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Parkinson's Disease HOL-emblem1-web.GIF (3556 bytes)

Ropinirole

BRAND: Requip

Ropinirole is a potent, non- ergoline dopamine agonist. Ropinirole is effective both as early monotherapy and as an adjunct to treatment with levodopa. Side effects are similar to other dopamine agonists and include nausea, somnolence, insomnia, dizziness, dyspepsia, and headache. Ergot-related pleural and retroperitoneal fibrosis have not been reported.

A number of well-controlled, double-blind, prospective clinical trials have confirmed the safety and efficacy of ropinirole in the treatment of Parkinson's disease. One study found that ropinirole, when used with levodopa, can reduce the dosage of levodopa by 19.4%.

When ropinirole was used alone for the treatment of Parkinson's disease in early stage patients, motor function was improved by 24% at six months in ropinirole-treated patients. Significantly fewer ropinirole-treated patients required "rescue" with levodopa compared with placebo-treated patients (11% vs. 29%). In a six month study comparing ropinirole with levodopa in early stage patients, a similar percentage of patients in each group experienced greater than 30% improvement (48% vs. 58%), although levodopa-treated patients experienced significantly greater improvement overall (32% vs. 44%).

Ropinirole has been demonstrated to be more effective than bromocriptine as rnonotherapy in patients who are not taking selegiline. In a six-month study comparing ropinirole with brornocriptine as early monotherapy, ropinirole brought about significantly greater improvement (34%) than bromocriptine (20%). Benefit was similar in selegiline-treated patients as selegiline appeared to enhance the efficacy of bromocriptine to the level of ropinirole.

Important Information About Ropinirole
bulletUse caution when driving, operating machinery, or performing other hazardous activities. ropinirole may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities.
bulletDizziness or drowsiness may be more likely to occur when you rise from a sitting or lying position. Rise slowly and use caution to prevent a fall.
bulletAlcohol, sleep aids, antihistamines, antidepressants, antipsychotics, and other medicines that cause drowsiness may increase the drowsiness caused by ropinirole. Do not take other medicines without first talking to your doctor.
bulletRopinirole may cause hallucinations, most commonly among elderly people. Call your doctor if you experience hallucinations.

Do Not Take Ropinirole If
bulletBefore taking this medication, tell your doctor if you have kidney disease. You may not be able to take ropinirole, or you may require a lower dose or special monitoring during therapy if you have kidney disease.
bulletRopinirole is in the FDA pregnancy category C. This means that it is not known whether ropinirole will harm an unborn baby. Do not take ropinirole without first talking to your doctor if you are pregnant.
bulletIt is not known whether ropinirole passes into breast milk. ropinirole may reduce breast milk production. Do not take ropinirole without first talking to your doctor if you are breast-feeding a baby.
bulletHallucinations may be more likely to occur in patients older than 65 years of age. Notify your doctor if you experience hallucinations.

Drug Overdose

Seek emergency medical attention if you have had a drug overdose.

Symptoms of a ropinirole overdose include nausea, vomiting, weakness, dizziness, fainting, agitation, confusion, hallucinations, muscle twitching, uncontrollable movements, a tingling sensation, and chest pain.

Avoid While Taking Ropinirol

Use caution when driving, operating machinery, or performing other hazardous activities. ropinirole may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities.

Dizziness or drowsiness may be more likely to occur when you rise from a sitting or lying position. Rise slowly and use caution to prevent a fall.

Alcohol, sleep aids, antihistamines, antidepressants, antipsychotics, and other medicines that cause drowsiness may increase the drowsiness caused by ropinirole. Do not take other medicines without first talking to your doctor.

Side Effects of Ropinirole

Stop taking ropinirole and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

Notify your doctor immediately if you experience hallucinations, fainting, or dizziness (especially when rising from a sitting or lying position). Your doctor may want to discontinue this medication or lower your dosage.

Continue to take ropinirole and talk to your doctor if you experience  less serious side effects such as:
bulletMild nausea
bulletVomiting
bulletUpset stomach
bulletDecreased appetite
bulletDiarrhea
bulletConstipation
bulletDry mouth
bulletSweating
bulletHeadache
bulletDrowsiness
bulletConfusion
bulletInsomnia
bulletAgitation
bulletAnxiety.

Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Drug Interaction

Before taking ropinirole, tell your doctor if you are taking any of the following medicines:
bulletA medication used to treat mania, schizophrenia, other psychiatric conditions, or nausea and vomiting, such as
bulletChlorpromazine (thorazine), fluphenazine (prolixin), mesoridazine (serentil), perphenazine (trilafon), thioridazine (mellaril), promazine (sparine), trifluoperazine (stelazine), thiothixene (navane), or haloperidol (haldol);
bulletAn estrogen (premarin, prempro, estratest, ogen, estraderm, climara, vivelle, estradiol, and others); or
bulletThe antibiotic ciprofloxacin (cipro).

You may require special monitoring or a dosage adjustment if you are taking any of the medicines listed above.

Ropinirole may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves.

Drugs other than those listed here may also interact with ropinirole. Do not take any other prescription or over-the-counter medicines or herbs without the approval of your doctor.

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