II. Indications
III. Pharmacokinetics
- Half life: 6 hours
- Hepatic metabolism
IV. Dosing: Parkinsonism
- Immediate Release start 0.25 mg three times daily (may increase by 0.25 mg/week up to 24 mg/day)
- Extended Release start 2 mg daily (may increase by 2 mg/week up to 24 mg/day)
V. Dosing: Restless Leg Syndrome
- Start: Requip 0.25 mg orally taken 2-3 hours before bedtime
- Interval for increasing dose: 3-7 days
- Titrating dose: Increase at set interval as above by one tablet if ineffective at current dose
- Start at 0.25 mg one tablet nightly for set interval in days
- Increase to two tablets (0.50 mg) nightly for set interval if ineffective at 0.25 mg
- Increase to three tablets (0.75 mg) nightly for set interval if ineffective at 0.50 mg
- Maximum dose: 6 tablets (1.5 mg) taken at bedtime
- Stopping: No titration needed
VI. Adverse Effects (similar to Mirapex)
- Nausea (common)
- Drowsiness (Limited to higher dosages)
- May be sudden, severe without warning
- May occur up to one year after starting Mirapex
- Has resulted in falling asleep while driving
- Augmentation of Restless Leg Symptoms
- Occurs in 25% of RLS patients on longterm therapy
- May progress in severity, and involve arms, trunk
- Often better if dose timing changed to earlier in day
- May be worse if dose increased
- Other uncommon adverse effects (rare at low dose)
- Hallucinations
- Pathologic Gambling (related to Dopamine receptor Agonist activity, D3)
- Orthostatic Hypotension
- Hypersexuality
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