REQUIP ® - Ropinirole

REQUIP ® is a medicinal product based on Ropinirole hydrochloride

THERAPEUTIC GROUP: Dopaminergic substances - dopamine agonists

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications REQUIP ® - Ropinirole

REQUIP ® is indicated both in monotherapy and in combination with Levodopa, in the treatment of Parkinson's disease.

Mechanism of action REQUIP ® - Ropinirole

REQUIP ® is a drug based on Ropinirole, a dopaminergic agonist, particularly active against D2-D3 dopamine receptors expressed at the level of the striatum, which taken orally and effectively absorbed by the gastro-enteric mucosa reaches appreciable concentrations in the circulatory stream, biodegradable evenly in the body.

Simulating the activity of Dopamine, they bind and activate dopamine D2 and D3 receptors, located at the level of the striatum, of the substantia nigra, of the pituitary gland, of the olfactory bulb and of the hypothalamus, making up for its deficiency, restoring the correct balance between direct and indirect route of the nuclei of the base, and therefore improving the typical Parkinson symptomatology characterized by tremor at rest and hypokinesia.

For its correct elimination, the chemical nature of Ropinirole first requires a hepatic metabolism, mainly supported by cytochromial enzymes, in particular from the CYP1A2 isoform, and subsequently an abundant renal excretion, after a significantly longer half-life than Levodopa.

Studies carried out and clinical efficacy

EFFECTIVENESS AND SAFETY OF ROPINIROL IN THE TREATMENT OF PARKINSON'S DISEASE

Zhonghua Yi Xue Za Zhi. 2013 Jul 2; 93 (25): 1952-7.

Clinical trial demonstrating how Ropinirole can be effective and safe in the treatment of Parkinson's disease, in over 200 Chinese patients enrolled between 2005 and 2007. In the face of the numerous side effects usually stated, the therapy was very well tolerated.

ROPINIROLO: POSOLOGICAL SCHEMES OF COMPARISON

BMC Neurol. 2013 Sep 2; 13: 113. doi: 10.1186 / 1471-2377-13-113.

Study comparing the clinical efficacy of Ropinirole prolonged release in Parkinson's disease once or twice a day.

The results seem to support the greater efficacy of bi-daily administration, which can significantly improve the complained symptomatology.

FATAL INTOXICATION BY ROPINIROL

J Forensic Leg Med. 2012 Oct; 19 (7): 422-5. doi: 10.1016 / j.jflm.2012.04.013. Epub 2012 May 11.

Case report reporting a death due to intoxication with Ropinirole and alcohol, in a 37-year-old patient.

These studies emphasize the need for medical supervision throughout the entire therapeutic process, in order to identify potential risk behaviors in a timely manner.

Method of use and dosage

REQUIP ®

Coated tablets of 0.25 - 0.5 - 1 - 2 and 5 mg of Ropinirole Hydrochloride.

Treatment with REQUIP ® must necessarily be defined by a doctor who is an expert in the treatment of neurological diseases, necessarily having to define the optimal dosage based on the clinical needs of the patient and the relative general health picture.

In fact, an adaptation of the doses normally used should be guaranteed in elderly patients or those suffering from liver and kidney diseases, for which unfortunately the half-life of the drug would be partially compromised.

The quantitative facet of Ropinirolo dosages provided for in REQUIP ® therefore allows the physician to define the optimal therapeutic scheme on a case by case basis, and to adjust the dosage when necessary.

REQUIP ® warnings - Ropinirole

Ropinirole therapy must necessarily be preceded by a careful medical examination to assess the severity of the symptoms present and any prescriptive appropriateness.

Dopamine agonist therapy could lead to the aggravation of the clinical conditions of patients with major psychiatric or psychotic disorders and cardiovascular diseases.

It is also recommended to be particularly careful when using machinery or driving vehicles during treatment with Ropinirole.

REQUIP ® contains lactose among its excipients, making it therefore contraindicated in patients with lactase enzyme deficiency, glucose-galactose malabsorption syndrome and galactosemia.

It is recommended to keep the medicine out of the reach of children.

PREGNANCY AND BREASTFEEDING

Given the absence of studies able to characterize the safety profile of del ropinirolo for fetal and infant health, it would be appropriate to extend the aforementioned contraindications to the use of REQUIP ® also to pregnancy and the subsequent breastfeeding period.

Interactions

In order to avoid pharmacokinetic changes such as to alter the normal biological activities of Ropinirole, the patient receiving REQUIP ® should avoid the simultaneous intake of neuroleptic drugs, dopamine antagonists, estrogens, inducers and cytochromial system inhibitors.

Contraindications REQUIP ® - Ropinirole

The use of REQUIP ® is contraindicated in patients who are hypersensitive to the active ingredient or to one of its excipients and in patients suffering from severe liver and kidney diseases

Undesirable effects - Side effects

Therapy with REQUIP ® could cause psychiatric disorders such as hallucinations, confusion, drowsiness, dizziness, nausea, heartburn and edema of the lower limbs.

Continuous medical supervision therefore becomes necessary even in the face of the high incidence of the aforementioned adverse reactions.