Ropinol
Generic Name
Ropinirole 0.25 mg tablet
Manufacturer
Medicinova Pharmaceuticals
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ropinol 025 mg tablet | ৳ 2.00 | ৳ 20.00 |
Description
Overview of the medicine
Ropinirole is a non-ergoline dopamine agonist used for the treatment of Parkinson's disease and Restless Legs Syndrome. It stimulates dopamine receptors in the brain, helping to improve motor symptoms associated with these conditions.
Uses & Indications
Dosage
Adults
For Parkinson's disease: Initial dose 0.25 mg three times daily. Titrate weekly by 0.25 mg/dose up to 1.5 mg three times daily based on response. For RLS: Initial dose 0.25 mg once daily, 1-3 hours before bedtime. May increase to 0.5 mg daily after 2 days, then by 0.5 mg increments weekly up to 4 mg daily.
Elderly
Similar to adult dosage, but titration should be done cautiously, monitoring for side effects like hypotension and somnolence.
Renal_impairment
No dosage adjustment is required for patients with mild to moderate renal impairment. For severe renal impairment (CrCl <30 mL/min) or patients on hemodialysis, consider a reduced starting dose and careful titration. Not recommended for patients on hemodialysis unless benefits outweigh risks.
How to Take
Administer orally with or without food. Tablets should be swallowed whole and not crushed, chewed, or divided. Take at the same time each day.
Mechanism of Action
Ropinirole is a selective non-ergoline dopamine D2 and D3 receptor agonist. It stimulates postsynaptic D2 and D3 receptors in the caudate putamen, thereby mimicking the effect of dopamine and alleviating motor symptoms in Parkinson's disease. For Restless Legs Syndrome, its exact mechanism is unknown but believed to involve dopaminergic pathways.
Pharmacokinetics
Onset
Onset of action for Parkinson's symptoms relief is generally within 1-2 hours, but full therapeutic effect may take weeks of titration. For RLS, onset is typically within a few hours of the first dose.
Excretion
Approximately 88% of the dose is excreted in the urine as metabolites, with less than 10% excreted as unchanged drug.
Half life
Elimination half-life is approximately 6 hours.
Absorption
Rapidly absorbed after oral administration, peak plasma concentrations reached in 1-2 hours. Absolute bioavailability is approximately 50%.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 CYP1A2 isoenzyme to inactive metabolites.
Side Effects
Contraindications
- Known hypersensitivity to ropinirole or any component of the formulation.
Drug Interactions
Other sedatives/CNS depressants
Increased risk of somnolence and sedation.
Estrogens (e.g., hormone replacement therapy)
May decrease ropinirole clearance, requiring dosage adjustment.
CYP1A2 inhibitors (e.g., ciprofloxacin, fluvoxamine)
May increase ropinirole plasma concentrations, requiring dosage adjustment.
Dopamine antagonists (e.g., antipsychotics, metoclopramide)
May reduce the efficacy of ropinirole.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, dizziness, somnolence, dyskinesia, agitation, chest pain, confusion, and hallucinations. Management is supportive, including gastric lavage, emesis, and symptomatic treatment. Dopamine antagonists (e.g., neuroleptics) may be considered.
Pregnancy & Lactation
Pregnancy Category C. Ropinirole should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in breast milk and may inhibit lactation; therefore, should not be used during breastfeeding.
Side Effects
Contraindications
- Known hypersensitivity to ropinirole or any component of the formulation.
Drug Interactions
Other sedatives/CNS depressants
Increased risk of somnolence and sedation.
Estrogens (e.g., hormone replacement therapy)
May decrease ropinirole clearance, requiring dosage adjustment.
CYP1A2 inhibitors (e.g., ciprofloxacin, fluvoxamine)
May increase ropinirole plasma concentrations, requiring dosage adjustment.
Dopamine antagonists (e.g., antipsychotics, metoclopramide)
May reduce the efficacy of ropinirole.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, dizziness, somnolence, dyskinesia, agitation, chest pain, confusion, and hallucinations. Management is supportive, including gastric lavage, emesis, and symptomatic treatment. Dopamine antagonists (e.g., neuroleptics) may be considered.
Pregnancy & Lactation
Pregnancy Category C. Ropinirole should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in breast milk and may inhibit lactation; therefore, should not be used during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved (internationally)
Patent Status
Expired
Clinical Trials
Ropinirole has been extensively studied in numerous clinical trials demonstrating its efficacy and safety for both Parkinson's disease and Restless Legs Syndrome, leading to its widespread approval.
Lab Monitoring
- No routine laboratory monitoring is typically required. Monitor blood pressure for orthostatic hypotension, especially during initiation and dose titration. Periodically assess for impulse control disorders.
Doctor Notes
- Counsel patients on the risk of impulse control disorders and sudden sleep attacks.
- Emphasize the importance of gradual dose titration and not stopping treatment abruptly.
- Monitor for orthostatic hypotension, especially in elderly patients and during dose escalation.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor.
- Do not stop taking Ropinirole abruptly, as this may lead to withdrawal symptoms or worsening of symptoms. Any discontinuation should be gradual under medical supervision.
- Be aware that Ropinirole may cause drowsiness or sudden sleep attacks. Avoid driving or operating heavy machinery until you know how the medication affects you.
- Report any unusual changes in behavior, mood, or new urges (e.g., gambling, spending, increased sexual urges) to your doctor.
Missed Dose Advice
If a dose is missed, skip the missed dose and take the next dose at the regularly scheduled time. Do not double the dose to catch up.
Driving Precautions
Ropinirole can cause severe drowsiness or sudden sleep attacks without warning, even during daily activities. Patients should be advised not to drive or engage in hazardous activities if they experience somnolence.
Lifestyle Advice
- Avoid or limit alcohol consumption as it can increase drowsiness and dizziness caused by Ropinirole.
- Maintain regular physical activity, which can be beneficial for both Parkinson's disease and Restless Legs Syndrome.
- Ensure a balanced diet and adequate hydration.
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