Ropinirole with Vitex Interaction Details
Brand Names Associated with Ropinirole
- Requip®
- Requip® XL
- Ropinirole
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 03, 2023
Interaction Effect
Increased dopaminergic side effects
Interaction Summary
Theoretically, the dopamine agonist activity of Vitex may add to that of other dopamine agonists, increasing the risk of dopaminergic adverse effects. Vitex has been effective in alleviating luteal phase defects due to hyperprolactinemia and in relieving symptoms related to premenstrual tension syndrome. Vitex reduced prolactin secretion in humans . In vitro, Vitex inhibited prolactin release by binding to the D2 receptor .
Severity
Minor
Onset
Delayed
Evidence
Probable
How To Manage Interaction
Avoid concomitant use of Vitex with rOPINIRole. If the patient chooses to take Vitex, monitor closely for symptoms of additive dopamine agonism such as nausea, headache, dizziness, fatigue, vomiting, and postural hypotension.
Mechanism Of Interaction
Additive dopaminergic effect
Literature Reports
A) Vitex agnus castus effectively normalized prolactin release in a randomized double-blind, placebo-controlled trial of 52 women with luteal phase defects due to latent hyperprolactinemia. Administration of Vitex agnus castus 20 mg daily for three months reduced prolactin release (from 23.7 to 22.5 nanogram (ng)/mL; p equal to 0.23), normalized shortened luteal phases (from 5.5 days to 10.5 days; p less than 0.005), and eliminated deficits in luteal progesterone synthesis (from 2.46 ng/mL to 9.69 ng/mL; p less than 0.001). No side effects were noted .
B) Vitex agnus castus and pyridoxine caused a similar reduction on the premenstrual tension scale (PMTS) in a randomized, controlled trial of 127 women with PMTS. Patients taking Vitex agnus castus (Agnolyt(R)) experienced more relief from breast tenderness, inner tension, headache, edema, constipation, and depression than those taking pyridoxine. Patients in the Vitex agnus castus group receive one capsule of Agnolyt(R) and one placebo capsule daily for 3 menstrual cycles. Patients in the pyridoxine group received one placebo capsule twice daily on days 1-15 of the menstrual cycle and pyridoxine 100 mg twice daily on days 16 to 35 of the menstrual cycle for 3 menstrual cycles. Unspecified gastrointestinal disturbances occurred in the treatment group along with two cases of skin reaction and one transient headache .
C) In vitro, Vitex (Agnus castus) was found to bind to the D2 receptor in rat pituitary cell cultures. Basal prolactin release was significantly inhibited by 0.5 milligram (mg) and 1 mg of Vitex extract/mL culture medium (p less than 0.05). Agnus castus extract doses from 0.125 mg/mL to 1 mg/mL significantly suppressed prolactin release in cells stimulated by thyrothropin releasing hormone (TRH) (p less than 0.05). Dopaminergic action was demonstrated in the rat corpus striatum membrane dopamine receptor assay. Agnus castus extract did not affect basal luteinizing hormone (LH) or follicle-stimulating hormone (FSH), indicating selectivity for prolactin secretion, and not generalized inhibition of pituitary hormone secretion. The effect was not due to a cytotoxic effect as demonstrated by the lack of effect on the MTT-conversion test. The authors concluded that Agnus castus exerted its prolactin inhibiting effect via stimulation of D2 receptors in the pituitary .
Ropinirole Overview
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Ropinirole is used alone or with other medications to treat the symptoms of Parkinson's disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance), including shaking of parts of the body, stiffness, slowed movements, and problems with balance. Ropinirole is also used to treat restless legs syndrome (RLS or Ekbom syndrome; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down). Ropinirole is in a class of medications called dopamine agonists. It works by acting in place of dopamine, a natural substance in the brain that is needed to control movement.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.