Rapilief
Generic Name
Ropinirole
Manufacturer
Eskayef Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| rapilief 4 mg capsule | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Rapilief 4 mg Capsule contains Ropinirole, a non-ergoline dopamine agonist. It is primarily used for the treatment of Parkinson's disease and Restless Legs Syndrome (RLS). Ropinirole works by mimicking the effect of dopamine, a natural substance in the brain that helps control movement.
Uses & Indications
Dosage
Adults
For Parkinson's disease: Initial dose of 0.25 mg three times daily, titrated gradually based on response and tolerability, up to a maximum of 24 mg/day. For RLS: Initial dose of 0.25 mg once daily, 1-3 hours before bedtime, titrated gradually based on response and tolerability, up to a maximum of 4 mg/day.
Elderly
No specific dose adjustment is required in elderly patients, but individual titration should be cautious due to potential increased sensitivity.
Renal_impairment
No dose adjustment needed for mild to moderate renal impairment. For severe renal impairment (CrCl <30 mL/min), a dose reduction or careful titration may be considered.
How to Take
Rapilief capsules should be taken orally, with or without food. It is important to swallow the capsule whole and not to chew, crush, or divide it. For RLS, take 1-3 hours before bedtime.
Mechanism of Action
Ropinirole is a non-ergoline dopamine agonist that selectively stimulates D2 and D3 dopamine receptors within the brain's caudate-putamen, thereby compensating for the diminished dopamine activity characteristic of Parkinson's disease. In Restless Legs Syndrome, its exact mechanism is not fully understood but is thought to involve the modulation of dopaminergic pathways in the spinal cord and brain.
Pharmacokinetics
Onset
Onset of action for motor symptom improvement can be gradual over days to weeks with titration. For RLS, symptom improvement can be seen within hours to days.
Excretion
Primarily excreted in the urine, predominantly as metabolites. Less than 10% is excreted unchanged.
Half life
Approximately 6 hours.
Absorption
Rapidly absorbed after oral administration, peak plasma concentrations typically within 1-2 hours. Bioavailability is approximately 50%.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 isoenzyme CYP1A2 into inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to Ropinirole or any component of the formulation.
- Severe hepatic impairment (use with caution).
Drug Interactions
Smoking
Induces CYP1A2, potentially reducing Ropinirole plasma levels.
Estrogens
May reduce Ropinirole clearance, potentially leading to increased plasma levels.
CYP1A2 Inhibitors (e.g., Ciprofloxacin, Fluvoxamine)
May increase Ropinirole plasma levels, requiring dose reduction.
Dopamine Antagonists (e.g., Antipsychotics, Metoclopramide)
May reduce the efficacy of Ropinirole.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, dizziness, somnolence, postural hypotension, hallucinations, paranoia, and dyskinesia. Management is symptomatic and supportive; consider gastric lavage and antiemetics if severe. Monitor vital signs and mental status.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Ropinirole is excreted into breast milk and may inhibit lactation; therefore, breastfeeding is not recommended.
Side Effects
Contraindications
- Hypersensitivity to Ropinirole or any component of the formulation.
- Severe hepatic impairment (use with caution).
Drug Interactions
Smoking
Induces CYP1A2, potentially reducing Ropinirole plasma levels.
Estrogens
May reduce Ropinirole clearance, potentially leading to increased plasma levels.
CYP1A2 Inhibitors (e.g., Ciprofloxacin, Fluvoxamine)
May increase Ropinirole plasma levels, requiring dose reduction.
Dopamine Antagonists (e.g., Antipsychotics, Metoclopramide)
May reduce the efficacy of Ropinirole.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, dizziness, somnolence, postural hypotension, hallucinations, paranoia, and dyskinesia. Management is symptomatic and supportive; consider gastric lavage and antiemetics if severe. Monitor vital signs and mental status.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Ropinirole is excreted into breast milk and may inhibit lactation; therefore, breastfeeding is not recommended.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Refer to packaging for exact shelf life, typically 24-36 months.
Availability
Available in pharmacies nationwide
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent
Clinical Trials
Extensive clinical trials have demonstrated Ropinirole's efficacy and safety in Parkinson's disease and RLS, leading to its global approval. Ongoing research explores its long-term effects and potential new indications.
Lab Monitoring
- No routine lab monitoring is generally required. Clinical monitoring for efficacy and side effects is essential.
Doctor Notes
- Emphasize slow titration to minimize side effects, especially orthostatic hypotension and nausea.
- Counsel patients on the risk of impulse control disorders and sudden sleep attacks.
- Regularly assess for efficacy, tolerability, and any new neurological or psychiatric symptoms.
Patient Guidelines
- Take Rapilief exactly as prescribed by your doctor.
- Do not stop taking Rapilief abruptly without consulting your doctor, as this can lead to serious withdrawal symptoms.
- Be aware of potential side effects such as sudden sleep attacks, dizziness, and compulsive behaviors. Report any unusual changes to your doctor.
- Avoid driving or operating machinery if you experience drowsiness or sudden sleep attacks.
Missed Dose Advice
If you miss a dose of Rapilief, skip the missed dose and take your next dose at the regularly scheduled time. Do not double the dose to make up for a missed one.
Driving Precautions
Rapilief may cause somnolence, dizziness, and sudden onset of sleep. Patients should be warned about driving or operating machinery and should avoid such activities if they experience these symptoms.
Lifestyle Advice
- Avoid alcohol consumption, as it may worsen drowsiness and other CNS side effects.
- Maintain regular sleep hygiene, especially if taking Rapilief for RLS.
- Report any new or worsening compulsive behaviors to your doctor immediately.
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