Requip Xl 8mg Prolonged-Release Tablets
PATIENT INFORMATION LEAFLET
ReQuip ® XL 8mg prolonged-release tablets
Ref: 1368/031016/1/F
PATIENT INFORMATION LEAFLET
ReQuip ® XL 8mg prolonged-release tablets
Ref: 1368/031016/1/F
POM
(ropinirole hydrochloride)
• uncontrollable movements (dyskinesias) are a very common side effect. If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first start taking ReQuip XL. Tell your doctor if this happens, as your doctor may need to adjust the dose of the medicines you are taking.
• feeling confused is a common side effect.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:www.mhra.gov.uk/yellowcard By reporting side effects you can help provide more information on the safety of this medicine.
5. HOW TO STORE REQUIP XL
KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.
Do not store above 25°C. Store in the original package to protect from light.
Do not take this medicine after the expiry date shown on the carton label. If your doctor tells you to stop taking the medicine, take any remaining medicine back to the pharmacist for safe disposal. Only keep this medicine if your doctor tells you to. If your medicine becomes discoloured or shows any signs of deterioration, ask your pharmacist who will advise you what to do.
Medicines should not be disposed of via waterwaste or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the enviroment.
6. CONTENTS OF THE PACK AND OTHER INFORMATION
What ReQuip XL contains
The active substance in ReQuip XL is ropinirole. Each prolonged-release tablet contains 8 mg, of ropinirole (as hydrochloride).
The other ingredients are: hypromellose, hydrogenated castor oil, carmellose sodium, povidone (K29-32), maltodextrin, magnesium stearate, lactose monohydrate, colloidal silica anhydrous, mannitol (E421), yellow iron oxide (E172), glycerol dibehenate • film coats:
8 mg tablet: hypromellose, yellow iron oxide (E172) titanium dioxide (E171), black iron oxide (E172), macrogol 400, red iron oxide (E172)
Manufacturer and Licence Holder
This medicine is manufactured by SmithKline Beecham Plc, T/A SmithKline Beecham Pharmaceuticals, Manor Royal, Crawley, West Sussex, RH10 9QJ, UK and is procured from within the EU and repackaged by the Product Licence Holder: Lexon (UK) Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE.
If you have any questions or are not sure about anything, ask your doctor or pharmacist. They will have additional information about this medicine and will be able to advise you.
PL 15184/1368 - ReQuip XL 8mg Tablets
ReQuip is a registered trademark of GlaxoSmithKline group of companies
Leaflet revision date: 03/10/16
Blind or partially sighted?
Is this leaflet hard to see or read? Phone Lexon (UK) Limited,
Tel: 01527 505414 for help.
A number of groups exist to provide further information and support to Parkinson's disease patients and their carers. The main one is the Parkinson's Disease Society, who you can contact at the address given below: Parkinson's Disease Society 215 Vauxhall Bridge Road London SW1V 1EJ
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor, nurse specialist or pharmacist.
This medicine has been prescribed for you only. Don't pass it on to others. It may harm them, even if their signs of illness are the same as yours.
If you get any side effects, talk to your doctor, nurse or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
Your medicine is called ReQuip XL 8mg prolonged-release tablets but will be referred to as ReQuip XL throughout this leaflet.
Please note that the leaflet also contains information about other strengths of the medicine ReQuip XL 2mg and ReQuip XL 4mg
What is in this leaflet:
1. What ReQuip XL is and what it is used for
2. What you need to know before you take ReQuip XL
3. How to take ReQuip XL
4. Possible side effects
5. How to store ReQuip XL
6. Contents of the pack and other information
1. WHAT REQUIP XL IS AND WHAT IT IS USED FOR
ReQuip XL is used to treat Parkinson’s disease.
The active ingredient in ReQuip XL is ropinirole, which belongs to a group of medicines called dopamine agonists. Dopamine agonists affect the brain in a similar way to a natural substance called dopamine.
People with Parkinson's disease have low levels of dopamine in some parts of their brains. Ropinirole has effects similar to those of natural dopamine, so it helps to reduce the symptoms of Parkinson's disease.
You can take ReQuip XL (like ReQuip) either on its own or along with L-dopa (see section 4 of this leaflet for more details). ReQuip XL should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson's disease.
Warnings and Precautions
Talk to your doctor or pharmacist before taking ReQuip XL:
• if you are pregnant or think you may be pregnant
• if you are breast-feeding
• if you are under 18 years old
• if you have a serious heart complaint
• if you have a history of or currently have a serious mental health problem
• if you have a history of or have experienced any unusual urges and/or behaviours (such as excessive gambling or excessive sexual behaviour, see section 4)
• if you have an intolerance to some sugars (such as lactose).
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.
■+ Tell your doctor or nurse if you think any of these may apply to you. Your doctor or nurse may decide that ReQuip XL isn't suitable for you, or that you need extra check-ups while you're taking it.
You also need to be careful with ReQuip XL if you drive or operate machinery. Please read the warning in section 3 of this leaflet.
Other medicines and ReQuip XL
Tell your doctor, nurse or pharmacist if you are taking, have recently taken, or might take any other medicines - including any herbal remedies or medicines you bought without a prescription.
Some medicines can affect the way ReQuip XL works, or make it more likely that you'll have side effects. ReQuip XL can also affect the way some other medicines work.
