Monograph Details
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Central Nervous System
> Parkinsonism
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REQUIP XL |
| 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 2mg, 4mg, 8mg; ext-rel tabs. |
| Also |
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• REQUIP
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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. Swallow whole. Taking with food may reduce nausea. Initially 2mg once daily for 1–2 weeks, then increase by 2mg/day at ≥1-week intervals to max 24mg/day. Switching from immediate-release ropinirole: give initial dose to closely match total daily dose of immediate-release form. |
| 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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