Requip

The active ingredient in Requip is ropinirole hydrochloride. Ropinirole is a dopaminergic agonist. The mechanism of action is not quite but it is thought to be related to its ability to stimulate dopamine receptors. Parkinson's disease and restless legs syndrome appear to be caused by abnormalities in the brain's dopamine system. Ropinirole, which acts similarly to dopamine, helps treat symptoms of Parkinson's disease and restless legs syndrome.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Requip. However, the following is a synopsis of the general guidelines for the use of Requip:

• If you are taking immediate-release Requip tablets, do not take extended-release tablets at the same time.
• The dose and timing of Requip in treating Parkinson's disease differ from those used to treat RLS. Follow the guidelines on the prescription label. If you have any questions concerning the ropinirole you received at the pharmacy, speak with your pharmacist.
• Requip may be taken with or without food. Take your medicine at the same time every day.
• Do not chew, crush, or break an extended-release Requip XL pill. Swallow the tablet whole.
• If you notice any component of the tablet in your feces, contact your doctor. This indicates that your body may not have absorbed all of the medication.
• If you are using this medication for RLS, notify your doctor if your symptoms worsen, occur in the morning or earlier than normal in the evening, or if you get restless symptoms in your hands or arms.
• Your symptoms may take many weeks to improve. Continue taking the medication as prescribed, and notify your doctor if your symptoms do not improve.
• Do not stop using Requip abruptly, as you may experience unpleasant withdrawal symptoms. Follow your doctor's recommendations for tapering your dosage.

The most common side effects of Requip seen in clinical trials include:

• Weakness
• Sleepiness or drowsiness.
• Nausea or vomiting.
• Syncope (brief loss of consciousness caused by a drop in blood flow to the brain)
• Changes in your heart rate.
• Viral infection.
• Indigestion.
• Stomach pain.
• Low blood pressure when standing (orthostatic hypotension).
• Increased blood pressure (hypertension).
• Constipation.

Some individuals may experience serious side effects while using Requip. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Serious withdrawal symptoms (neuroleptic malignant syndrome): fever, sweating, chest pain, rigid muscles, being unaware of your surroundings, fast or irregular heartbeat.
• Extreme somnolence, including sudden sleep onset.
• Dyskinesia (for patients with advanced Parkinson’s disease).
• Impulse-control behaviors: intense desires for specific compulsive behaviors (e.g., gambling, shopping, binge eating, participating in sexual activity).
• Other changes in behavior or hallucinations.
• Allergic reaction to Requip.

These are not all of the possible side effects of Requip. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Requip, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• If you have an allergy to ropinirole, you should not use Requip.
• To ensure that Requip is safe for you, inform your doctor if you have
• Low blood pressure or high blood pressure.
• Renal disease (or if you are on dialysis).
• Heart disease, heart rhythm issues.
• A sleep disorder, such as narcolepsy, or other conditions that may produce daytime sleepiness.
• If you are a smoker.
• People with Parkinson's disease may be more likely to get skin cancer (melanoma). Speak with your doctor about this risk and what skin symptoms to look for.
• Requip may lead you to fall asleep while doing regular everyday activities including working, chatting, eating, or driving. Even if you feel aware, you may fall asleep suddenly. Inform your healthcare provider if you have daytime tiredness or drowsiness. If you are unsure about how this medication may affect you, avoid driving or doing anything that requires you to be awake and attentive.
• While using this medicine, you may experience heightened sexual urges, strange gambling desires, or other extreme urges from the effects of ropinirole. Consult your doctor if you have any extreme or unexpected desires while taking Requip.
• Consider dose reduction or discontinuation if urges/compulsive behaviors develop.
• Do not share this drug with anyone, even if they have the same symptoms as you. Avoid alcohol, as it can exacerbate certain of Requip's negative effects. Cold or allergy medicine, narcotic pain relievers, sleeping pills, muscle relaxants, and seizure, depression, or anxiety medications can all contribute to ropinirole-induced sleepiness. Inform your doctor if you frequently take any of these other medications.
• Requip can cause hallucinations (the sense of hearing or seeing something that does not exist), which are especially common among the elderly. If you are experiencing worsening hallucinations, call your doctor.

If you are allergic to ropinirole or any of the inactive ingredients in the formulation, you should not take Requip.

Requip often begins acting within 1.5 to 2 hours depending on the dose of ropinirole. This is why, for restless leg syndrome, you should take the prescription 1 to 3 hours before going to bed.

When Requip is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Requip may interact with levodopa, ciprofloxacin, fluvoxamine, metoclopramide, omeprazole, medications for nausea and vomiting or mental disease, and estrogens.
• CYP1A2 inhibitors
• Because ropinirole is a dopamine agonist, dopamine antagonists such as neuroleptics (phenothiazines, butyrophenones, thioxanthenes) or metoclopramide may impair Requip's efficacy.

Requip is available in 2 dosage forms: immediate-release and extended-release tablets.

Immediate-release tablet

Parkinson's disease: The typical starting dose is 0.25 mg taken orally three times each day. The maximum dose is 24 mg.

Restless legs syndrome: The typical starting dose is 0.25 mg taken orally once daily, 1 to 3 hours before bedtime. The maximum daily dose is 4 mg.

Extended-release tablets

Parkinson's disease: The typical first dose is 2 mg orally once a day for the first 1 to 2 weeks of therapy. The maximum daily dose is 24 mg.

If you miss a dose of medication, take it as soon as you remember. If your next dose is coming up soon, skip the missed dose. Do not take extra medication to make up for the missing dosage.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

GlaxoSmithKline (GSK) is the pharmaceutical company that manufactures brand-name Requip.

There are several lower-cost generic versions available of Requip.

Do not stop using Requip or adjust your dosage without first consulting your doctor. If you abruptly stop taking the drug or modify your doses, you may experience adverse effects such as fever, muscle stiffness, and confusion.

Dopamine agonists such as pramipexole, ropinirole, and rotigotine are not generally recommended for use during pregnancy. Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Requip is not recommended if you are breastfeeding. The medication can make nursing more difficult because it reduces the amount of breast milk your body produces making lactation more difficult as well as may have adverse reactions on the infant. Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.