Rotigotine Transdermal Patch

Rotigotine patches, sold as Neupro, treat two conditions:

• Neupro is used for Parkinson's disease.
• Neupro is used for moderate-to-severe primary Restless Legs Syndrome.

Rotigotine is a non-ergoline dopamine agonist. It mimics dopamine by stimulating dopamine receptors in the brain.

In Parkinson's disease, this is thought to involve an area called the caudate-putamen. The exact way it helps Parkinson's disease and RLS is not known.

Neupro is a patch worn on the skin and replaced once a day. You can use it with or without food.

• Apply to clean, dry, intact skin on the front of the abdomen, thigh, hip, flank, shoulder, or upper arm.
• Press firmly for 30 seconds, especially around the edges.
• Rotate sites daily. Don't reuse a site within 14 days.
• If the area is hairy, shave it at least 3 days before applying.
• If you forget to change the patch or it falls off, apply a new one for the rest of the day.
• Your dose may be made with one or more patches. To stop, your doctor will lower the dose gradually.

The most common side effects include:

Call your doctor about falling asleep suddenly, hallucinations, fainting, compulsive urges, or severe skin reactions.

• Sudden sleep onset: some people fell asleep during daily activities, including driving, sometimes without warning.
• Hallucinations and psychosis: new or worse confusion, paranoia, or odd behavior can occur.
• Low blood pressure and fainting: most likely when starting or raising the dose.
• Compulsive behaviors: urges to gamble, spend, binge eat, or have sex.
• Higher blood pressure and heart rate in some people.
• Weight gain and swelling: especially in Parkinson's disease.
• Dyskinesia: Neupro can cause or worsen uncontrolled movements, especially with levodopa.
• Skin reactions: can be severe.
• Stopping suddenly: can cause high fever and confusion.
• Sulfite allergy: the patch contains sodium metabisulfite.

Few interactions are listed for Neupro, but one matters:

• Antipsychotics and metoclopramide: these dopamine blockers may reduce how well Neupro works.
• Sedating medicines: your doctor should ask about these because they may raise the risk of drowsiness.

Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.

• Don't use it if you're allergic to rotigotine or any patch ingredient.
• Tell your doctor about sulfite sensitivity or asthma.
• Tell your doctor about psychotic disorders, heart disease, low blood pressure, or fainting.
• Heart failure or kidney problems call for monitoring of weight and swelling.
• Pregnancy: animal data show possible fetal harm; human data are lacking.
• Breastfeeding: it may reduce milk production, and effects on infants are unknown.
• Children: not established as safe or effective.
• Older adults: no overall differences were seen, but some may be more sensitive.

Too much may cause nausea, vomiting, low blood pressure, involuntary movements, hallucinations, confusion, and convulsions. There is no known antidote. Remove extra patches right away and seek medical help, where heart rate, rhythm, and blood pressure are monitored.

Rotigotine acts as a dopamine agonist. In a study at doses up to 24 mg/24 hours, it showed no sign of lengthening the QT interval, a measure of heart rhythm timing.

After you apply the patch, the drug shows up in the blood after about 3 hours on average. Levels have no sharp peak, and steady levels are reached within 2 to 3 days. Where you place the patch can change how much is absorbed, with the shoulder absorbing more than the thigh in one study.

The body breaks rotigotine down into mostly inactive forms, and most leaves in the urine. After the patch is removed, levels fall with a half-life of 5 to 7 hours.

Store at 20º - 25ºC (68º - 77ºF); excursions permitted between 15º - 30ºC (59º - 86ºF). stored in the original pouch. store outside of pouch.