REQUIP XL Rx
Generic Name and Formulations:
Ropinirole (as HCl) 2mg, 4mg, 6mg, 8mg, 12mg; ext-rel tabs.
Indications for REQUIP XL:
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.
See full labeling. Consider discontinuing if excessive daytime sleepiness or if sudden onset of sleep during daily activities occurs. Monitor for drowsiness or sleepiness, and for orthostatic hypotension. Dyskinesia. Sleep disorders. Severe renal or hepatic impairment. Significant cardiovascular disease; monitor for hypertension and changes in heart rate. Psychotic disorders. Urges/compulsive behaviors. Monitor for melanoma; perform periodic skin exams. Fibrotic complications. Avoid abrupt cessation. Elderly. Pregnancy. Nursing mothers.
Dopamine agonist (non-ergot).
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.
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.
Tabs—100; XL tabs—30