Renal Dose Adjustment (Based on CrCl)
- 30-50 mL/min: No dose adjustments
- <30 mL/min: Dose adjustments not defined
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined; use with caution
See Supplemental Patient Information
- Falling asleep during activities of daily living, including operation of vehicles resulting in accidents, somnolence, and excessive drowsiness have been reported during therapy. Some events were reported more than 1 year after treatment initiation
- Discontinue therapy if a patient develops significant daytime sleepiness or episodes of falling asleep during activities that require active participation. Advise patients not to drive and to avoid other potentially dangerous activities if therapy is continued
- Syncope, associated with bradycardia, has been reported with ropinirole in both Parkinson’s disease patients and RLS patients. Therapy should be used cautiously in patients with significant cardiovascular disease
- Dopamine agonists may cause postural hypotension, especially during dose escalation. Patients should be carefully monitored for signs and symptoms of postural hypotension and should be informed of this risk
- Hallucinations may occur in patients receiving ropinirole. Risk increases in patients >65 yrs of age and when ropinirole is co-administered with entacapone and L-dopa
- Therapy may increase the dopaminergic side effects of L-dopa and may cause and/or worsen preexisting dyskinesia in patients treated with L-dopa for Parkinson's disease
- Administration of ropinirole in patients with major psychotic disorder may exacerbate the psychosis. Many treatments for psychosis may decrease the effectiveness of ropinirole
- A symptom complex resembling the neuroleptic malignant syndrome (NMS) may occur when there is rapid dose reduction, withdrawal of, or changes in dopaminergic therapy. Therefore, dose should be gradually tapered at the end of treatment as a prophylactic measure
- Fibrotic complications, including pulmonary infiltrates, pleural effusion, pleural fibrosis, pericarditis, interstitial lung disease, and cardiac valvulopathy have been reported with ropinirole
- Inform patients treated with ropinirole about the risk of melanoma in Parkinson’s disease and advise them to undergo periodic dermatologic screening
- Patients treated with ropinirole have reported experiences of intense urges to gamble, increased sexual urges, and inability to control these urges while taking one or more of the medications that increase central dopaminergic tone. Dose reduction or discontinuation should be considered in patients experiencing these urges
- Treatment of RLS with dopaminergic agents can result in rebound (worsening of symptoms in early morning hours) and/or augmentation (worsening of the symptoms, earlier onset of symptoms, and spread of symptoms to other extremities)
Cautions: Use cautiously in
- Hepatic impairment
- Sleep disorder
- Alcohol use
- Hypotension
- CNS depressant use
- Smoking habit changes
- Avoid abrupt withdrawal (Parkinson’s disease)
- Elderly patients
Supplemental Patient Information
- Advise patients not to double their next dose when a dose is missed
- Advise patients to avoid alcohol or other CNS depressant drugs during treatment
- Caution patients about the possibility of somnolence and advise them not to engage in any potentially dangerous activities requiring mental alertness
- Inform patients not to rise rapidly after sitting or lying down, especially if they have been doing so for long periods, and especially at the start of ropinirole therapy
- Instruct patients to be alert to the possibility of increases in blood pressure during treatment
Pregnancy Category:C
Breastfeeding: No information is available on the use of ropinirole during breastfeeding, but it suppresses serum prolactin and may interfere with breastfeeding. An alternate drug may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 7 April 2010). According to the manufacturer's data, ropinirole inhibits prolactin secretion in humans and could potentially inhibit lactation. A decision has to be made whether to discontinue the drug or discontinue nursing, analyzing the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Requip XL 8 MG TB24 [Bottle] (GLAXO SMITH KLINE)
30 mg = $249.99
90 mg = $695.93 - Requip XL 6 MG TB24 [Bottle] (GLAXO SMITH KLINE)
30 mg = $259.99
90 mg = $749.99 - Requip 4 MG TABS [Bottle] (GLAXO SMITH KLINE)
90 mg = $306.98
270 mg = $887.92 - Requip XL 4 MG TB24 [Bottle] (GLAXO SMITH KLINE)
90 mg = $460.01
270 mg = $1339.94 - Requip XL 12 MG TB24 [Bottle] (GLAXO SMITH KLINE)
30 mg = $390.01
90 mg = $1119.91 - Requip 5 MG TABS [Bottle] (GLAXO SMITH KLINE)
90 mg = $302
270 mg = $870.98 - Requip 0.5 MG TABS [Bottle] (GLAXO SMITH KLINE)
90 mg = $305.98
270 mg = $891.01 - Requip 1 MG TABS [Bottle] (GLAXO SMITH KLINE)
90 mg = $299.99
270 mg = $860 - Requip 2 MG TABS [Bottle] (GLAXO SMITH KLINE)
90 mg = $291.99
270 mg = $849.95 - Requip 0.25 MG TABS [Bottle] (GLAXO SMITH KLINE)
90 mg = $291.99
270 mg = $849.95 - Requip 3 MG TABS [Bottle] (GLAXO SMITH KLINE)
90 mg = $302
270 mg = $870.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
