Requip


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Related to Requip: Restless Leg Syndrome, Requip XL

rOPINIRole

(roe-pin-i-role) ,

Requip

(trade name),

Requip XL

(trade name)

Classification

Therapeutic: antiparkinson agents
Pharmacologic: dopamine agonists
Pregnancy Category: C

Indications

Management of signs and symptoms of idiopathic Parkinson’s disease.Restless leg syndrome (immediate-release only).

Action

Stimulates dopamine receptors in the brain.

Therapeutic effects

Decreased tremor and rigidity in Parkinson’s disease.
Decreased leg restlessness.

Pharmacokinetics

Absorption: 55% absorbed following oral administration.
Distribution: Widely distributed.
Metabolism and Excretion: Extensively metabolized by the liver (by cytochrome P450 CYP1A2 enzyme system); <10% excreted unchanged in urine.
Half-life: 6 hr.

Time/action profile

ROUTEONSETPEAKDURATION
POunknownunknown8 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity.
Use Cautiously in: Hepatic impairment (slower titration may be required);Severe cardiovascular disease; Obstetric / Lactation / Pediatric: Safety not established; may inhibit lactation; Geriatric: ↑ risk of hallucinations.

Adverse Reactions/Side Effects

Central nervous system

  • sleep attacks (life-threatening)
  • dizziness (most frequent)
  • syncope (most frequent)
  • confusion
  • drowsiness
  • fatigue
  • hallucinations
  • headache
  • dyskinesia
  • impulse control disorders (gambling, sexual)
  • weakness

Ear, Eye, Nose, Throat

  • abnormal vision

Cardiovascular

  • orthostatic hypotension
  • peripheral edema

Gastrointestinal

  • constipation
  • dry mouth
  • dyspepsia
  • nausea
  • vomiting

Dermatologic

  • sweating
  • melanoma

Interactions

Drug-Drug interaction

Drugs that alter the activity of cytochrome P450 CYP1A2 enzyme system may affect the activity of ropinirole.Effects may be ↑ by estrogens.Effects may be ↓ by phenothiazines, butyrophenones, thioxanthenes, or metoclopramide.May ↑ effects of levodopa (may allow dose ↓ of levodopa).

Route/Dosage

Oral (Adults) Parkinson's disease—Immediate-release: 0.25 mg 3 times daily for 1 wk, then 0.5 mg 3 times daily for 1 wk, then 0.75 mg 3 times daily for 1 wk, then 1 mg 3 times daily for 1 wk; then may ↑ by 1.5 mg/day every wk up to 9 mg/day; then may ↑ by up to 3 mg/day every wk up to 24 mg/day; Extended-release: 2 mg once daily for 1–2 wk; may ↑ by 2 mg/day every wk up to 24 mg/day. Restless leg syndrome—0.25 mg once daily initially, 1–3 hr before bedtime. After 2 days, ↑ to 0.5 mg once daily and to 1 mg once daily by the end of first week of dosing, then ↑ by 0.5 mg weekly, up to 4 mg/day as needed/tolerated.

Availability (generic available)

Tablets: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg Cost: Generic — 0.25 mg $250.21 / 100, 0.5 mg $250.21 / 100, 1 mg $250.21 / 100, 2 mg $250.21 / 100, 3 mg $259.54 / 100, 4 mg $259.85 / 100, 5 mg $259.85 / 100
Extended-release tablets: 2 mg, 4 mg, 6 mg, 8 mg, 12 mg Cost: Generic — 2 mg $82.05 / 30, 4 mg $164.10 / 30, 6 mg $246.16 / 30, 8 mg $246.16 / 30, 12 mg $410.47 / 30

Nursing implications

Nursing assessment

  • Assess BP periodically during therapy.
  • Assess patient for drowsiness and sleep attacks. Drowsiness is a common side effect of ropinirole, but sleep attacks or episodes of falling asleep during activities that require active participation may occur without warning. Assess patient for concomitant medications that have sedating effects or may increase serum ropinirole levels (see Interactions). May require discontinuation of therapy.
  • Parkinson's Disease: Assess patient for signs and symptoms of Parkinson’s disease (tremor, muscle weakness and rigidity, ataxic gait) prior to and during therapy.
  • Restless Leg Syndrome: Assess sleep patterns and frequency of restless leg disturbances.
  • Lab Test Considerations: May cause ↑ BUN.

