Requip


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Related to Requip: Restless Leg Syndrome, Requip XL

ropinirole hydrochloride

Adartrel (UK), Requip, Requip XL

Pharmacologic class: Dopamine agonist

Therapeutic class: Antidyskinetic

Pregnancy risk category C

Action

Unknown. Thought to stimulate dopamine receptors in brain.

Availability

Tablets: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg

Tablets (extended-release): 2 mg, 4 mg, 6 mg, 8 mg

Indications and dosages

Idiopathic Parkinson's disease

Adults: For conventional tablets, initially, 0.25 mg P.O. t.i.d. for 1 week, followed by 0.5 mg P.O. t.i.d. for 1 week, then 0.75 mg t.i.d. for 1 week, and then 1 mg t.i.d. for 1 week. After week 4, may increase by 1.5 mg/day q week, up to 9 mg/day; then may increase further by up to 3 mg/day q week, up to 24 mg/day. For extended-release tablets, initially 2 mg P.O. once daily for 1 to 2 weeks, followed by increases of 2 mg/day at 1-week or longer intervals as appropriate, depending on therapeutic response and tolerability, up to a recommended maximum dosage of 24 mg/day.

Moderate to severe primary restless leg syndrome

Adults: Initially, 0.25 mg P.O. once daily, 1 to 3 hours before bedtime. After 2 days, may increase dosage to 0.5 mg once daily and to 1 mg once daily during week 2. For weeks 3 through 6, may increase dosage by 0.5 mg/week, to a dosage of 3 mg; at week 7, dosage may be increased to 4 mg (immediate-release tablets only).

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:

• severe hepatic impairment or cardiovascular disease, bradycardia

• elderly patients

• pregnant patients

• breastfeeding patients (use not recommended).

Administration

• Give with food if drug causes nausea.

• Assess patient for therapeutic response and tolerability at 1-week intervals (minimum) or longer after each dosage increment.

• Know that drug withdrawal should occur over 7 days, with frequency reduced to twice-daily dosing for first 4 days and then to once-daily dosing for next 3 days.

Adverse reactions

CNS: headache, dizziness, confusion, drowsiness, fatigue, neuralgia, amnesia, hyperesthesia, yawning, dystonia, increased dyskinesia, hyperkinesia, akathisia, hallucinations, abnormal thinking, poor concentration, syncope, vertigo, myoclonus, asthenia, malaise, sleep attacks

CV: orthostatic hypotension, hypertension, palpitations, extrasystole, peripheral edema, peripheral ischemia, chest pain, tachycardia, atrial fibrillation

EENT: abnormal vision, rhinitis, sinusitis, pharyngitis

GI: nausea, vomiting, flatulence, abdominal pain, dyspepsia, dry mouth, anorexia

GU: urinary tract infection, decreased libido, erectile dysfunction

Respiratory: bronchitis, dyspnea

Skin: diaphoresis, flushing

Other: viral infection, pain, edema

Interactions

Drug-drug. Butyrophenones (such as haloperidol), metoclopramide, phenothiazines, thioxanthenes: decreased ropinirole effects

Ciprofloxacin, estrogens: increased ropinirole effects

Drugs that alter activity of CYP450-1A2 enzyme system: altered ropinirole clearance

Levodopa: increased levodopa effects

Drug-diagnostic tests. Alkaline phosphatase, blood urea nitrogen: increased levels

Drug-herbs. Kava: decreased ropinirole efficacy

Patient monitoring

• Monitor vital signs, especially for orthostatic hypotension. Assess for peripheral edema.

• Assess neurologic status carefully. Report severe adverse reactions.

• Monitor nutritional and hydration status.

Patient teaching

• Encourage patient to take drug with food if it causes nausea.

• Instruct patient to swallow extended-release tablets whole and not to chew, crush, or divide them.

• Inform patient that hallucinations may occur during ropinirole therapy.

• Advise patient that he may experience the urge to gamble, increased sexual urges, or other intense urges and the inability to control these urges.

• Inform patient (and caregiver, as appropriate) that drug can cause serious CNS reactions; tell him which ones to report. Recommend appropriate safety measures.

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure decrease.

Caution patient not to stop drug abruptly. Dosage must be tapered.

• Advise patient to report swelling of hands or feet.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, vision, and alertness.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

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 ?
CNS sales fell 8% in FY to pounds sterling 1.5 billion, as Paxil faced generic competition in Japan and Europe and Requip and Lamictal XR faced generics in the U.S.
Hauser found that PD patients who failed to obtain good symptom control after taking a certain dopamine agonist drug, such as apomorphine (Apokyn), pramipexole (Mirapex), or ropinirole (Requip), achieved much greater symptom relief by taking the commonly prescribed PD drug rasagiline (Azilect).
Current treatments for PD involve dopamine agonists--drugs such as Mirapex (pramipexole) and Requip (ropinirole), which functionally mimic the effects of dopamine in the brain--and Comtan (entacapone) in conjunction with levodopa, the widely-used and effective PD medication that converts to dopamine.
Ropinirole (Requip) and pramipexole (Mirapex) are FDA-approved to treat moderate to severe RLS.
For example, drugs to treat Parkinson's disease, including ropinirole (Requip) and pramipexole (Mirapex), also have FDA approval to treat moderate-to-severe RLS.
Prescribed drug ReQuip is taken to alleviate symptoms of the nervous system disorder, which causes shaking.
Ropinirole, known by the trade name ReQuip. There are 21 claims of sex addiction, 16 of compulsive gambling, 11 of obsessive-compulsive disorder, one of compulsive shopping and one from a person who said it made him a transvestite.
In a landmark ruling, GSK was ordered to pay damages of E400,000 ([pounds sterling]160,000) to Didier Jambart, who began taking Requip in 2003.
2010) ("Perhaps Requip is a cause of problem gambling, but the scientific knowledge is not yet there.
The phenomenon, known as augmentation, occurs in "something like 80%" of RLS patients treated with carbidopa-levodopa (Sinemet) nightly, and maybe up to 20% treated with pramipexole (Mirapex) and ropinirole (Requip), she said.
The phenomena, known as augmentation, probably occurs in "something like 80%" of RLS patients treated with carbidopa-levodopa (Sinemet) nightly, and maybe up to 20% treated with pramipexole (Mirapex) and ropinirole (Requip), Dr.