III. Dosing: Restless Leg Syndrome

  1. Start: Requip 0.25 mg orally taken 2-3 hours before bedtime
  2. Interval for increasing dose: 3-7 days
  3. Titrating dose: Increase at set interval as above by one tablet if ineffective at current dose
    1. Start at 0.25 mg one tablet nightly for set interval in days
    2. Increase to two tablets (0.50 mg) nightly for set interval if ineffective at 0.25 mg
    3. Increase to three tablets (0.75 mg) nightly for set interval if ineffective at 0.50 mg
  4. Maximum dose: 6 tablets (1.5 mg) taken at bedtime
  5. Stopping: No titration needed

IV. Adverse Effects (similar to Mirapex)

  1. Nausea (common)
  2. Drowsiness (Limited to higher dosages)
    1. May be sudden, severe without warning
    2. May occur up to one year after starting Mirapex
    3. Has resulted in falling asleep while driving
  3. Augmentation of Restless Leg Symptoms
    1. Occurs in 25% of RLS patients on longterm therapy
    2. May progress in severity, and involve arms, trunk
    3. Often better if dose timing changed to earlier in day
    4. May be worse if dose increased
  4. Other uncommon adverse effects (rare at low dose)
    1. Hallucinations
    2. Pathologic Gambling (related to Dopamine receptor agonist activity, D3)
    3. Orthostatic Hypotension
    4. Hypersexuality

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Cost: Medications

ropinirole (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
ROPINIROLE HCL 0.25 MG TABLET Generic $0.10 each
ROPINIROLE HCL 0.5 MG TABLET Generic $0.09 each
ROPINIROLE HCL 1 MG TABLET Generic $0.09 each
ROPINIROLE HCL 2 MG TABLET Generic $0.10 each
ROPINIROLE HCL 3 MG TABLET Generic $0.10 each
ROPINIROLE HCL 4 MG TABLET Generic $0.10 each
ROPINIROLE HCL 5 MG TABLET Generic $0.11 each
ROPINIROLE HCL ER 12 MG TABLET Generic $5.53 each
ROPINIROLE HCL ER 2 MG TABLET Generic $1.54 each
ROPINIROLE HCL ER 4 MG TABLET Generic $2.91 each
ROPINIROLE HCL ER 6 MG TABLET Generic $4.36 each
ROPINIROLE HCL ER 8 MG TABLET Generic $4.32 each
requip (on 1/1/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
REQUIP 1 MG TABLET Generic $0.09 each
REQUIP XL 2 MG TABLET Generic $1.54 each
REQUIP XL 4 MG TABLET Generic $2.91 each
REQUIP XL 6 MG TABLET Generic $4.36 each
REQUIP XL 8 MG TABLET Generic $4.32 each

Ontology: ropinirole (C0244821)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C046649
SnomedCT 108473005, 372499000
English 4-(2-(di-n-propylamino)ethyl)-2(3H)-indolone, ropinirol, ropinirole, ropinirole [Chemical/Ingredient], rOPINIRole, ROPINIROLE, Ropinirole, Ropinirole (product), Ropinirole (substance)
Spanish ropinirola (sustancia), ropinirol (sustancia), ropinirola, ropinirol (producto), ropinirol

Ontology: Requip (C0593342)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C046649
English Requip, requip, GlaxoSmithKline brand of ropinirole hydrochloride, SmithKline Beecham brand of ropinirole hydrochloride