Ropinirole

The recommended adult starting dose of ropinirole is 0.25 mg taken 3 times daily. The dose may be increased weekly up to a maximum of 8 mg taken 3 times daily as needed in individual circumstances.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.

Ropinirole may be taken with or without food. If nausea occurs, take the tablets with food to prevent stomach upset. The tablets should be swallowed whole and not chewed.

Ropinirole should not be stopped suddenly. If you feel it is necessary to stop taking ropinirole, discuss the best way to do so with your doctor.

It is important to take Ropinirole exactly as prescribed by the doctor. If you miss a dose of Ropinirole, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Ropinirole at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; occasionally, it may cause trembling and involuntary movements (also known as dyskinesia); it may cause drowsiness or dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause nausea and vomiting; it may cause heavy perspiration. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

0.25 mg
Each white-to-off-white, film-coated, raised-pentagon-shaped tablet with "RI" over "0.25" on one side and a logo on the other contains 0.25 mg of ropinirole as ropinirole hydrochloride. Nonmedicinal ingredients: croscarmellose sodium, lactose monohydrate, magnesium stearate, and microcrystalline cellulose. Tablet coating: polyvinyl alcohol (part hydrolyzed), titanium dioxide, polyethylene glycol, and talc.

1 mg
Each green, film-coated, raised-pentagon-shaped tablet with "RI" over "1"on one side and a logo on the other contains 1 mg of ropinirole as ropinirole hydrochloride. Nonmedicinal ingredients: croscarmellose sodium, lactose monohydrate, magnesium stearate, and microcrystalline cellulose. Tablet coating: polyvinyl alcohol (part hydrolyzed), titanium dioxide, polyethylene glycol, talc, FD&C Blue No. 2, and iron oxide yellow.

Do not take ropinirole if you are allergic to ropinirole or any ingredients of the medication.

There may be an interaction between ropinirole and any of the following:

• alcohol
• Aldesleukin
• Aliskiren
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• Amiodarone
• angiotensin converting enzyme inhibitors (ACEIs; Captopril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., Candesartan, Irbesartan, Losartan)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• Apomorphine
• barbiturates (e.g., butalbital, pentobarbital Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• Bortezomib
• brimonidine
• Bromocriptine
• Buprenorphine
• Bupropion
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• cannabis
• chloral hydrate
• ciprofloxacin
• conivaptan
• Deferasirox
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Duloxetine
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• Entacapone
• Flibanserin
• Fluvoxamine
• general anesthetics (medications used to put people to sleep before surgery)
• Guanfacine
• iron sucrose
• Leflunomide
• levodopa
• Methylphenidate
• Metoclopramide
• Mexiletine
• Minoxidil
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine, Tizanidine)
• Nabilone
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• Obinutuzumab
• Pentoxifylline
• phosphodiesterase-5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pramipexole
• rasagiline
• Riociguat
• sacubitril
• scopolamine
• seizure medications (e.g., Clobazam, Ethosuximide, felbamate, Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• Stiripentol
• suvorexant
• Tapentadol
• Teriflunomide
• tolcapone
• Tramadol
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• Vemurafenib
• Warfarin
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Behaviour and personality changes: Ropinirole can cause behaviour changes including hallucinations, pathological gambling, and increased libido. Personality changes may also occur, including paranoia, anxiety or nervousness, or a sense of not being oneself.

If you experience changes in behaviour or are aware of these changes happening in someone who is taking ropinirole, contact the doctor as soon as possible.

Breathing problems: Ropinirole has been known to cause scarring or thickening of the tissues in the abdomen, including the lungs and heart. If you experience any difficulty breathing or chest pain, contact your doctor as soon as possible.

Dizziness: Ropinirole may cause dizziness when getting up from a lying or sitting position to a standing position. This usually happens at the start of treatment or when the dose is being increased. You can decrease the frequency of this happening by rising slowly when you sit up or stand up.

Hallucinations: Ropinirole causes hallucinations for about 5% of people who take it and for about 10% of people who take it at the same time as levodopa. The incidence of hallucinations increases as the dose increases. If you experience hallucinations or are aware of a person who is taking ropinirole experiencing hallucinations, contact the doctor as soon as possible.

Heart disease: Ropinirole has not been studied for use by people with significant heart disease. If you have heart disease and are taking ropinirole, discuss with your doctor how Ropinirole may affect your medical condition, and how your medical condition may affect the dosing and effectiveness of Ropinirole. Your doctor will want to monitor your heart condition closely while you are taking ropinirole.

Kidney function: If you have reduced kidney function or Kidney Disease, discuss with your doctor how Ropinirole may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Ropinirole, and whether any special monitoring is needed

Liver function: The safety and effectiveness of ropinirole when used by people with reduced liver function has not been studied. Ropinirole is not recommended for people with reduced liver function.

Melanoma: People with Parkinson's disease may be at increased risk of developing melanoma (a type of Skin Cancer). It is not known if this increased risk is due to Parkinson's disease or to the medications used to treat Parkinson's disease. Your doctor will monitor you for skin cancer while you are taking Ropinirole. Talk to your doctor if you have any concerns.

Neuroleptic malignant syndrome (NMS): As with other medications that have an effect on movement disorders, ropinirole can trigger a potentially fatal set of symptoms known as neuroleptic malignant syndrome (NMS). If you experience symptoms of NMS, such as high Fever, muscle stiffness, confusion or loss of consciousness, sweating, rapid or irregular heartbeat, seek immediate medical attention.

This is more likely to occur if ropinirole is stopped suddenly or the dose is decreased rapidly. If you are considering stopping Ropinirole, discuss the appropriate way to reduce ropinirole with your doctor.

Sudden onset of sleep: Ropinirole can cause the sudden, unpredictable onset of sleep. This can happen while participating in the daily activities of living, including driving or operating machinery. This effect may occur at any point while taking the medication.

Because there is no warning when or if this will occur, do not drive or operate dangerous machinery while you are taking ropinirole.

Uncontrolled movements: Ropinirole may cause an increase in irregular, jerky movements or uncontrolled body movements when it is taken with levodopa. If you notice movement problems worsening, contact your doctor as soon as possible.

Pregnancy: The use of ropinirole during pregnancy is not recommended. If you become pregnant while taking Ropinirole, contact your doctor immediately.

Breast-feeding: Ropinirole reduces the production of breast milk, and therefore, should not be taken by women who wish to breast-feed.

Children: The safety and effectiveness of Ropinirole have not been established for use by children.

This medication is typically used 3 times a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. This medication should be swallowed whole. It should not be split, crushed or chewed. If you forget a dose, contact your pharmacist. This medication may be taken with or without food. If it were, however, to cause nausea, taking the product with food could provide relief.