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What Requip is and what it is used for
ReQuip is used to treat Parkinson’s disease. The active ingredient in ReQuip is ropinirole, which belongs to a group of medicines called dopamine agonists. Dopamine agonists affect the brain in a similar way to a natural substance called dopamine. People with Parkinson’s disease have low levels of dopamine in some parts of their brains. Ropinirole has effects similar to those of natural dopamine, so it helps to reduce the symptoms of Parkinson’s disease
How to take Requip
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. You may be given ReQuip on its own to treat the symptoms of your Parkinson’s disease, or you may be given ReQuip as well as another medicine called L-dopa (also called levodopa). If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first start taking ReQuip. Tell your doctor if this happens, as your doctor may need to adjust the dose of the medicines you are taking. Tell your doctor if you or your family notices that you are developing any unusual behaviours (such as an unusual urge to gamble or increased sexual urges and/or behaviours) while you are taking ReQuip. Your doctor may need to adjust or stop your dose. How much ReQuip will you need to take? It may take a while to find out the best dose of ReQuip for you. The usual starting dose is 0.25 mg of ropinirole three times each day for the first week. Then your doctor will increase your dose each week, for the next three weeks. After that, your doctor will gradually increase the dose until you are taking the dose that is best for you. The usual is 1 mg to 3 mg three times each day (making a total daily dose of 3 mg to 9 mg). If your Parkinson’s disease symptoms have not improved enough, your doctor may decide to gradually increase your dose some more. Some people take up to 8 mg of ReQuip three times a day (24 mg daily altogether). If you are also taking other medicines for Parkinson’s disease, your doctor may advise you to gradually reduce the dose of the other medicine. Don’t take any more ReQuip than your doctor has recommended. It may take a few weeks for ReQuip to work for you. Taking your dose of ReQuip Take ReQuip three times a day. Swallow your ReQuip tablets, with a glass of water. It’s best to take ReQuip with food, because that makes it less likely that you’ll feel sick (nauseous). If you take more ReQuip than you should Contact a doctor or pharmacist immediately. If possible, show them the ReQuip pack. Someone who has taken an overdose of ReQuip may have any of these symptoms: feeling sick (nausea), being sick (vomiting), dizziness (a spinning sensation), feeling drowsy, mental or physical tiredness, fainting, hallucinations. If you forget to take ReQuip Do not take a double dose to make up for a forgotten dose. Just take your next dose at the usual time. If you have missed taking ReQuip for more than a few days, ask your doctor for advice on how to start taking it again. If you stop taking ReQuip Do not stop taking ReQuip without advice. Take ReQuip for as long as your doctor recommends. Don’t stop unless your doctor advises you to. If you suddenly stop taking ReQuip your Parkinson’s disease symptoms may quickly get much worse. A sudden stop could cause you to develop a medical condition called neuroleptic malignant syndrome which may represent a major health risk. The symptoms include: akinesia (loss of muscle movement), rigid muscles, fever, unstable blood pressure, tachycardia (increased heart rate), confusion, drepressed level of consciousness (e.g. coma). If you need to stop taking ReQuip your doctor will reduce your dose gradually. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everyone gets them.
The side effects of ReQuip are more likely to happen when you first start taking it, or when your dose
has just been increased. They are usually mild and may become less troublesome after you have taken
the dose for a while.
If you are worried about side effects, talk to your doctor.
Very common side effects: may affect more than 1 in 10 people
• feeling drowsy
• feeling sick (nausea)
Common side effects: may affect up to 1 in 10 people
• hallucinations (sensing things that are not real)
• being sick (vomiting)
• feeling dizzy (a spinning sensation)
• stomach pain
• swelling of the legs, feet or hands
Uncommon side effects: may affect up to 1 in 100 people
• feeling dizzy or faint, especially when you stand up suddenly (this is caused by a drop in blood pressure)
• feeling very sleepy during the day (extreme somnolence)
• falling asleep very suddenly without feeling sleepy first (sudden sleep onset episodes)
• mental problems such as delirium (severe confusion), delusions (unreasonable ideas) or paranoia (unreasonable suspicions) You may experience the following side effects:
• inability to resist the impulse, drive or temptation to perform an action that could be harmful to you or others, which may include:
• strong impulse to gamble excessively despite serious personal or family consequences.
• altered or increased sexual interest and behaviour of significant concern to you or to others, for example, an increased sexual drive.
• uncontrollable excessive shopping or spending
• binge eating (eating large amounts of food in a short time period) or compulsive eating (eating more food than normal and more than is needed to satisfy your hunger) Tell your doctor if you experience any of these behaviours; they will discuss ways of managing or reducing the symptoms
Very rare side effects: may affect up to 1 in 10,000 people
• changes in liver function, which have shown up in blood tests
• allergic reactions such as red, itchy swellings on the skin (hives), swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing, rash or intense itching Some patients may have the following side effects (frequency not known: cannot be estimated from the available data)
• excessive use of ReQuip (craving for large doses of dopaminergic drugs in excess of that required to control motor symptoms, known as dopamine dysregulation syndrome).
• Depression, apathy, anxiety, lack of energy, sweating or pain may occur (called dopamine agonist withdrawal syndrome or DAWS) after stopping or reducing your Requip treatment. If you are taking ReQuip with L-dopa People who are taking ReQuip with L-dopa may develop other side effects over time:
• uncontrollable movements (dyskinesias) are a very common side effect. Tell your doctor if this happens, as your doctor may need to adjust the doses of the medicines you are taking
• feeling confused is a common side effect
Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard By reporting side effects you can help provide more information on the safety of this
How to Store Requip
Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the blister and on the carton. The expiry date refers to the last day of that month. Do not store this medicine above 25°C. Keep in a dry place, away from light. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
2 to 3 weeks on average
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