Ropison

Indications

Ropinirole is used to treat Parkinson's disease, either alone in early stages or together with Levodopa, and to treat moderate to severe restless legs syndrome (an uncomfortable urge to move the legs, usually in the evening or at night).

How It Works

Ropinirole is a dopamine agonist. It copies the action of dopamine, a brain chemical that helps control movement and is low in Parkinson's disease. By stimulating dopamine receptors, it reduces stiffness, slowness and shaking, and calms the restless sensations in the legs.

Dosage and Administration

The dose is started low and increased slowly by your doctor, as prescribed.

• Restless legs syndrome: usually starting at 0.25 mg once a day, taken 1 to 3 hours before bedtime, then increased gradually as needed.
• Parkinson's disease: started at a low dose three times a day (or once a day for prolonged release tablets) and increased step by step over weeks to the dose that works for you.

Take with food to reduce nausea. Do not stop suddenly.

Interactions

• Ciprofloxacin, Fluvoxamine and other medicines that block the CYP1A2 enzyme can raise ropinirole levels.
• Smoking, starting or stopping, can change its levels.
• Antipsychotics and Metoclopramide block dopamine and reduce its effect.
• Estrogens such as in hormone therapy may raise its levels.
• Alcohol and sedating medicines increase drowsiness.

Contraindications

• Allergy to Ropinirole.
• Severe kidney disease without dialysis, or severe liver disease.

Side Effects

Common side effects are nausea, sleepiness, dizziness, fainting or light headedness on standing, swelling of the legs, and hallucinations (especially in older people with Parkinson's). Some people experience sudden sleep episodes during the day. Impulse control problems such as compulsive gambling, shopping, eating or increased sexual urges can occur.

Get urgent medical help if you fall asleep suddenly while active, faint, have severe confusion or hallucinations, or show signs of a severe allergic reaction.

Pregnancy and Lactation

Not recommended in pregnancy unless the doctor decides the benefit outweighs the risk. It may reduce milk production and should not be used while breastfeeding.

Precautions and Warnings

• Do not drive or operate machines if you feel sleepy or have had sudden sleep episodes.
• Tell your doctor or family to watch for unusual urges or behaviour changes.
• Do not stop suddenly; a fever and stiffness like reaction or withdrawal symptoms can occur. The dose is reduced gradually.
• Use with care in heart disease, serious mental illness and low blood pressure.
• In restless legs syndrome, symptoms may start earlier in the day or become stronger over time (augmentation); tell your doctor.

Overdose

Overdose may cause nausea, vomiting, dizziness, drowsiness, confusion, hallucinations and involuntary movements. Get medical help immediately.

Therapeutic Class

Antiparkinson agent (non ergot dopamine agonist).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.