Ropinirole 1mg Film-Coated Tablets
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PACKAGE LEAFLET: INFORMATION FOR USER
ROPINIROLE 0.25 mg FILM-COATED TABLETS ROPINIROLE 0.5 mg FILM-COATED TABLETS ROPINIROLE 1 mg FILM-COATED TABLETS ROPINIROLE 2 mg FILM-COATED TABLETS
Ropinirole
Read all of this leaflet carefully before you start
taking this medicine.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
• If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
In this leaflet:
1. What Ropinirole Hydrochloride Tablets is and what it is used for
2. Before you take Ropinirole Hydrochloride Tablets
3. How to take Ropinirole Hydrochloride Tablets
4. Possible side effects
5. How to store Ropinirole Hydrochloride Tablets
6. Further information
1. What Ropinirole Hydrochloride Tablets is and what it is used for
Ropinirole Hydrochloride Tablets belongs to a group of medicines called dopamine agonists. Dopamine agonists act like a naturally occurring chemical in your brain called dopamine. Ropinirole Hydrochloride Tablets is used to treat the symptoms of moderate to severe idiopathic Restless Legs Syndrome. Moderate to severe Restless Legs Syndrome is typically represented by patients who have difficulty sleeping and severe discomfort in their legs or arms.
Restless Legs Syndrome is a condition characterized by an irreversible urge to move the legs and occasionally the arms, usually accompanied by uncomfortable sensations such as tingling, burning or prickling. These feelings occur during periods of rest or inactivity such as sitting or lying down, especially in bed, and are worse in the evening or at night. Usually the only relief is obtained by walking about or moving the affected limbs, which often leads to problems sleeping. Ropinirole Hydrochloride Tablets relieves the discomfort and reduces the urge to move the limbs that disturb night time sleep.
Parkinson's disease is characterized by having low levels of dopamine in some parts of the brain. Ropinirole has effects similar to those of natural dopamine, so it helps to reduce the symptoms of Parkinson's disease.
2. Before you take Ropinirole Hydrochloride Tablets
Do not take Ropinirole Hydrochloride Tablets;
• If you are allergic (hypersensitive) to the active ingredient, Ropinirole or any other ingredients of Ropinirole Hydrochloride Tablets (see Sections 4 and 6) .
• If you have liver disease (discuss with your doctor as you may be able to have the medicine if your liver disease is not too severe)
• If you have serious kidney disease.
If you are unsure, it is essential to talk to your doctor.
Take special care with Ropinirole Hydrochloride Tablets;
• If you are intolerant to some sugars (e.g. lactose).
• If you are pregnant or think you are pregnant.
• If you are breast-feeding.
• If you are under 18 years of age.
• If you have serious heart complaint.
• If you have serious mental health problem.
In these situations tell your doctor before you start to take this medicine, your doctor should carefully supervise your treatment. If during treatment your symptoms become worse, start earlier in the day or after less time at rest, or affect other parts of your body such as arms, you should see your doctor who may adjust the dose of Ropinirole Hydrochloride Tablets that you are taking.
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.
Taking other medicines:
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. The effect of Ropinirole Hydrochloride Tablets may be increased or decreased by other medicines and vice versa. These medicines include:
• Ciprofloxacin (an antibiotic).
• Enoxacin (an antibiotic).
• Fluvaxamine (a drug used to treat depression).
• Theophyllline (a drug used to treat asthma).
• Hormone replacement therapy (also called HRT).
• Anti-psycotics and other drugs that block dopamine in the brain (e.g. sulpiride or metoclopramide).
Tell your doctor if;
• You are already receiving any other medicines for Restless Legs Syndrome or Parkinson's syndrome.
• You give up or start smoking while taking
Ropinirole Hydrochloride Tablets. Your doctor may need to adjust your dose.
• You are taking Ropinirole Hydrochloride Tablets and the doctor is going to prescribe you any other medicine.
Taking Ropinirole Hydrochloride Tablets with food and drink:
Taking Ropinirole Hydrochloride Tablets with food may reduce the likelihood of you feeling or being sick.
Pregnancy and breast-feeding:
Tell your doctor immediately if;
• You are pregnant.
• You think you might be or are planning to
become pregnant.
• You are breast-feeding.
Ropinirole Hydrochloride Tablets should not be used during breast-feeding as milk production may be affected. Ropinirole Hydrochloride Tablets should only be used during pregnancy after your doctor has considered the benefit to you and the potential risk of harm to your unborn child. Your doctor will advise you to discontinue this medicine.
Driving and using machines:
This medicine does not usually affect people's normal activities. However, ropinirole hydrochloride tablets can cause extreme sleepiness (somnolence) and sudden sleep onset episodes. If you do suffer from these effects you must not drive or put yourself in a situation where sleepiness or falling asleep may put you at risk of serious injury or death (for example using machinery) until these episodes have been resolved.
