Indications for: Ropinirole Ext-Rel
Swallow whole. Initially 2mg once daily for 1–2 weeks, then increase by 2mg/day at ≥1-week intervals up to max 24mg/day (for advanced disease: usually up to max 8mg/day; early disease: usually up to max 12mg/day). ESRD on dialysis: initially 2mg once daily; max 18mg/day. Switching from immediate-release ropinirole: give initial dose to closely match total daily dose of immediate-release form. Withdraw gradually over 7 days.
Ropinirole Ext-Rel Warnings/Precautions:
See full labeling. Consider discontinuing if excessive daytime sleepiness or falling asleep during activities occurs. Sleep disorder. Psychotic disorder. 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 drowsiness or sleepiness, orthostatic hypotension, potential withdrawal symptoms. Fibrotic complications. Avoid abrupt cessation. Elderly. Pregnancy. Nursing mothers.
Ropinirole Ext-Rel Classification:
Dopamine agonist (non-ergot).
Ropinirole Ext-Rel 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 hormone replacement therapy are added or discontinued.
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.
Formerly known under the brand name Requip, Requip XL.