Zuellig Pharma


Concise Prescribing Info
Signs & symptoms of early-stage idiopathic Parkinson's disease as monotherapy or in combination w/ levodopa ie, over disease course, through to late stages when the levodopa effect wears off or becomes inconsistent & fluctuations of therapeutic effect occur (end of dose or 'on-off' fluctuations).
Dosage/Direction for Use
Applied once daily. Early stage Parkinson's disease Initially, single daily dose of 2 mg/24 hr then increased in wkly increments of 2 mg/24 hr. Max: 8 mg/24 hr. Advanced stage Parkinson's disease w/ fluctuations Initially, single daily dose of 4 mg/24 hr increased in wkly increments of 2 mg/24 hr. Max: 16 mg/24 hr. Treatment discontinuation Reduce daily dose by 2 mg/24 hr preferably every other day until complete w/drawal.
Hypersensitivity. MRI or cardioversion.
Special Precautions
MRI & cardioversion. Monitor BP especially at the start of treatment. Syncope/pre-syncope in patients w/ severe CV diseases. Somnolence & episodes of sudden sleep onset. Regularly monitor for impulse control disorders development. Abrupt w/drawal may lead to neuroleptic malignant syndrome. Abnormal thinking & behavior. Retroperitoneal fibrosis, pulmonary infiltrates, pleural effusion & thickening, pericarditis & cardiac valvulopathy. Do not give neuroleptics as antiemetics. Ophthalmologic monitoring at regular intervals or if vision abnormalities occur. Avoid direct sunlight exposure to area of patch. Rotate application site on a daily basis & avoid using same site w/in 14 days. Peripheral oedema. Concomitant use w/ L-dopa. Allergic-type reactions w/ Na metabisulphite. May affect ability to drive & use machines. Women of childbearing potential should use effective contraception. Pregnancy & lactation.
Adverse Reactions
Somnolence, dizziness, headache; nausea, vomiting; application & instillation site reactions (eg, erythema, pruritus, irritation, rash, dermatitis, vesicles, pain, eczema, inflammation, swelling, discolouration, papules, exfoliation, urticaria, hypersensitivity). Perception disturbances (eg, hallucination, visual & auditory hallucination, illusion), insomnia, sleep disorder, nightmare, abnormal dreams, impulse-control disorders (eg, pathological gambling, stereotypy/punding, binge eating/eating disorder, compulsive shopping); disturbances in consciousness (eg, syncope, vasovagal syncope, loss of consciousness), dyskinesia, postural dizziness, lethargy); vertigo; palpitations; orthostatic hypotension, HTN; hiccups; constipation, dry mouth, dyspepsia; erythema, hyperhidrosis, pruritus; peripheral oedema, asthenic conditions (eg, fatigue, asthenia, malaise); decreased wt; fall.
Drug Interactions
Effectiveness may be diminished by dopamine antagonists eg, neuroleptics (eg, phenothiazines, butyrophenones, thioxanthenes) or metoclopramide. Possible additive effects w/ sedatives or other CNS depressants (eg, benzodiazepines, antipsychotics, antidepressants) or alcohol. May potentiate dopaminergic adverse reaction of L-dopa.
ATC Classification
N04BC09 - rotigotine ; Belongs to the class of dopamine agonists. Used in the management of Parkinson's disease.
Neupro transdermal patch 2 mg/24 hr
10 cm<sup>2</sup> x 28 × 1's
Neupro transdermal patch 6 mg/24 hr
30 cm<sup>2</sup> x 28 × 1's
Neupro transdermal patch 8 mg/24 hr
40 cm<sup>2</sup> x 28 × 1's
Neupro transdermal patch 4 mg/24 hr
20 cm<sup>2</sup> x 28 × 1's
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