Due to the pharmacological action of ropinirole, patients with severe cardiovascular disease should be treated with caution.
Patients with a history or presence of major psychotic disorders should only be treated with dopamine agonists if the potential benefits outweigh the risks.
Impulse control symptoms including compulsive behaviours (including pathological gambling, hypersexuality, compulsive shopping and binge eating have been reported in patients treated with dopaminergic agents, including ropinirole (see Adverse Reactions). These were generally reversible upon dose reduction or treatment discontinuation. In some ropinirole cases, other factors were present such as a history of compulsive behaviours or concurrent dopaminergic treatment.
Ropinirole prolonged release tablets are designed to release medication over 24 hour period. If rapid gastrointestinal transit occurs, there may be risk of incomplete release of medication, and medication residue being passed in the stool.
Effects on the Ability to Drive or Operate Machinery: No data are available on the effect of ropinirole on the ability to drive or use machinery.
Patients should be cautioned about their ability to drive or operate machinery whilst taking REQUIP PD 24 HOUR because of the possibility of somnolence and dizziness (including vertigo).
Patients should be informed about very rare cases of sudden onset of sleep without any prior warning or apparent daytime somnolence (see Adverse Reactions), which have primarily been observed in patients with Parkinson's disease, and should be cautioned that their safety and that of others is at risk should this happen when driving or operating machinery. If patients develop significant daytime sleepiness or episodes of falling asleep during activities that require active participation, patients should be told not to drive and to avoid other potentially dangerous activities.