ropinirole

CLINICAL USE

Anti-Parkinson agent Restless legs syndrome

DOSE IN NORMAL RENAL FUNCTION

Parkinson’s disease: 9–24 mg daily in divided dosesRestless legs syndrome: 0.25 mg daily initially, increasing to a maximum of 4 mg daily

PHARMACOKINETICS

Molecular weight :260.4 (296.8 as hydrochloride)

%Protein binding :10–40

%Excreted unchanged in urine :

<10 :

Volume of distribution (L/kg) :8

half-life – normal/ESRD (hrs) :6/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

30–50 Dose as in normal renal function10–30 Dose as in normal renal function. Use with caution

<10 : Dose as in normal renal function. Use with caution

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD :Unlikely dialysability. Dose as in GFR <10 mL/min

HDF/high flux :Unlikely to be dialysed. Dose as in GFR <10 mL/min

CAV/VVHD :Unlikely dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antipsychotics: antagonism of anti- Parkinsonian effect – avoid concomitant useMetoclopramide: antagonism of anti- Parkinsonian effect – avoid concomitant useOestrogens and progestogens: concentration increased

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

If administered with L-dopa, decrease the dose of L-dopa by 20%Take with meals to improve GI tolerance, but Cmax increases by 2.6 hoursNo data in renal impairment Ropinirole is hepatically metabolised to inactive metabolitesFor use in restless legs syndrome in CKD 5, start with a low dose and increase according to tolerability.

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