Important information about some of the ingredients of Ropinirole hydrochloride tablets
This medicinal product contains lactose. If you have been told by your doctor that you have intolerance to lactose or any sugars, contact your doctor before taking this medicinal product.
3. How to take Ropinirole Hydrochloride Tablets
Always take Ropinirole Hydrochloride Tablets exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
Do not give Ropinirole Hydrochloride Tablets to children.
Ropinirole Hydrochloride Tablets is not normally prescribed for people under 18.
If you are elderly your doctor may increase your dose more slowly.
In Restless legs Syndrome:
• The starting dose is 0.25 mg once daily. After two days your doctor will probably increase your dose to 0.5 mg once daily for the remainder of your first week of treatment. Then your doctor may increase your dose to 1 mg once a day at week 2. The dose may be increased by 0.5 mg per week over the next two weeks to a dose of 2 mg once a day. In some patients with insufficient improvement, the dose may be increased gradually up to a maximum of 4 mg daily. After three months of treatment with Ropinirole Hydrochloride Tablets, your doctor may adjust your dose or discontinue your treatment depending on your symptoms and how you feel.
In Parkinson's disease:
• The starting dose is 0.25 mg Ropinirole three times a day for one week. Then the dose is gradually increased in accordance to the following:
1st week: 0.25 mg ropinirole 3 times a daily.
2nd week: 0.5 mg ropinirole 3 times daily 3rd week: 0.75 mg ropinirole 3 times daily 4th week: 1 mg ropinirole 3 times daily Hereafter your doctor may increase or decrease the dose that you are taking to get the best effect. The usual dose is between 1 mg to 3 mg ropinirole taken three times daily (a total daily dose of 3 mg to 9 mg), but if sufficient effects are not achieved or maintained, the total daily dose may be gradually increased upto 24 mg. if you are also taking other medicines for Parkinson's disease your doctor may advise you to gradually reduce the dose of other medicine. If you are taking L-dopa you may experience some uncontrolled movement (dyskinesias) when you first start taking Ropinirole Hydrochloride Tablet tell your doctor if this happens, as your doctor may need to adjust doses of the medicines you are taking.
• Take Ropinirole Hydrochloride Tablets three times a day by mouth, every day at about the same time each day. Ropinirole Hydrochloride Tablets is usually taken just before bedtime, but can be taken up to 3 hours before going to bed.
• Swallow the Ropinirole Hydrochloride Tablets whole with water. Taking Ropinirole Hydrochloride Tablets with food may decrease the occurrence of nausea (feeling sick), which is a possible side effect of Ropinirole Hydrochloride Tablets. Do not chew the tablet(s).
• You should continue to take your medicine even if you do not feel better as it may take a number of weeks for your medicine to work for you. If you have the impression that the effect of Ropinirole Hydrochloride Tablets is too strong or too weak talk to your doctor or pharmacist. Do not take more tablets than your doctor has recommended.
If you take more Ropinirole Hydrochloride Tablets than you should:
If you have taken more Ropinirole Hydrochloride Tablets than you were told to, or if someone else has taken any Ropinirole Hydrochloride Tablets contact accident and emergency department of your nearest hospital. Take any left over tablets or empty box with you for easier identification.
If you forget to take Ropinirole Hydrochloride Tablets:
Do not take a double dose to make up for the forgotten dose, take you next dose as usual and continue you course. If you have missed taking Ropinirole Hydrochloride Tablets for more than a few days consult your doctor for advice on restarting Ropinirole Hydrochloride Tablets.
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If you stop taking Ropinirole Hydrochloride Tablets:
If your symptoms worsen after you stop treatment with Ropinirole Hydrochloride Tablets, you should contact your doctor. If you have any further questions on the use of this product, ask your doctor or pharmacist. If stopping treatment the dose should always be reduced gradually. Your doctor will advise you.
4. Possible side effects
Like all medicines, Ropinirole Hydrochloride Tablets can cause side effects, although not everybody gets them.
The more common side effects of Ropinirole Hydrochloride Tablets are more likely to happen when you start taking it, or when your dose has just been increased. They are usually mild, and may become less troublesome after you have taken the dose for a while.
If you become delirious (severe confusion) or experience an allergic reaction:
• red, itchy swellings on your skin (hive)
• swelling of the face, lips, mouth, tongue or throat (angioedema)
• difficultly breathing or swallowing,
• rash or intense itching
Stop taking your medicine and inform your doctor immediately.
