Ropinirole Hydrochloride(row pin’ ah roll)
Requip, Requip XLDNC
PREGNANCY CATEGORY C
Drug Classes
Antiparkinsonian
Dopamine receptor agonist
Therapeutic Actions
Acts as a non-ergot dopamine agonist acting directly on postsynaptic dopamine receptors of neurons in the brain, mimicking the effects of the neurotransmitter dopamine, which is thought to be deficient in parkinsonism.
Indications
Treatment of idiopathic Parkinson disease in the early stages as well as in the late stages (immediate-release or ER)
Treatment of moderate to severe primary restless legs syndrome (immediate-release only)
Contraindications and Cautions
Contraindicated with hypersensitivity to ropinirole, severe ischemic heart disease or peripheral vascular disease, lactation.
Use cautiously with dyskinesia, orthostatic hypotension, hepatic or renal impairment, pregnancy, history of sleep disorders or somnolence.
Available Forms
Tablets—0.25, 0.5, 1, 2, 3, 4, 5 mg; ER tabletsDNC—2, 4, 6, 8, 12 mg
Dosages
Adults
Parkinson disease: Initially, 0.25 mg PO tid for 1st wk; 0.5 mg PO tid for 2nd wk; 0.75 mg PO tid for 3rd wk; 1 mg PO tid for 4th wk. May increase by 1.5 mg/day at 1-wk intervals to 9 mg/day, then by up to 3 mg/day at 1-wk intervals to a maximum dose of 24 mg/day. ER tablets: Initially, 2 mg/day PO; after 1–2 wk, may increase by 2 mg/day; titrate with weekly increases of 2 mg/day to a maximum of 24 mg/day. If used with levodopa, decrease levodopa dosage gradually; average dosage reduction is 31% with immediate-release ropinirole and 34% with ER forms.
Restless legs syndrome: 0.25 mg/day PO, 1–3 hr before bed; after 2 days, increase to 0.5 mg/day PO; after 1 week to 1 mg/day PO. Week 3, increase to 1.5 mg/day; week 4—2 mg/day, week 5—2.5 mg/day; week 6—3 mg/day; week 7—4 mg/day PO if needed to control symptoms.
Pediatric patients
Safety and efficacy not established.
Geriatric patients
Elderly are at higher risk for development of hallucinations; monitor closely and adjust dosage more slowly.
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