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Requip
Last reviewed: 03.07.2025
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Requip is a medication used in the treatment of Parkinson's disease.
Indications Requipa
It is used to treat shaking palsy. It can be used in several different therapeutic regimens:
- monotherapy in the early stages of the disease in people who require dopaminergic treatment (to delay the use of levodopa drugs);
- complex treatment for people taking levodopa medications – to enhance the drug effect, reduce the symptoms that develop when levodopa is discontinued, and also to adjust the doses of levodopa.
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Release form
The drug is released in tablets of 2, 4 or 8 mg, in the amount of 14 pieces inside a blister pack. The box contains 2 or 6 such packages.
Pharmacodynamics
Requip has a central and peripheral effect in the treatment of shaking palsy.
The substance ropinirole has an effect on the deteriorating dopaminergic nerves of the black element, which have a presynaptic nature, which provides it with the role of an artificial neurotransmitter. The component reduces the indicators of hypodynamia, and at the same time weakens rigidity with tremor, which are the main signs of the disease.
In addition, the active element of LS, by stimulating dopamine endings inside the striatum, compensates for the lack of dopamine inside the systems of this body and the black element.
Ropinirole has a stimulating effect on levodopa - among other things, on the frequency of the "on-off effect" and the withdrawal effect caused by long-term use of levodopa drugs, which allows for a reduction in its dose. At the same time, the effect of the active component develops in the pituitary gland with the hypothalamus, and against its background, prolactin production processes are inhibited.
Pharmacokinetics
Absorption of ropinirole after oral administration of the drug occurs at a low rate - the plasma Cmax indicator is noted after 6 hours. The level of bioavailability is quite low - on average about 50%. In the case of a combination of the drug with fatty foods, an increase in the systemic exposure of the drug and an increase in the Cmax and AUC values by 44% and 20%, respectively, is recorded. At the same time, the duration of Tmax increases by 3 hours.
The severity of the overall effect of the drug depends on the portion size - as the dosage increases, the effectiveness of the drug also increases.
Ropinirole is poorly synthesized with blood protein (approximately 10-40%), but due to its strong lipophilicity has high Vd values (approximately 7 l/kg). Metabolism occurs mainly with the participation of the isoenzyme CYP1A2.
The half-life of the substance is approximately 6 hours (with the participation of the kidneys).
Ropinirole clearance values are slightly reduced in elderly people – by approximately 15%. However, there is no need to change the drug dosage because of this.
In people with chronic or acute renal failure undergoing hemodialysis, the level of drug clearance decreases by 30%.
Dosing and administration
The portion size is selected taking into account the individual characteristics of the patient - his tolerance, as well as the degree of severity of the drug's effect.
The tablets are taken orally, without regard to food intake, once a day. They should not be chewed or crushed.
When prescribing a drug, it is necessary to take into account the possible need for titration of the dosage in case of missing a dose 1+ times.
Dosage reduction can be carried out only in situations where the patient experiences drowsiness or other negative manifestations. In the future, the portion should be increased again.
Mode of use during monotherapy.
The optimal initial dose is 2 mg taken once during the first 7 days of the course. After that, the interval should be reduced to less than 1 week and the dose should be increased (by 2 mg) each new week for 1 month. During the 4th week, the maximum daily dose should be 8 mg. If there is no result, the dose should be increased further (by 4 mg) at intervals of 1-2 weeks. A maximum of 24 mg of the drug is allowed per day.
Combined drug use regimen.
When using Requip in the doses used in monotherapy, together with levodopa medications, the dose size of the second drug can be gradually reduced in accordance with the medicinal effect. During clinical trials, it was found that when the dose of levodopa was reduced to 30%, no damage to the medicinal effect was observed.
The use of drugs in complex treatment at the stage of titration of the ropinirole dosage may lead to the appearance of dyskinesia. Reducing the dose of levodopa may reduce the severity of these manifestations.
When discontinuing the drug, it is necessary to follow the sequence, gradually reducing the daily dose over a period of at least 7 days. When stopping the drug for 1+ days, in the event of starting a repeat cycle, it is necessary to consider the need for titration of the dose.
People with severe renal impairment should begin therapy with a single daily dose of 2 mg. The dose should be increased based on tolerance. For people on hemodialysis, the maximum daily dose is 18 mg. Maintenance doses are not required.
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Use Requipa during pregnancy
It is prohibited to prescribe Requip to pregnant women.
Contraindications
Among the contraindications:
- acute form of psychosis;
- severe renal dysfunction (without regular hemodialysis sessions);
- problems with liver function;
- hereditary diseases (such as hypolactasia, glucose-galactose malabsorption syndrome, and lactose deficiency);
- breastfeeding period;
- the presence of intolerance to the components of the drug.
Caution is required when used in people with severe cardiovascular dysfunction.
Prescribing the drug to people with a history of psychological disorders is permitted only in situations where the potential benefit outweighs the likelihood of complications.
Side effects Requipa
People with progressive Parkinsonism may experience motor coordination problems during therapy. To reduce the severity of these symptoms, it may be necessary to discontinue the use of levodopa medications. Other negative symptoms include:
- disorders of the central nervous system and the peripheral nervous system: visual perception disorder (except for hallucinations), increased libido, psychotic states (this includes delirium with delusions), development of hypersexuality, increased impulsivity, severe drowsiness with the possibility of sudden falling asleep, and also gambling addiction. Such manifestations often disappear after discontinuation of drug intake. Therapy using sedative medications can also be carried out;
- problems with the cardiovascular system: orthostatic collapse or decreased blood pressure;
- allergy symptoms: the appearance of hives or rashes, and in addition, the development of Quincke's edema.
Interactions with other drugs
Typical neuroleptics with dopyramine antagonists weaken the medicinal properties of ropinirole.
The drug does not interact with domperidone or levodopa, which eliminates the need to adjust doses when combining these drugs. In general, the medication does not interact with most drugs used for Parkinsonism.
Medicines that inhibit the activity of the CYP1A2 element (including enoxacin with ciprofloxacin, as well as fluvoxamine, etc.) increase the AUC and Cmax values of the active element by 84% and 60%, respectively. Because of this, when combining them, it is necessary to adjust the portion sizes of ropinirole.
Combination with large doses of estrogens can increase ropinirole levels, which is why when starting hormonal treatment during a course using Requip, it is necessary to review the portion sizes.
People who smoke or quit smoking need to adjust the dosage of the drug, because nicotine has a stimulating effect on the isoenzyme CYP1A2.
Storage conditions
Requip is kept in a place closed to small children. Temperature values are maximum 25°C.
Shelf life
Requip in tablets with a volume of 2 mg can be used for a period of 24 months from the date of its release. For tablets with a volume of 4 and 8 mg, the shelf life is 36 months.
Application for children
The drug should not be used by children under 18 years of age.
Analogues
The drug Sindranol is an analogue of this medication.
Attention!
To simplify the perception of information, this instruction for use of the drug "Requip" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.