Select therapeutic use:

Parkinsonism:

Indications for REQUIP:

Parkinson's disease.

Adult:

Initially 0.25mg 3 times daily, then increase by 0.25mg 3 times daily at 1-week intervals to 1mg 3 times daily to 4th week. May increase by 1.5mg/day at 1-week intervals up to 9mg/day, then by up to 3mg/day at 1-week intervals to max 24mg/day. ESRD on dialysis: initially 0.25mg 3 times daily; max 18mg/day. Withdraw gradually over 7 days.

Children:

Not established.

Warnings/Precautions:

See full labeling. Consider discontinuing if excessive daytime sleepiness or falling asleep during activities occurs. Sleep disorder. Psychotic disorder. Monitor for drowsiness or sleepiness, and for orthostatic hypotension. Dyskinesia. Severe renal or hepatic impairment. Significant cardiovascular disease; monitor for hypertension and changes in heart rate. Consider dose reduction or discontinuation if urges/compulsive behaviors develop. Monitor for melanoma; perform periodic skin exams. Fibrotic complications. Avoid abrupt cessation. Elderly. Pregnancy. Nursing mothers.

See Also:

Pharmacologic Class:

Dopamine agonist (non-ergot).

Interactions:

May potentiate dopaminergic effects (eg, dyskinesia) with levodopa; consider reducing dose of levodopa. Additive CNS effects when concomitant alcohol, other CNS depressants (eg, benzodiazepines, antipsychotics, antidepressants). May be potentiated by CYP1A2 inhibitors (eg, ciprofloxacin). May be antagonized by CYP1A2 inducers (eg, cigarette smoking) or dopamine antagonists (eg, phenothiazines, butyrophenones, metoclopramide). Adjust ropinirole dose if estrogens are added or discontinued.

Adverse Reactions:

Early parkinsonism (without levodopa): nausea, somnolence (including sudden sleep onset), dizziness, syncope, asthenia, infection, edema, vomiting, dyspepsia, hypertension, headache, abdominal pain/discomfort, constipation. Advanced disease (with levodopa): also dyskinesia, confusion, hallucinations (esp. in elderly), sweating. Both: withdrawal-emergent hyperpyrexia and confusion.

Metabolism:

Hepatic.

Elimination:

Renal. Half-life: 6 hours.

How Supplied:

Tabs—100; XL tabs—30

Pricing for REQUIP

1mg tablet (Qty: 30)
Appx. price $8
GoodRx

Restless legs syndrome:

Indications for REQUIP:

Restless legs syndrome.

Adult:

Titrate gradually. Take once-daily 1–3 hrs before bedtime. Initially 0.25mg on Days 1 & 2, then 0.5mg on Days 3–7, increase by 0.5mg/day at 1-week intervals to 3mg then may increase to 4mg after 1 week; max 4mg/day. ESRD on dialysis: initially 0.25mg once daily; max 3mg/day. Withdraw gradually.

Children:

Not established.

Warnings/Precautions:

See full labeling. Consider discontinuing if excessive daytime sleepiness or falling asleep during activities occurs. Sleep disorder. Psychotic disorder. Monitor for drowsiness or sleepiness, and for orthostatic hypotension. Dyskinesia. Severe renal or hepatic impairment. Significant cardiovascular disease; monitor for hypertension and changes in heart rate. Consider dose reduction or discontinuation if urges/compulsive behaviors develop. Monitor for melanoma; perform periodic skin exams. Fibrotic complications. Avoid abrupt cessation. Elderly. Pregnancy. Nursing mothers.

Pharmacologic Class:

Dopamine agonist (non-ergot).

Interactions:

Additive CNS effects when concomitant alcohol, other CNS depressants (eg, benzodiazepines, antipsychotics, antidepressants). Potentiated by ciprofloxacin, possibly other CYP1A2 inhibitors. May be antagonized by dopamine antagonists (eg, phenothiazines, butyrophenones, metoclopramide). Adjust ropinirole dose if estrogens are added or discontinued. Monitor with drugs that induce CYP1A2 (eg, cigarette smoke).

Adverse Reactions:

Nausea, vomiting, somnolence, dizziness, fatigue, asthenia, malaise; hallucinations, dyskinesia, withdrawal-emergent hyperpyrexia and confusion, augmentation and early-morning rebound.

Metabolism:

Hepatic.

Elimination:

Renal. Half-life: 6 hours.

How Supplied:

Tabs—100

Pricing for REQUIP

1mg tablet (Qty: 30)
Appx. price $8
GoodRx