CLINICAL USE


Parkinson’s disease Symptomatic treatment of restless legs

DOSE IN NORMAL RENAL FUNCTION

Parkinson’s disease: 88 – 1100 mcg 3 times a dayRestless legs: 88–540 mcg taken 2–3 hours before bedtime

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :302.3 (as hydrochloride)
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :<20
  • %Excreted unchanged in urine &nbsp &nbsp : <90
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :400–500 litres
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :8–14/36

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Initially 88 mcg twice daily and titrate slowly
  • 10 to 20 &nbsp &nbsp : Initially 88 mcg once daily and titrate slowly
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Initially 88 mcg once daily and titrate slowly

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR=10–20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsAvoid concomitant use with antipsychotics

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments

    OTHER INFORMATION

    88 mcg of base ≡ 125 mcg of salt, 180 mcg ≡ 250 mcg, 350 mcg ≡ 500 mcg, 700 mcg ≡ 1 mg, 1.1 mg ≡ 1.5 mgLess than 9% of dose is removed by haemodialysisDrowsiness is a common side effect especially at higher dosesFor restless legs, dose as in normal renal function.