Ropinol

Introduction
Ropinol is a prescription medicine used in the treatment of Parkinson’s disease and restless leg syndrome (an urge to move the legs usually accompanied or caused by uncomfortable and unpleasant leg sensations). It helps to treat excessive shaking by slowing down the body movements. Ropinol should be taken with food. However, take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Take this medicine in the dose and duration as advised by your doctor and if you have missed a dose, take it as soon as you remember it. You should never skip any doses and finish the full course of treatment even if you feel better. It is important that this medication is not stopped suddenly without talking to your doctor. Some common side effects of this medicine include headache, fainting, vomiting, weakness, nausea, edema (swelling), abnormality of voluntary movements and dyspepsia (indigestion). It also causes dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. Inform your doctor if you develop any unusual changes in mood, an abnormally high sex drive, an urge to gamble or uncontrolled spending as these may prove very harmful.

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Uses of Ropinol
Parkinson's disease
Restless leg syndrome
Side effects of Ropinol
Common
Headache
Dizziness
Fainting
Sleepiness
Vomiting
Weakness
Nausea
Edema (swelling)
Abnormality of voluntary movements
Indigestion
Hallucination
Confusion
Viral infection
How to use Ropinol
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Ropinol is to be taken with food.
How Ropinol works
Ropinol works by increasing the action of dopamine, a chemical messenger that is needed to control movement in the brain.
Quick Tips
You have been prescribed Ropinol to treat your symptoms of Parkinson’s disease and/or restless leg syndrome.
It can be taken with or without food. Taking it with food may reduce nausea.
For restless leg syndrome, take this medicine 2 to 3 hours before bedtime.
Avoid activities that require you to be alert, such as driving a car until you know how this medication affects you.
When you first start taking Ropinol, it may cause sudden drop in your blood pressure when you change positions. To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down.
Inform your doctor if you develop compulsive behaviors that are hard to control, such as binge eating, gambling, spending money, and sexual urges.
Talk to your doctor in case you develop hallucinations or other changes in your behavior.
Do not stop taking the medication suddenly without talking to your doctor.
Brief Description
Indication
Parkinson’s disease, Restless leg syndrome
Administration
May be taken with or without food. May be taken w/ meals to reduce occurrence of nausea.
Adult Dose
Oral As monotherapy in Parkinson’s disease Adult: Initially, 250 mcg tid, may increase by 750 mcg at wkly intervals for the first 4 wk. Subsequent increments can be made in steps of 1.5 mg at wkly intervals up to 9 mg/day, then in steps of 3 mg at wkly intervals. Usual dose ranges from 3-9 mg daily. Max: 24 mg/day. Higher dose may be necessary if used in conjunction with levodopa. Gradual withdrawal is recommended. Restless leg syndrome Adult: Initially, 250 mcg daily for 2 days, taken 1-3 hr before bedtime. May increase to 500 mcg daily for the next few days. Subsequent increments may be made in steps of 500 mcg at wkly intervals until 3 mg daily is reached. Max: 4 mg daily. Hepatic impairment: Dosing adjustments may be required.

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Contraindication
Lactation.
Mode of Action
Ropinirole is a non-ergot dopamine D2-agonist with similar actions to those of bromocriptine. It is used in the management of Parkinson’s disease, either alone or as an adjunct to levodopa.
Precaution
Pregnancy. May impair ability to drive or operate machinery. Withdrawal should be gradual. Hepatic or renal impairment. May cause daytime sleepiness or episodes of falling asleep during activities. May cause or worsen pre-existing dyskinesia.
Side Effect
>10% Nausea (40-60%),Dizziness (6-40%),Somnolence (11-40%),Syncope (1-12%),Vomiting (12%),Fatigue (8-11%),Viral infection (11%),Dyspepsia (10%) 1-10% Hypertension (5%),Flushing (3%),Orthostasis (1-6%),Chest pain (4%),Palpitation (3%),Extrasystoles (2%),Tachycardia (2%),Hyperhidrosis (3%),Abnormal pain (3-7%),Anorexia (4%),Flatulence (3%),Malaise (3%),Hypoesthesia (4%),Urinary tract infection (5%),Impotence (3%),Alkaline phosphatase (3%),Abnormal vision (6%),Xerophthalmia (2%),Increased diaphoresis (3-6%) <1% Agitation,Aneurysm,Aphasia,Bradycardia,Cardiac arrest,Valvulopathy,Cellulitis,Colitis,Delusion,Delirium,Diaphoresis,Dyspnea,Ulceration,Glaucoma,Psychotic-like behavior,Impulse control/compulsive behavior,Withdrawal-emergent hyperpyrexia and confusion,Melanoma,Fibrotic complications _ Interaction Inhibitors of CYP1A2 e.g. cimetidine, ciprofloxacin, erythromycin, fluvoxamine, isoniazid, ritonavir and zileuton may increase serum concentrations of ropinirole. Oestrogens and tobacco smoking may decrease clearance of ropinirole. Efficacy may be reduced by dopamine antagonists such as phenothiazines and metoclopramide.