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What is Rotigotine
Rotigotine hydrochloride is a transdermal non-ergoline dopamine agonist used for the treatment of Parkinson’s disease (PD) and restless leg syndrome (RLS).
Effectiveness with and without concomitant levodopa treatment was established in advanced and early stage PD patients, respectively.
In one study, median oral doses of levodopa significantly decreased from 1400 mg/day to 400 mg/day during combined therapy with rotigotine.
Use of rotigotine can improve motor performance and activities of daily living in patients with PD.
This dosage form can also allow the theory to be tested that continuous dopaminergic stimulation from the initiation of PD therapy will help to limit motor complications (i.e., on-off syndrome).
Dopamine receptor agonists are widely used as an effective treatment for RLS, presumably because of their longer half-lives and good tolerability compared with levodopa. Rotigotine (Neupro) was approved by the FDA in May 2007 for early stage idiopathic Parkinson’s disease, and in April 2012 for advanced stage idiopathic Parkinson’s disease and restless legs syndrome.
Brand Name
Neupro
Indications
- Parkinson’s disease
- restless legs syndrome (RLS)
For the treatment of the signs and symptoms of idiopathic Parkinson’s disease
in patients with early-stage idiopathic Parkinson’s disease
Side Effects
- abnormal dreams
- agitation
- anorexia
- arthralgia
- asthenia
- confusion
- constipation
- cough
- delirium
- depression
- diarrhea
- dizziness
- drowsiness
- dysesthesia
- dyskinesia
- dyspepsia
- edema
- erythema
- fatigue
- hallucinations
- headache
- hiccups
- hot flashes
- hyperhidrosis
- hypertension
- hypoglycemia
- impotence (erectile dysfunction)
- impulse control symptoms
- insomnia
- lethargy
- maculopapular rash
- musculoskeletal pain
- nasal congestion
- nausea
- nightmares
- orthostatic hypotension
- paranoia
- paresthesias
- peripheral edema
- pharyngitis
- pruritus
- psychosis
- restless legs syndrome (RLS) augmentation
- restless legs syndrome (RLS) rebound
- retroperitoneal fibrosis
- sinus tachycardia
- sinusitis
- sudden sleep onset
- syncope
- tinnitus
- tremor
- vertigo
- visual impairment
- vomiting
- weight gain
- weight loss
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- abrupt discontinuation
- ambient temperature increase
- asthma
- behavioral changes
- breast-feeding
- cardiac disease
- children
- defibrillation (cardioversion)
- driving or operating machinery
- ethanol ingestion
- geriatric
- heart failure
- heating pad
- hypertension
- impulse control symptoms
- infants
- magnetic resonance imaging (MRI)
- melanoma
- orthostatic hypotension
- peripheral edema
- pregnancy
- psychosis
- renal impairment
- schizophrenia
- sulfite hypersensitivity
- sunlight (UV) exposure
- syncope
- tardive dyskinesia
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Tramadol
- Alfentanil
- Alprazolam
- Amitriptyline; Chlordiazepoxide
- Amobarbital
- Anxiolytics; Sedatives; and Hypnotics
- Aripiprazole
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- atypical antipsychotic
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Benzodiazepines
- Brexpiprazole
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Buprenorphine
- Buprenorphine; Naloxone
- Buspirone
- Butabarbital
- Butorphanol
- Cannabidiol
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cariprazine
- Cenobamate
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Clonazepam
- Clorazepate
- Clozapine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Deutetrabenazine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Diazepam
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Donepezil; Memantine
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Droperidol
- Esketamine
- Estazolam
- Ethanol
- Fentanyl
- Fluoxetine; Olanzapine
- Flurazepam
- Gabapentin
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Haloperidol
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxyzine
- Ibuprofen; Oxycodone
- Iloperidone
- Lasmiditan
- Lemborexant
- Levocetirizine
- Levodopa
- Levorphanol
- Lofexidine
- Lorazepam
- Loxapine
- Lumateperone
- Lurasidone
- Memantine
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
- Methadone
- Metoclopramide
- Midazolam
- Molindone
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nalbuphine
- Olanzapine
- Opiate Agonists-Antagonists
- Oxazepam
- Oxycodone
- Oxymorphone
- Paliperidone
- Pentazocine
- Pentazocine; Naloxone
- Pentobarbital
- Phenobarbital
- Phenothiazines
- Pimozide
- Pregabalin
- Quazepam
- Quetiapine
- Ramelteon
- Remifentanil
- Risperidone
- Secobarbital
- Solriamfetol
- Sufentanil
- Tapentadol
- Temazepam
- Thiothixene
- Tramadol
- Triazolam
- Ziprasidone
