Ropinirole

Ropinirole: May be taken with or without food. May be taken w/ meals to reduce occurrence of nausea. Swallow whole, do not chew/crush/divide.

Patient with pre-existing dyskinesias, significant CV disease, predisposition to hypotension, cerebrovascular disease. Smokers. Avoid abrupt withdrawal. ESRD (undergoing dialysis) and hepatic impairment. Pregnancy and lactation. Patient receiving estrogen or CYP1A2 inhibitors or inducers. Not recommended for patient with severe renal impairment (CrCl <30 mL/min) without regular dialysis. Avoid use in patient with major psychotic disorder. Patient Counselling This drug may cause excessive daytime somnolence or sudden onset of sleep, if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure periodically; daytime alertness, CNS depression, fall risk, and behaviour changes. Perform periodic skin examinations.

Significant: Paradoxical worsening of RLS symptoms (augmentation or early morning rebound), impulse control disorders (e.g. pathological gambling, hypersexuality, compulsive buying, binge eating), dyskinesias, psychotic effects (e.g. hallucinations, paranoid ideation, delusions, confusion, psychotic-like behaviour, mania, disorientation, aggressiveness, agitation, delirium), somnolence and episodes of sudden sleep onset, orthostatic hypotension or hypotension; syncope, sometimes associated with bradycardia; fibrotic complications (e.g. pleural effusion, pleural fibrosis, interstitial lung disease, cardiac valvulopathy), neuroleptic malignant syndrome (abrupt withdrawal or rapid dose reduction), dopamine agonist withdrawal syndrome. Ear and labyrinth disorders: Vertigo. Gastrointestinal disorders: Nausea, vomiting, constipation, abdominal pain, heartburn, dyspepsia. General disorders and administration site conditions: Peripheral oedema, fatigue, pain. Immune system disorders: Hypersensitivity reaction (e.g. urticaria, angioedema, rash, pruritus). Infections and infestations: Viral infection. Injury, poisoning and procedural complications: Fall. Investigations: Increased liver enzymes. Nervous system disorders: Dizziness, headache. Vascular disorders: Hypertension.

Increased plasma concentration with CYP1A2 inhibitors (e.g. ciprofloxacin, enoxacin, fluvoxamine) and hormone replacement therapy (e.g. estrogen). May diminish therapeutic efficacy with neuroleptics (e.g. phenothiazines, butyrophenones, thioxanthenes) and other centrally active dopamine antagonists (e.g. sulpiride, metoclopramide). May result in INR imbalance in concomitant use with vitamin K antagonists. Concomitant use with CNS depressants may enhance the sedative effect of ropinirole.

Antiparkinsonian Drugs

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