Ropinirole should be used cautiously in patients with preexisting psychosis.
However, if estrogen therapy is stopped or started during treatment with ropinirole, then adjustment of the ropinirole dose may be required.
Approximately 24 of patients who received REQUIP in the double-blind, placebo-controlled advanced Parkinson s disease with L-dopa trials discontinued treatment due to adverse reactions compared with 18 of patients who received placebo. In vitro metabolism studies showed that CYP1A2 is the major enzyme responsible for the metabolism of ropinirole. It is also used to treat a condition called Restless Legs Syndrome RLS. Advise patients with Parkinson s disease that they have a higher risk of developing melanoma.
There is thus the potential for inducers or inhibitors of this enzyme to alter the clearance of ropinirole. Because somnolence is a frequent adverse reaction with potentially serious consequences, patients should not drive a car, operate machinery, or engage in other potentially dangerous activities until they have gained sufficient experience with REQUIP to gauge whether or not it affects their mental and or motor performance adversely.
Ask your doctor before use if you are taking the following medications:
Patients should be instructed to avoid an evening dose because of the risk of supine hypertension.
In children, if pain is controlled with oral analgesia, clear liquids are tolerated, and there is no evidence of infection, they are closely monitored for spontaneous passage for 3 to 4 weeks prior to definitive therapy, since most data demonstrate safe lower uretal stone expulsion in the first 10 days of conservative medical management.
Concomitant administration of apomorphine and CNS depressants, such as ropinirole, could result in additive depressant effects. If a significant interruption in therapy has occurred, retitration of the drug is warranted. This scale was developed and validated by the IRLSSG 20 and comprises 10 questions about restless legs syndrome symptoms and their impact on daily activities and mood.
However, if estrogen therapy is stopped or started during treatment with ropinirole, then adjustment of the ropinirole dose may be required. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines. Titration should be based on individual patient therapeutic response and tolerability, up to a maximum recommended dose of 4 mg daily.