Requip Xl 2mg Prolonged-Release Tablets
Patient Information Leaflet
Requip® XL 2 mg Prolonged-Release Tablets (ropinirole hydrochloride)
Information about your medication
Please read right through this leaflet before you start taking these tablets.
This medicine has been prescribed for you personally. Don't pass it on to other people - it may harm them, even if their symptoms seem to be the same as yours.
Keep this leaflet. You may need to read it again.
If you have any more questions, ask your Parkinson's disease doctor, Parkinson's disease nurse specialist or pharmacist (chemist).
If you have serious side effects, or if you notice any side effects not listed in this leaflet, tell your doctor, nurse or pharmacist.
The name of your medicine is Requip XL 2 mg Prolonged-Release Tablets but will be referred to as Requip XL throughout the remainder of this leaflet. Requip XL is also available in other strengths.
In this leaflet
1) What Requip XL is and what it is for
2) Before you take Requip XL
3) While you’re taking Requip XL
4) How to take Requip XL
5) Possible side effects
6) How to store Requip XL
7) Further information
1) WHAT REQUIP XL IS AND WHAT IT IS 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.
2) BEFORE YOU TAKE REQUIP XL
Don’t take Requip XL:
• if you're allergic (hypersensitive) to ropinirole or any of the other ingredients of Requip XL (see Section 6)
• if you have serious kidney disease
• if you have liver disease
• Tell your doctor or nurse if you think any of these may apply to you.
Take special care with Requip XL
Your doctor needs to know before you take Requip XL:
• if you are pregnant or think you may be pregnant
• if you are breast-feeding
• if you are under 18 years old
• if you have a serious heart complaint
• if you have a history of or currently have a serious mental health problem
• if you have a history of or have experienced any unusual urges and/or behaviours (such as excessive gambling or excessive sexual behaviour)
• if you have an intolerance to some sugars (such as lactose).
Tell your doctor if you or your family/carer notices that you are developing urges or cravings to behave in ways that are unusual for you and you cannot resist the impulse, drive or temptation to carry out certain activities that could harm yourself or others. These are called impulse control disorders and can include behaviours such as addictive gambling, excessive eating or spending, an abnormally high sex drive or an increase in sexual thoughts or feelings. Your doctor may need to adjust or stop your dose.
• Tell your doctor or nurse if you think any of these may apply to you. Your doctor or nurse may decide that Requip XL isn't suitable for you, or that you need extra check-ups while you're taking it.
You also need to be careful with Requip XL if you drive or operate machinery. Please read the warning in Section 3 of this leaflet.
Requip XL contains lactose and sunset yellow
Requip XL tablets contain a sugar called lactose. If you have been told that you have an intolerance to some sugars, contact your doctor or nurse before taking Requip XL.
The 4 mg tablets contain a colouring called sunset yellow (E110), which may cause allergic reactions.
Other medicines and Requip XL
Tell your doctor, nurse or pharmacist if you’re taking, or have recently taken, any other medicines - including any herbal remedies or medicines you bought without a prescription.
Some medicines can affect the way Requip XL works, or make it more likely that you'll have side effects. Requip XL can also affect the way some other medicines work.
These include:
• the anti-depressant, fluvoxamine
• HRT (hormone replacement therapy)
• medication for other mental health problems, for example sulpiride
• metoclopramide, which is used to treat nausea and heartburn
• cimetidine, used in the treatment of stomach ulcers
• the antibiotics, ciprofloxacin or enoxacin
• any other medicine for Parkinson's disease.
• Tell your doctor or nurse if you're taking, or have recently taken, any of these.
Remember to tell your doctor or nurse if you start taking any other medicine while you're taking Requip XL.
Pregnancy and breast-feeding
Requip XL is not recommended if you are pregnant unless your doctor advises that the benefit of you taking Requip XL is greater than the risk to your unborn baby.
Requip XL is not recommended if you are breast-feeding, as it can
affect your milk production.
Tell your doctor or nurse immediately:
• if you're pregnant, if you think you might be pregnant, or if you're planning to become pregnant
• if you're breast-feeding or planning to breast-feed.
Your doctor or nurse may advise you to stop taking Requip XL.
Children
Do not give Requip XL to children. Requip XL is not normally prescribed for people under 18.
3) WHILE YOU’RE TAKING REQUIP XL
If you drive or operate machinery
Requip XL can make you feel drowsy or dizzy.
It can make people feel extremely sleepy, and it sometimes makes people fall asleep very suddenly without warning.
