ropinirole (Requip, Requip-XL)
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Introduction
Tradename: Requip.
Indications
- symptomatic treatment of idiopathic Parkinson's disease
- parkinsonism
- treatment of restless legs syndrome[7]
Contraindications
Dosage
- week 1: 0.25 mg PO TID
- week 2: 0.5 mg PO TID
- week 3: 0.75 mg PO TID
- week 4: 1.0 mg PO TID
- increase by 1.5 mg/day weekly up to 9 mg/day
- increase by 3 mg/day weekly up to a maximum of 24 mg/day
- decrease L-dopa as tolerated
- for discontinuation, taper over a 7 day period
- may be taken with or without food
Tabs: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 5 mg. (not scored) Requip-XL, QD dosing
Pharmacokinetics
- metabolized in the liver by cyt P450 1A2
Adverse effects
- common (> 10%)
- less common (1-10%)
- hallucinations, confusion, falls, yawning, impaired concentration, amnesia, anxiety, nervousness, anemia, elevated alkaline phosphatase, abdominal pain, anorexia, flatulence, diarrhea, constipation, flushing, asthenia, chest pain, dependent edema, leg edema, malaise, orthostatic hypotension#, paresis, tremor, hyperesthesia, vertigo, impotence, bronchitis, dyspnea, peripheral ischemia, eye abnormality, visual disturbance, diplopia, xerophthalmia, pyuria, urinary tract infection
- other
- sudden sleep attacks have been reported[3]
- compulsive behavior
* syncope may be associated with bradycardia
# orthostatic hypotension may be related to dopaminergic agonist tendency to impair regulation of systemic blood pressure
- drug adverse effects of adrenergic receptor agonists
- drug adverse effects of dopaminergic receptor agonists
- drug adverse effects of sympathomimetic(s)
Drug interactions
- any drug which inhibits cyt P450 1A2 can increase ropinirole levels
- any drug which induces cyt P450 1A2 can diminish ropinirole levels
- ciprofloxacin increases serum ropinirole (60%)
- estrogens decrease clearance of roprinole (36%)
- dopamine antagonists are expected to reduce effectiveness
- ropinirole may potentiate adverse effects of L-dopa
Mechanism of action
- dopamine D2 receptor agonist
- may have neuroprotective effects
More general terms
Additional terms
- cytochrome p450 1A2 (cytochrome P3-450, phenacetin deethylase, cytochrome p450-4, CYP1A2)
- Parkinson's disease (paralysis agitans, PD)
References
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ Prescriber's Letter 13(3): 2006 Cytochrome P450 drug interactions Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220233&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 3.0 3.1 Prescriber's Letter 9(3):17 2002
- ↑ Bronstein J, In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 29-Oct 2, 2004
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012
- ↑ Deprecated Reference
- ↑ 7.0 7.1 Bogan RK, Fry JM, Schmidt MH et al Ropinirole in the treatment of patients with restless legs syndrome: a US-based randomized, double-blind, placebo- controlled clinical trial. Mayo Clin Proc. 2006 Jan;81(1):17-27. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16438474