupro.
This medicine may affect blood pressure, so it should be measured regularly, especially at the beginning of treatment.
Loss of consciousness can occur. This can happen especially when the patient starts using Neupro or when the dose is increased. Tell the doctor if the patient loses consciousness or feel dizzy.
Eye examinations are recommended at regular intervals while using Neupro. However, if the patient notices any problems with the sight in-between examinations, contact the doctor immediately.
If the patient has serious liver problems, the doctor may need to adjust the dose. If the liver problems get worse during treatment, contact the doctor as soon as possible.
If the patient feels very drowsy or find that he/she falls asleep suddenly, please contact the doctor (see also Driving and using machines as follows).
Tell the doctor if the patient or the patient's family/carer notices developing urges or cravings to behave in ways that are unusual for the patient and cannot resist the impulse, drive or temptation to carry out certain activities that could harm himself/herself or others. These are called impulse control disorders and can include behaviours such as addictive gambling, excessive eating or spending, an abnormal high sex drive or preoccupation with an increase in sexual thoughts or feelings. The doctor may need to adjust or stop the dose.
Neupro may cause abnormal thinking and behaviour. This abnormal thinking and behaviour can consist of one or more of a variety of manifestations including abnormal thoughts about reality, delusions, hallucinations (seeing or hearing things that are not real), confusion, disorientation, aggressive behaviour, agitation, and delirium. If the patient notices such effects, please contact the doctor.
Neupro can cause skin reactions, such as reddening and itching. They are usually mild or moderate, and only affect the area of skin the patch has been on. The reactions normally disappear after a few hours when you remove the patch. If the patient has a skin reaction which lasts for more than a few days, is severe, or spreads outside the area of skin that was covered by the patch, please contact the doctor.
Avoid sunlight and solarium exposure on areas of skin showing any kind of skin reaction caused by Neupro. To help avoid the skin reactions, put the patch on a different area of skin every day, and only use the same area again after 14 days.
Neupro contains sodium metabisulphite (E223): Sodium metabisulphite (E223) may rarely cause severe hypersensitivity reactions and bronchospasm.
Driving and using machines: Neupro may make the patient feel very drowsy, and may fall asleep very suddenly. If this affects the patient, do not drive or take part in activities where not being alert may put the patient or others at risk of serious injury, for example, using machines.
In isolated cases people have fallen asleep while driving and this has caused accidents.
Children and adolescents: Neupro should not be used by children because its safety and efficacy has not been established in children.
Pregnancy and breast-feeding: If pregnant or breast-feeding, may be pregnant or are planning to have a baby, ask the doctor or pharmacist for advice before taking this medicine.
Do not use Neupro if the patient is pregnant, as the effects of rotigotine on pregnancy and the unborn baby are not known. Breast-feeding is not recommended during treatment with Neupro. Rotigotine may pass into the breast milk and affect the baby and is also likely to reduce the amount of milk produced.