Potential Nursing Diagnoses

Impaired physical mobility (Indications)
Risk for injury (Indications,  Side Effects)

Implementation

  • Do not confuse ropinirole with Risperdal (risperidone) or risperidone.
  • Oral: May be administered with or without food. Administration with food may decrease nausea. Extended-release tablets should be swallowed whole; do not break, crush, or chew.

Patient/Family Teaching

  • Instruct patient to take medication exactly as directed. Missed doses should be taken as soon as possible, but not if almost time for next dose. Do not double doses.
  • Caution patient to change positions slowly to minimize orthostatic hypotension.
  • May cause drowsiness and unexpected episodes of falling asleep. Caution patient to avoid driving or other activities requiring alertness until response to medication is known. Advise patient to notify health care professional if episodes of falling asleep occur.
  • Advise patient to avoid alcohol and other CNS depressants concurrently with ropinirole.
  • Advise patient that increasing fluids, sugarless gum or candy, ice, or saliva substitutes may help minimize dry mouth. Consult health care professional if dry mouth continues for >2 wk.
  • Advise patient to have periodic skin exams to check for lesions that may be melanoma.
  • Advise patient to notify health care professional if new or increased gambling, sexual, or other impulse control disorders occur.

Evaluation/Desired Outcomes

  • Decreased tremor and rigidity in Parkinson’s disease.
  • Decrease in restless legs and improved sleep.

Requip

(rē′kwĭp′)
A trademark for the drug ropinirole hydrochloride.

Requip®

Ropinirole Pharmacology A 2nd-generation dopamine agonist for treating Parkinson's disease. See Parkinson's disease.

Requip

A brand name for ROPINIROLE.
References in periodicals archive ?
ReQuip is taken to alleviate the symptoms of the central nervous system disorder, which causes shaking.
While taking Requip, Jambart attempted suicide eight times and his risky sexual encounters resulted in him being raped.
Vicki had eight weeks off work and started taking ReQuip, a drug to control the symptoms and slow the condition.
In October 2004 his doctor prescribed an alternative dopamine agonist, Requip.
The approval is for multiple strengths of the drug, which is the generic version of GlaxoSmithKline Plc's Requip that is used to treat Parkinson's disease and primary restless leg syndrome.
Patients should 22 mg also tell their doctor 24 mg if they experience new or increased gambling, sexual, or other intense urges while taking Requip XL.
Anticipated Generic Availability Brand Name (generic name) Common Uses (2008) Tegretol XR Seizures January-March (carbamazepine extended-release) Fosamax and Fosamax Weekly Osteoporosis February (alendronate sodium) Requip (ropinirole Hcl) Parkinson's/Restless May Legs Syndrome Risperdal (risperidone) Mental/mood disorders June/July Dovonex (calcipotriene) Psoriasis July-September Cipro HC (ciprofloxacin/ External ear July-September hydrocortisone solution) infections Severent Diskus and Inhaler Asthma/chronic July-September (salmeterol) obstructive pulmonary disease Altace (ramipril) Cardiovascular October Paxil CR (paroxetine Anxiety, depression October hydrochloride) Imitrex (sumatriptan) Migraines To Be Determined Sources: LifeWise; Premera Blue Cross; University of Michigan; U.
Ropinirole, a non-ergoline dopamine agonist, is marketed as Requip by Glaxo-SmithKline Inc.
Fortunately, these conditions respond well to medications, such as, Requip and Mirapex (originally marketed for Parkinson's disease) and muscle relaxants.
In the regional portfolio, ahead of final year results due to be announced on Thursday, GlaxoSmithKline's drug Requip XL was again in the spotlight.
is a dopamine agonist that was first approved by the FDA for the treatment of Parkinson's disease in 1997, along with GlaxoSmithKline's similar drug Requip (ropinirole).