Ropinirole

Indications
 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.
Hepatic impairment: Dosing adjustments may be necessary.
Oral
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.
Contraindications
 Lactation.
Warnings / Precautions
 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.
Adverse Reactions
 Sudden onset of sleep with or without any prior feeling of drowsiness. Nausea, abdominal pain; dizziness, somnolence, headache, hallucinations; dyskinesias.
Overdose Reactions
 Symptoms include nausea, vomiting, visual hallucinations, hyperhidrosis, asthenia and nightmares. General supportive measures and monitoring of vital signs are recommended. May consider gastric lavage.
Drug Interactions
 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.
See Below for More ropinirole Drug Interactions
Mechanism of Actions
 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.
Absorption: Rapidly absorbed from the GI tract after oral admin. Bioavailability: about 50%.
Distribution: Widely distributed. Plasma protein binding: 10-40%.
Metabolism: Extensively metabolised in the liver by CYP1A2.
Excretion: Excreted in the urine as inactive metabolites; <10% of the oral dose is excreted unchanged. Elimination half-life: about 6 hr.
Administration
 May be taken with or without food. (May be taken w/ meals to reduce occurrence of nausea.)
Prolonged release: May be taken with or without food. (May be taken w/ meals to reduce occurrence of nausea. Swallow whole, do not chew/crush/divide.)
Storage Conditions
 Oral: Store at 20-25°C.
ATC Classification
 N04BC04 - ropinirole ; Belongs to the class of dopamine agonist. Used in the management of Parkinson's disease.
Storage
 Oral: Store at 20-25°C.
Available As
  • Ropinirole 0.25 mg
  • Ropinirole 0.5 mg
  • Ropinirole 1 mg
  • Ropinirole 2 mg

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