Ropinirole interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

  What to do: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

  4 sources

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):

Conditions

Conditions in which Ropinirole needs care, as documented in this source.

• Hypotension

  Major

  Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension, especially during dose escalation. Therapy with dopamine agonists should be monitored carefully in patients with Parkinson's disease since they may have an impaired ability to respond to an orthostatic challenge, and also in patients receiving antihypertensive drugs.

  11 sources

  1. Hoehn MM "Levodopa-induced postural hypotension. Treatment with fludrocortisone." Arch Neurol 32 (1975): 50-1
  2. Iwasaki S, Hamaguchi K, Iwasaki A, Takakusagi M, Narabayashi Y "Hypotensive effect of long-term levodopa in patients with Parkinson's disease." Eur Neurol 30 (1990): 194-9
  3. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn (2001):
  4. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals (2001):
  5. "Product Information. Sinemet CR (carbidopa-levodopa)." DuPont Pharmaceuticals (2001):
  6. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim (2001):
  7. "Product Information. Requip (ropinirole)." SmithKline Beecham (2001):
  8. "Product Information. Comtan (entacapone)." Novartis Pharmaceuticals (2001):

  Show all 11 sourcesShow fewer sources

  9. "Product Information. Azilect (rasagiline)." Teva Pharmaceuticals USA (2006):
  10. "Product Information. Neupro (rotigotine)." Schwarz Pharma (2007):
  11. "Product Information. Xadago (safinamide)." US WorldMeds LLC (2017):

• Neuroleptic Malignant Syndrome

  Major

  Neuroleptic malignant syndrome (NMS) has not occurred during administration of ropinirole, however, the syndrome has rarely been precipitated by rapid dosage reduction, abrupt discontinuation, or changes in other dopamine agonist therapy.

  1 source

  1. "Product Information. Requip (ropinirole)." SmithKline Beecham (2001):

• Psychotic Disorders

  Major

  Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinson agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs.

  8 sources

  1. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn (2001):
  2. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim (2001):
  3. "Product Information. Requip (ropinirole)." SmithKline Beecham (2001):
  4. "Product Information. Comtan (entacapone)." Novartis Pharmaceuticals (2001):
  5. "Product Information. Lodosyn (carbidopa)." DuPont Pharma (2001):
  6. "Product Information. Azilect (rasagiline)." Teva Pharmaceuticals USA (2006):
  7. "Product Information. Neupro (rotigotine)." Schwarz Pharma (2007):
  8. "Product Information. Xadago (safinamide)." US WorldMeds LLC (2017):

• Cardiovascular Diseases

  Moderate

  The trials of ropinirole excluded patients with significant cardiovascular disease, hence patients with cardiovascular conditions should be treated with caution.

  1 source

  1. "Product Information. Requip (ropinirole)." SmithKline Beecham (2001):

• Kidney Diseases

  Moderate

  Ropinirole is primarily eliminated by the kidney. Less than 10% of ropinirole is excreted unchanged in the urine. No dose adjustment is necessary in patients with moderate renal impairment (CrCl 30 to 50 mL/min). For patients with end-stage renal disease on hemodialysis, a reduced maximum dose is recommended.

  1 source

  1. "Product Information. Requip (ropinirole)." SmithKline Beecham (2001):

• Liver Diseases

  Moderate

  The pharmacokinetic disposition of ropinirole has not been studied in patients with hepatic impairment, however, the serum concentration of ropinirole may be increased and the elimination half-life prolonged in these patients. Therapy with ropinirole should be administered cautiously in patients with hepatic impairment, and dosages titrated according to patient parameters and clinical tolerability.

  2 sources

  1. Bloomer JC, Clarke SE, Chenery RJ "In vitro identification of the P450 enzymes responsible for the metabolism of ropinirole." Drug Metab Dispos 25 (1997): 840-4
  2. "Product Information. Requip (ropinirole)." SmithKline Beecham (2001):