Monograph Details
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Central Nervous System
> Parkinsonism
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REQUIP |
| Manufacturer |
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GlaxoSmithKline Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Dopamine agonist (non-ergot). |
| Generic Name |
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Ropinirole (as HCl) 0.25mg, 0.5mg, 1mg, 2mg, 3mg, 4mg, 5mg; tabs. |
| Also |
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• REQUIP XL
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| Indications |
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Idiopathic Parkinson's disease. |
| Children |
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Not recommended. |
| Adults |
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Titrate gradually. Taking with food may reduce nausea. Initially 0.25mg 3 times daily, then increase by 0.25mg 3 times daily at 1-week intervals to 1mg 3 times daily to 4th week. May increase by 1.5mg/day at 1-week intervals up to 9mg/day, then by up to 3mg/day at 1-week intervals to max 24mg/day. |
| Precautions |
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See literature. Consider discontinuing if excessive daytime sleepiness or if sudden onset of sleep during daily activities occurs. Monitor for drowsiness or sleepiness, and for orthostatic hypotension. Dyskinesia. Sleep disorders. Severe renal or hepatic impairment. Severe cardiovascular disease. Hypertension. Changes in heart rate. Psychotic disorders. Avoid abrupt cessation (withdraw over 1 week). Elderly may have higher risk of hallucinations. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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Consider reducing concomitant levodopa dose. Alcohol, other CNS depressants may be potentiated. Potentiated by ciprofloxacin, possibly other CYP1A2 inhibitors. May be antagonized by dopamine antagonists (eg, phenothiazines, butyrophenones, metoclopramide). Adjust ropinirole dose if estrogens are added or discontinued. Monitor with drugs that induce CYP1A2 (eg, cigarette smoke). |
| Adverse Reactions |
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Early parkinsonism (without levodopa): Nausea, somnolence (including sudden sleep onset), abdominal pain/discomfort, dizziness, headache, constipation; dyskinesia, vomiting, syncope, fatigue, dyspepsia, infections, pain, sweating, asthenia, edema, postural hypotension, hypertension, changes in heart rate, pharyngitis, confusion, hallucinations, abnormal vision, aggravated parkinsonism. Advanced disease (with levodopa): also arthralgia, tremor, anxiety, dry mouth, hypokinesia, paresthesia. |
| How Supplied |
Tabs—100
XL tabs—30, 90 |
| Additional Resources |
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• Related Prescribing Note |
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