rotigotine

Contraindicated in:

Hypersensitivity to rotigotine or sulfites.

Use Cautiously in:

Severe cardiovascular disease (may ↑ risk of postural hypotension or syncope);
Severe hepatic impairment;
Major psychotic disorder;
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypertension, peripheral edema, postural hypotension, syncope, tachycardia

Derm: application site reactions, melanoma, pruritus, purpura, sweating

GI: nausea, vomiting, anorexia, dry mouth, dyspepsia

GU: urinary incontinence

Metab: weight gain

MS: ↑creatine kinase, leg pain

Neuro: insomnia, abnormal gait, aggression, agitation, ataxia, confusion, delirium, delusions, disorientation, dizziness, drowsiness, dyskinesia, hallucinations, headache, hypertonia, hypoesthesia, mania, neuralgia, paranoid ideation, paresthesia, sudden sleep attacks, urges (gambling, sexual)

Misc: fever

Interactions ⬆ ⬇

Drug-drug:

Concurrent use of dopamine antagonists, including some antipsychotics or metoclopramide, may ↓ effectiveness.

Availability ⬆ ⬇

Transdermal system: 1 mg/24 hr; 2 mg/24 hr; 3 mg/24 hr; 4 mg/24 hr; 6 mg/24 hr; 8 mg/24 hr

Route/Dosage ⬆ ⬇

Parkinson's Disease

Transdermal (Adults ): Early stage: Apply 2 mg/24 hr patch once daily initially; may ↑ by 2 mg/24 hr patch once weekly (max dose = 6 mg/24 hr); Advanced stage: Apply 4 mg/24 hr patch once daily initially; may ↑ by 2 mg/24 hr patch once weekly (max dose = 8 mg/24 hr).

Restless Legs Syndrome

Transdermal (Adults ): Apply 1 mg/24 hr patch once daily initially; may ↑ by 1 mg/24 hr patch once weekly (max dose = 3 mg/24 hr).

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Acts as an agonist of dopamine in the CNS, primarily at D2 receptor sites.

Therapeutic effects:

Improvement in symptoms of Parkinson's disease.
Decreased leg restlessness

Classifications ⬆ ⬇

Therapeutic Classification: antiparkinson agents

Pharmacologic Classification: dopamine agonists

Pharmacokinetics ⬆ ⬇

Absorption: 46% absorbed from patch over 24 hr.

Distribution: Unknown.

Protein Binding: 90%

Metabolism/Excretion: Mostly metabolized and excreted in urine as metabolites (71%); 23% excreted in feces.

Half-Life: Biphasic: initial half-life 3 hr; terminal half-life 5–7 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
Transdermal	1–3 hr	15–18 hr (range 4–27 hr)	24 hr

Patient/Family Teaching ⬆ ⬇

Instruct patient on proper method of patch application. Advise patient to wear patch continuously for 24 hr and to apply system at the same time each day; if patch change is missed, apply as soon as possible and replace at usual time the following day. Patients may bathe, shower, or swim with patch on. If patch falls off, apply a new on immediately to a different site and change according to regular schedule. Consult health care professional before reducing dose or discontinuing medication; may cause withdrawal symptoms, fever, confusion, or severe muscle stiffness.
May cause drowsiness and unexpected episodes of falling asleep. Caution patient to avoid driving and other activities requiring alertness until response to medication is known. Advise patient to notify health care professional if episodes of falling asleep occur.
Advise patient to notify health care professional if application site reaction occurs.
Inform patient that rotigotine may cause hallucinations.
Caution patient to avoid exposing patch to external heat (heating pad, electric blanket, heat lamp, sauna, hot tub, heated water bed, prolonged direct sunlight).
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications or alcohol.
Advise patient to notify health care professional if they experience new or increased gambling sexual urges, or other intense urges during therapy. May require discontinuation.
Advise patient to have health care professional check their skin for skin cancer regularly due to increase risk of melanoma.
Advise patient to remove rotigotine patch prior to magnetic resonance imaging or cardioversion.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

50474- UCB, Inc.
- 50474-801- Neupro
  - 50474-801-03- 30 POUCH in 1 CARTON (50474-801-03) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-801- Neupro
  - 50474-801-17- 7 POUCH in 1 CARTON (50474-801-17) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-802- Neupro
  - 50474-802-03- 30 POUCH in 1 CARTON (50474-802-03) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-802- Neupro
  - 50474-802-17- 7 POUCH in 1 CARTON (50474-802-17) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-803- Neupro
  - 50474-803-03- 30 POUCH in 1 CARTON (50474-803-03) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-803- Neupro
  - 50474-803-17- 7 POUCH in 1 CARTON (50474-803-17) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-804- Neupro
  - 50474-804-03- 30 POUCH in 1 CARTON (50474-804-03) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-804- Neupro
  - 50474-804-17- 7 POUCH in 1 CARTON (50474-804-17) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-805- Neupro
  - 50474-805-03- 30 POUCH in 1 CARTON (50474-805-03) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-805- Neupro
  - 50474-805-17- 7 POUCH in 1 CARTON (50474-805-17) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-806- Neupro
  - 50474-806-03- 30 POUCH in 1 CARTON (50474-806-03) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-806- Neupro
  - 50474-806-17- 7 POUCH in 1 CARTON (50474-806-17) > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

50474- UCB, Inc.
- 50474-808- Neupro
  - 50474-808-11- 2 BOX in 1 KIT (50474-808-11) > 1 KIT in 1 BOX * 7 POUCH in 1 BOX > 1 PATCH in 1 POUCH > 24 h in 1 PATCH * 7 POUCH in 1 BOX > 1 PATCH in 1 POUCH > 24 h in 1 PATCH

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