If you could be affected: don’t drive, don’t operate machines and don’t
put yourself in any situation where feeling sleepy or falling asleep could put you (or other people) at risk of serious injury or death. Don't take part in these activities until you are sure you're not affected.
* Talk to your doctor or nurse if this causes problems for you.
Smoking and Requip XL
Tell your doctor or nurse if you start smoking, or give up smoking, while you're taking Requip XL. Your doctor or nurse may need to adjust your dose.
Food and drink with Requip XL
You can take Requip XL with or without food, as you prefer. Because high fat foods might increase the amount of ropinirole absorbed by your body, it is recommended that you do not take Requip XL at the same time as a high fat meal.
4) HOW TO TAKE REQUIP XL
Always take Requip XL exactly as your Parkinson’s disease doctor or nurse has told you to. Check with your doctor, nurse or pharmacist if you're not sure.
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 usual 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 day.
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 someone takes too much Requip XL
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
Don’t take extra tablets or a double dose to make up for a missed 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.
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.
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 product, ask your doctor or pharmacist.
5) POSSIBLE SIDE EFFECTS
Like all medicines, Requip XL 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
These may affect more than 1 in 10 people taking Requip XL:
• fainting
• feeling drowsy
• feeling sick (nausea).
Common side effects
These may affect more than 1 in 100 people taking Requip XL:
• hallucinations (sensing things that are not real)
• being sick (vomiting)
• feeling dizzy (a spinning sensation)
• heartburn
• stomach pain
• constipation
• swelling of the legs, feet or hands.
Uncommon side effects
These may affect more than 1 in 1,000 people taking Requip XL:
• 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
• falling asleep very suddenly without feeling sleepy first (sudden sleep onset episodes)
• mental problems such as delirium (severe confusion), delusions (unreasonable ideas) or paranoia (unreasonable suspicions).
You may experience the following side effects:
• 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
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.
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.
If you get side effects
If you notice any unwanted effects (even ones not mentioned in this leaflet) or if any of the side effects becomes troublesome while you're taking Requip XL:
• Tell your doctor, nurse or pharmacist.
6) HOW TO STORE REQUIP XL
Keep Requip XL out of the sight and reach of children.
Don't use Requip XL after the expiry date shown on the carton.
Do not store above 25°C. Store in the original package in order to protect from light.
If your tablets become discoloured or show any sign of deterioration, return them to your pharmacist.
If you have any unwanted Requip XL tablets, don't dispose of them in waste water or household rubbish. Take them back to your pharmacist, who will dispose of them in a way that won't harm the environment.
7) FURTHER INFORMATION What Requip XL contains
The active substance in Requip XL is ropinirole. Each prolonged-release tablet contains 2 mg of ropinirole (as hydrochloride).
The other ingredients are:
hypromellose, hydrogenated castor oil, carmellose sodium, povidone K29/32, maltodextrin, magnesium stearate, lactose monohydrate, anhydrous colloidal silica, mannitol E421, iron oxide yellow E172, glycerol dibehenate, titanium dioxide E171, macrogol 400
In addition, the different strengths of tablets contain other ingredients as follows:
2 mg tablet: iron oxide red E172
What Requip XL looks like and contents of the pack
Requip XL (all strengths) prolonged-release tablets are provided as capsule-shaped, film-coated tablets, marked ‘GS' on one side.
Requip XL 2 mg: pink tablets marked ‘3V2' on reverse side.
All strengths: blister packs of 28 tablets.
Marketing authorisation holder and manufacturer
Marketing Authorisation Holder:
Procured from within the EU by the Product Licence holder MPT Pharma Ltd, Westgate Business Park, Unit 5-7 Tintagel Way, Aldridge, Walsall WS9 8ER, U.K.
Repackaged by XXXXXXXXXXXXXXXXXXXXX
Requip XL 2 mg prolonged-released tablets PL: 33532/0048
POM
Manufactured by Glaxo Wellcome S.A., Avenida de Extremadura 3 09400 Aranda de Duero Burgos Spain.
SmithKline Beecham Pharmaceuticals, Manor Royal, Crawley, West Sussex RH10 9QJ. U.K.
A number of groups exist to provide further information and support to Parkinson's disease patients and their carers. The main one is Parkinson's UK, who you can contact at the address given below:
Parkinson's UK
215 Vauxhall Bridge Road
London SW1V 1EJ
ReQuip® is a registered trademark of the GlaxoSmithKline group of companies
Leaflet date: 04th July 2013 Leaflet code: xxxxxxxxxx