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Ropinirole

    DEA Class;  Rx

    Common Brand Names; Requip, Requip XL

    • Antiparkinson Agents, Dopamine Agonists

    Oral non-ergot-derived dopamine agonist
    Used for Parkinson’s disease and moderate to severe restless legs syndrome (RLS) in adults
    Monitor for hallucinations, psychotic-like behavior, impulse control symptoms, and sleep attacks

    Indicated for the treatment of Parkinson’s disease.

    For the treatment of restless legs syndrome (RLS).
     
     

    Known hypersensitivity/allergic reaction (including urticaria, angioedema, rash, pruritus) to ropinirole or to any of the excipients

    • Nausea (40-60%)
    • Dizziness (6-40%)
    • Somnolence (11-40%)
    • Syncope (1-12%)
    • Vomiting (12%)
    • Fatigue (8-11%)
    • Viral infection (11%)
    • Dyspepsia (10%)
    • Falls (10%)
    • Hypertension (5%)
    • Flushing (3%)
    • Orthostasis (1-6%)
    • Chest pain (4%)
    • Palpitation (3%)
    • Extrasystoles (2%)
    • Tachycardia (2%)
    • Hyperhidrosis (3%)
    • Abnormal pain (3-7%)
    • Anorexia (4%)
    • Flatulence (3%)
    • Malaise (3%)
    • Hypoesthesia (4%)
    • Urinary tract infection (5%)
    • Impotence (3%)
    • Alkaline phosphatase (3%)
    • Abnormal vision (6%)
    • Xerophthalmia (2%)
    • Increased diaphoresis (3-6%)

    Risk of somnolence associated with use for restless legs syndrome, as well as (rare) risk of syncope, hypotension, and hallucinations

    May cause psychotic-like behavior; abnormal thinking and behavior can consist of one or more of a variety of manifestations including paranoid ideation, delusions, hallucinations, confusion, disorientation, aggressive behavior, agitation, and delirium; risk may be increased in the elderly; consider dose reduction or stopping the medication if a patient develops psychiatric symptoms while taking the medication

    Risk of orthostatic hypotension with extended-release formulation

    Possible risk of erratic behavior associated with dopamine agonists, compulsive behavior including urge to gamble and increased sexual urges

    Potential for elevation in blood pressure and changes in heart rate should be considered when treating patients with cardiovascular disease with extended release formulation

    Dyskinesia seen with concurrent use of levodopa

    Increased risk of melanoma development and pleural retroperitoneal fibrosis reported, but causation not established; monitoring warranted

    Use caution in patients with history of hepatic/renal impairment, psychotic disorders, dyskinesias, restless leg syndrome

    In patients with advanced Parkinson’s disease dyskinesia may occur

    Pregnancy

    There are no adequate data on developmental risk associated with use in pregnant women; in animal studies, ropinirole had adverse effects on development when administered to pregnant rats at doses similar to (neurobehavioral impairment) or greater than (teratogenicity and embryolethality at >36 times) maximum recommended human dose (MRHD) for Parkinson’s disease

    Lactation

    There are no data on presence of ropinirole in human milk, the effects of ropinirole on breastfed infant, or effects of ropinirole on milk production; however, inhibition of lactation is expected because ropinirole inhibits secretion of prolactin in humans; ropinirole or metabolites, or both, are present in rat milk

    Adults

    24 mg/day PO.

    Elderly

    24 mg/day PO.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Ropinirole

    tablet

    • 0.25mg
    • 0.5mg
    • 1mg
    • 2mg
    • 3mg
    • 4mg
    • 5mg

    tablet, extended release

    • 2mg
    • 4mg
    • 6mg
    • 8mg
    • 12mg