In studies of the treatment of Parkinson's disease the side effects of ropinirole are somewhat different to those seen when treating Restless Legs which are as follows:
Parkinson's disease
When ropinirole tablets are used to treat Parkinson's disease, the following side effects have been reported:
Very common side effects (affects more than 1 user in 10):
• Feeling drowsy
• Nausea (feeling or being sick)
• Disturbance of movements (dyskinesia)
• Fainting
Common side effects (affects 1 to 10 users in 100):
• Vomiting
• Stomach pain
• Sensing things that are not real
• Heartburn
• Dizziness (including vertigo)
• Swelling of legs
• Feeling confused
Un common side effects (affects 1 to 10 users in 1,000):
• Increased sexual desire
• Feeling sleepy during the day
• Falling asleep very suddenly without feeling sleepy first (Sudden onset sleep episodes)
• Mental problems such as delirium (severe confusion), delusions (unreasonable ideas)or paranoia (unreasonable suspicions)
• Feeling dizzy or faint, especially when you stand up suddenly (this is caused by a drop in blood pressure)
• Hypotension (Reduce the blood pressure)
Very rare side effects (affects less than 1 user in 10,000):
• Change liver function
• Allergic reactions such as red, itchy swellings on the skin, swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing, rash or intense itching
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 behaviors; they will discuss ways of managing or reducing the symptoms
Restless Legs Syndrome
Very common side effects (affects more than 1
user in 10):
• Vomiting
• Nausea (feeling or being sick)
Common side effects (affects 1 to 10 users in 100):
• Fatigue (tiredness, weakness)
• Feeling drowsy
• Nervousness
• Dizziness (including vertigo)
• Stomach pain
• Fainting
Un common side effects (affects 1 to 10 users in 1,000):
• Hypotension (Reduce the blood pressure)
• Postural hypotension (Decrease in blood pressure while sitting or standing)
• Feeling confused
• Hallucinations (Emergence of surprising or warded-off memory or fantasy images)
Very rare side effects (affects less than 1 user in 10,000):
• Altered liver function
• Excessive daytime somnolence (excessive drowsiness)
• Sudden sleep onset episodes
• delirious (severe confusion)
• illusions (false ideas)
• paranoia (excessive anxiety or fear)
There are some reports of patients treated for Parkinson's disease with medicinal products of this group of substance (dopamine agonists) who showed pathological compulsive gambling or compulsive and excessive sexual drive. These adverse effects were reversible when doses were reduced or treatment was stopped.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
5. How to store Ropinirole Hydrochloride Tablets
• Keep out of the reach and sight of children.
• Do not use Ropinirole Hydrochloride Tablets after the expiry date which is stated on the carton or bottle after (exp). The expiry date refers to last day of that month.
• Do not store above 25°C.
• For HDPE container: Shelf-life after date of first opening is 6 months.
• Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
6. Further information
What Ropinirole Hydrochloride Tablets contain:
The active substance is Ropinirole. Each film-coated tablet contains either 0.25 mg, 0.5 mg, 1 mg or 2 mg of ropinirole (as hydrochloride).
The other ingredients are:
Core tablet consist of lactose monohydrate, cellulose microcrystalline, croscarmellose sodium and magnesium stearate.
Film-coating of the tablets consist of Hypromellose 6cp (E464), titanium dioxide (E171) and macrogol 400.
Additionally 0.25 mg tablet contains polysorbate 80 (E433), 0.5 mg tablet contains iron oxide yellow (E172), iron oxide red (E172), indigo carmine aluminum lake (E132), 1 mg tablet contains iron oxide yellow (E172), indigo carmine aluminum lake (E132) and 2 mg tablet contains iron oxide yellow (E172), iron oxide red (E172).
What Ropinirole Hydrochloride Tablets looks like and content of the pack:
Ropinirole 0.25 mg tablets are white to off white, round, biconvex, film coated tablets plain on both sides. The tablets are packed in blister packs containing 21 or 42 tablets and in HDPE bottles containing 12 or 84 tablets.
Ropinirole 0.5 mg tablets are yellow, round, biconvex, film coated tablets plain on both sides. The tablets are packed in blister packs containing 21 or 42 tablets and in HDPE bottles containing 28 or 84 tablets.
Ropinirole 1 mg tablets are green, round, biconvex, film coated tablets plain on both sides. The tablets are packed in blister packs containing 21 or 42 tablets and in HDPE bottles containing 84 tablets.
Ropinirole 2 mg tablets are pink, round, biconvex, film coated tablets plain on both sides. The tablets are packed in blister packs containing 63 tablets and in HDPE bottles containing 84 tablets.
The Blister packs of the tablets are packed in a carton with package leaflet while HDPe bottles of the tablets are packed with silica gel canister in a carton with a package leaflet.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Accord Healthcare Limited,
Sage House, 319, Pinner Road,
North Harrow, Middlesex, HA1 4hF,
UK
The leaflet was last approved in 11/2012.