Ropinirole


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Parkinson's disease Initial: 250 mcg 3 times/day, may increase slowly. Usual: 3-9 mg/day. Max: 24 mg/day. Higher dose may be needed if used w/ levodopa. Restless leg syndrome Initial: 250 mcg/day for 2 days, taken 1-3 hr before bedtime. Up to 500 mcg/day for the next few days if needed. May further increase slowly to 3 mg/day. Max: 4 mg/day.
Dosage Details
Oral
Monotherapy in Parkinson's disease
Adult: Initially, 250 mcg tid, may increase by 750 mcg at wkly intervals for the first 4 wk. Subsequent increments can be made in steps of 1.5 mg at wkly intervals up to 9 mg/day, then in steps of 3 mg at wkly intervals. Usual dose ranges from 3-9 mg daily. Max: 24 mg/day. Higher dose may be necessary if used in conjunction with levodopa. Gradual withdrawal is recommended.

Oral
Restless leg syndrome
Adult: Initially, 250 mcg daily for 2 days, taken 1-3 hr before bedtime. May increase to 500 mcg daily for the next few days. Subsequent increments may be made in steps of 500 mcg at wkly intervals until 3 mg daily is reached. Max: 4 mg daily.
Hepatic Impairment
Oral:
Monotherapy in Parkinson's disease: Dosing adjustments may be necessary.
Restless leg syndrome: Dosing adjustments may be required.
Administration
Tab: May be taken with or without food.
Extended-Release Tab: May be taken with or without food. Swallow whole, do not crush/divide/chew.
Contraindications
Lactation.
Special Precautions
Pregnancy. May impair ability to drive or operate machinery. Withdrawal should be gradual. Hepatic or renal impairment. May cause daytime sleepiness or episodes of falling asleep during activities. May cause or worsen pre-existing dyskinesia.
Adverse Reactions
Sudden onset of sleep with or without any prior feeling of drowsiness. Nausea, abdominal pain; dizziness, somnolence, headache, hallucinations; dyskinesias.
Overdosage
Symptoms include nausea, vomiting, visual hallucinations, hyperhidrosis, asthenia and nightmares. General supportive measures and monitoring of vital signs are recommended. May consider gastric lavage.
Drug Interactions
Inhibitors of CYP1A2 e.g. cimetidine, ciprofloxacin, erythromycin, fluvoxamine, isoniazid, ritonavir and zileuton may increase serum concentrations of ropinirole. Oestrogens and tobacco smoking may decrease clearance of ropinirole. Efficacy may be reduced by dopamine antagonists such as phenothiazines and metoclopramide.
Action
Description: Ropinirole is a non-ergot dopamine D2-agonist with similar actions to those of bromocriptine. It is used in the management of Parkinson's disease, either alone or as an adjunct to levodopa.
Pharmacokinetics:
Absorption: Rapidly absorbed from the GI tract after oral admin. Bioavailability: about 50%.
Distribution: Widely distributed. Plasma protein binding: 10-40%.
Metabolism: Extensively metabolised in the liver by CYP1A2.
Excretion: Excreted in the urine as inactive metabolites; <10% of the oral dose is excreted unchanged. Elimination half-life: about 6 hr.
Storage
Store at 20-25°C.
Disclaimer: This information is independently developed by MIMS based on Ropinirole from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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