(Ropinirole Hydrochloride ER)
Brand Name Choices
What Requip XL is and what it is used for
ReQuip XL is used to treat Parkinson’s disease. The active ingredient in ReQuip XL 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. You can take ReQuip XL (like ReQuip) either on its own or along with L-dopa (see section 4 of this leaflet for more details). ReQuip XL should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson’s disease.
How to take Requip XL
Always take this medicine exactly as your doctor or nurse or pharmacist has told you. Check with your
doctor, nurse or pharmacist if you are not sure.
Do not give ReQuip XL to children. ReQuip XL is not normally prescribed for people under 18.
You may be given ReQuip XL on its own to treat the symptoms of your Parkinson’s disease. Or you may be
given ReQuip XL as well as another medicine called L-dopa (also called levodopa). ReQuip XL should be
prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson’s disease.
If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first
start taking ReQuip XL. 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 XL. Your
doctor may need to adjust your dose.
If you are switching from ReQuip film-coated (immediate-release) tablets
Your doctor or nurse will base your dose of ReQuip XL on the dose of ReQuip you were taking. You will
take the same or similar daily dose of ReQuip XL to your previous dose of ReQuip but you will only take
ReQuip XL once a day.
Take your ReQuip as normal the day before you switch. Then take your ReQuip XL on the next day and
don’t take any more ReQuip.
Your doctor or nurse will be monitoring your progress closely after switching to ReQuip XL. If there is any
change in the control of your symptoms before your next appointment, talk to your doctor or nurse as soon as
possible in case dose adjustment is needed.
How much ReQuip XL will you need to take?
It may take a while to find out the best dose of ReQuip XL for you.
The recommended starting dose of ReQuip XL tablets is 2 mg once daily for the first week. Your doctor
may increase your dose to 4 mg of ReQuip XL tablets once daily, from the second week of treatment. If you
are very elderly your doctor may increase your dose more slowly. After that, the doctor may adjust your dose
until you are taking the dose that is best for you. Some people take up to 24 mg of ReQuip XL tablets each
If at the start of your treatment, you experience side effects that you find difficult to tolerate, speak to your
doctor. Your doctor may advise you to switch to a lower dose of ReQuip film-coated (immediate-release)
tablets which you will take three times a day.
Don’t take more ReQuip XL than your doctor or nurse has recommended.
It may take a few weeks for ReQuip XL to work for you.
Taking your dose of ReQuip XL
Take ReQuip XL once a day, at the same time each day.
Swallow your ReQuip XL tablets whole, with a glass of water.
Don’t break, chew or crush the tablets
•if you do, there’s a danger you could overdose, because the medicine will be released into your body too quickly. ReQuip XL tablets are designed to release the drug into your body over a 24 hour period. If the tablets pass through your body in less than 24 hours the medicine may not be completely released. You may see tablets in your stool. If this happens, let your doctor know. If you take more ReQuip XL than you should Contact a doctor, nurse or pharmacist immediately. If possible, show them the ReQuip XL pack. Someone who has taken an overdose of ReQuip XL 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 XL Do not take a double dose to make up for a forgotten dose. If you have missed taking ReQuip XL for one day or more, ask your doctor or nurse for advice on how to start taking it again. If you stop taking ReQuip XL Don’t stop taking ReQuip XL without advice. Take ReQuip XL for as long as your doctor or nurse recommends. Don’t stop unless your doctor or nurse advises you to. If you suddenly stop taking ReQuip XL, 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, depressed level of consciousness (e.g. coma). If you need to stop taking ReQuip XL, your doctor or nurse will reduce your dose gradually. If you have any further questions on the use of this medicine, ask your doctor, nurse or pharmacist.
Possible side effects
Like all medicines, this medicine can have side effects, but not everyone gets them.
The more common side effects of ReQuip XL 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’ve taken the dose for a while. If you’re worried about side effects, talk to your doctor or nurse.
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
• falling asleep very suddenly without feeling sleepy first (sudden sleep onset episodes)
• 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
• mental problems such as delirium (severe confusion), delusions (unreasonable ideas) or paranoia (unreasonable suspicions) You may experience the following side effects (frequency not known):
• 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 A very small number of people taking ReQuip XL (less than 1 in 10,000) have experienced:
• 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)
• act in an aggressive manner
• excessive use of ReQuip XL (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 XL treatment. If you’re taking ReQuip XL with L-dopa People who are taking ReQuip XL with L-dopa may develop other side effects over time:
• uncontrollable movements (dyskinesias) are a very common side effect. If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first start taking ReQuip XL. Tell your doctor if this happens, as your doctor may need to adjust the dose 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 medicine.
How to Store Requip XL
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 the carton. The expiry date refers to the last day of that month. Do not store above 25°C. Store in the original package. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use.
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