Requip PD

Ropinirole HCl

Treatment of Parkinson's disease as initial treatment in monotherapy, in order to delay the introduction of levodopa; in combination w/ levodopa, over the course of the disease, when the effect of levodopa wears off or becomes inconsistent & fluctuations in the therapeutic effect occur ("end of dose" or "on-off" type fluctuations).

Initially 2 mg once daily for the 1st wk, increased to 4 mg once daily from the 2nd wk. If sufficient symptomatic control is not achieved or maintained at a dose of 4 mg once daily, the daily dose may be increased by 2 mg at wkly or longer intervals up to a dose of 8 mg once daily. If sufficient symptomatic control is still not achieved or maintained at a dose of 8 mg once daily, the daily dose may be increased by 2-4 mg at 2 wkly or longer intervals. Max: 24 mg daily. Switching from Requip immediate-release (IR) to Requip PD prolonged-release (PR) Total daily dose: 0.75-2.25 mg IR=2 mg PR; 3-4.5 mg IR=4 mg PR; 6 mg IR=6 mg PR; 7.5-9 mg IR=8 mg PR; 12 mg IR=12 mg PR; 15-18 mg IR=16 mg PR; 21 mg IR=20 mg PR; 24 mg IR=24 mg PR. End stage renal disease (CrCl <30 mL/min), patient on haemodialysis Initially 2 mg once daily. Max: 18 mg/day in patients receiving regular dialysis.

May be taken with or without food: Swallow whole, do not chew/crush/divide.

Hypersensitivity. Severe renal impairment (CrCl <30 mL/min) w/o regular haemodialysis. Hepatic impairment.

Monitor BP particularly in patients w/ severe CV disease (in particular coronary insufficiency). Patients w/ history or presence of major psychotic disorders. Monitor regularly for development of impulse control disorders & its behavioural symptoms, including pathological gambling, increased libido, hypersexuality, compulsive spending or buying, binge eating & compulsive eating. Associated w/ somnolence & episodes of sudden sleep onset, particularly in patients w/ Parkinson's disease. Symptoms suggestive of neuroleptic malignant syndrome w/ abrupt w/drawal. Risk of incomplete release of medication & of medication residue in the stool if rapid GI transit occurs. Dopamine agonist w/drawal syndrome; discontinue treatment gradually. Hallucinations when treated w/ dopamine agonists & levodopa. Rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. 4-mg tab contains azo colouring agent sunset yellow (E110). Adjust dose in patients w/ end stage renal disease (patients on haemodialysis). Not recommended in patients w/ hepatic impairment. Exercise caution while driving or operating machines during treatment. Pregnancy & lactation. Elderly. Not recommended in childn <18 yr.

Somnolence, nausea, hallucinations, dizziness, sudden onset of sleep, constipation, oedema peripheral, postural hypotension, hypotension, dyskinesia.

Decreased effectiveness w/ neuroleptics & other centrally-active dopamine antagonists eg, sulpiride or metoclopramide. Increased C_max & AUC w/ CYP1A2 inhibitors eg, ciprofloxacin, enoxacin, cimetidine or fluvoxamine. Increased plasma conc w/ high doses of oestrogens. Dose adjustment may be necessary if patients stop or start smoking (CYP1A2 inducer).

Antiparkinsonian Drugs

N04BC04 - ropinirole ; Belongs to the class of dopamine agonist. Used in the management of Parkinson's disease.

P₁S₁S₃