What ReQuip XL looks like and contents of the pack
ReQuip XL 8mg prolonged-release tablets are Red capsule-shaped, film-coated tablets marked “GS” on one side and “5CC” on the other.
2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE REQUIP XL
Do not take ReQuip XL
• if you are allergic to ropinirole or any of the other ingredients of this medicine (listed in section 6)
• if you have serious kidney disease
• if you have liver disease
These include:
• the anti-depressant, fluvoxamine
• HRT (hormone replacement therapy)
• medication for other mental health problems, for example sulpiride
• metoclopramide, which is used to treat nausea and heartburn
• cimetidine, used in the treatment of stomach ulcers
• the antibiotics, ciprofloxacin or enoxacin
• any other medicine for Parkinson’s disease.
4. POSSIBLE SIDE EFFECTS
Remember to tell your doctor or nurse if you
start taking any other medicine while you're taking ReQuip XL.
ReQuip XL with food and drink
You can take ReQuip XL with or without food, as you prefer. Because high fat foods might increase the amount of ropinirole absorbed by your body, it is recommended that you do not take ReQuip XL at the same time as a high fat meal.
Pregnancy and breast-feeding ReQuip XL is not recommended if you are pregnant, unless your doctor advises that the benefit of you taking ReQuip XL is greater than the risk to your unborn baby.
ReQuip XL is not recommended if you are breastfeeding, as it can affect your milk production.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Driving and using machines
ReQuip XL can make you feel drowsy or dizzy.
It can make people feel extremely sleepy, and it
sometimes makes people fall asleep very suddenly without warning.
If you could be affected: don't drive, don’t operate machines and don’t put yourself in any situation where feeling sleepy or falling asleep could put you (or other people) at risk of serious injury or death. Don't take part in these activities until you are sure you're not affected.
^ Talk to your doctor or nurse if this causes problems for you.
ReQuip XL contains lactose and sunset yellow
ReQuip XL tablets contain a sugar called lactose. If you have been told that you have an intolerance to some sugars, contact your doctor or nurse before taking ReQuip XL.
The 4 mg tablets contain a colouring called sunset yellow (E110), which may cause allergic reactions.
Smoking and ReQuip XL
Tell your doctor or nurse if you start smoking, or give up smoking, while you're taking ReQuip XL. Your doctor or nurse may need to adjust your dose.
3. HOW TO TAKE REQUIP XL
Always take this medicine exactly as your
doctor or nurse or pharmacist has told you.
Check with your doctor, nurse or pharmacist if you are not sure.
You may be given ReQuip XL on its own to treat the symptoms of your Parkinson's disease. Or you may be given ReQuip XL as well as another medicine called L-dopa (also called levodopa). ReQuip XL should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson's disease.
If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first start taking ReQuip XL. Tell your doctor if this happens, as your doctor may need to adjust the dose of the medicines you are taking.
Tell your doctor if you or your family notices that you are developing any unusual behaviours (such as an unusual urge to gamble or increased sexual urges and/or behaviours) while you are taking ReQuip XL. Your doctor may need to adjust your dose.
If you are switching from ReQuip film-coated (immediate-release) tablets
Your doctor or nurse will base your dose of ReQuip XL on the dose of ReQuip you were taking. You will take the same or similar daily dose of ReQuip XL to your previous dose of ReQuip but you will only take ReQuip XL once a day.
Take your ReQuip as normal the day before you switch. Then take your ReQuip XL on the next day and don't take any more ReQuip.
Your doctor or nurse will be monitoring your progress closely after switching to ReQuip XL.
If there is any change in the control of your symptoms before your next appointment, talk to your doctor or nurse as soon as possible in case dose adjustment is needed.
How much ReQuip XL will you need to take?
It may take a while to find out the best dose of ReQuip XL for you.
The recommended starting dose of ReQuip XL tablets is 2 mg once daily for the first week.
Your doctor may increase your dose to 4 mg of ReQuip XL tablets once daily, from the second week of treatment. If you are very elderly your doctor may increase your dose more slowly. After that, the doctor may adjust your dose until you are taking the dose that is best for you. Some people take up to 24 mg of ReQuip XL tablets each day.
If at the start of your treatment, you experience side effects that you find difficult to tolerate, speak to your doctor. Your doctor may advise you to switch to a lower dose of ReQuip film-coated (immediate-release) tablets which you will take three times a day.
Don’t take more ReQuip XL than your doctor or nurse has recommended.
It may take a few weeks for ReQuip XL to work for you.
Taking your dose of ReQuip XL
Take ReQuip XL once a day, at the same time each day.
Swallow your ReQuip XL tablets whole, with a glass of water.
Don’t break, chew or crush the tablets - if you do, there's a danger you could overdose, because the medicine will be released into your body too quickly.
ReQuip XL tablets are designed to release the drug into your body over a 24 hour period. If the tablets pass through your body in less than 24 hours the medicine may not be completely released. You may see tablets in your stool. If this happens, let your doctor know.
If you take more ReQuip XL than you should Contact a doctor, nurse or pharmacist immediately. If possible, show them the ReQuip XL pack.
Someone who has taken an overdose of ReQuip XL may have any of these symptoms: feeling sick (nausea), being sick (vomiting), dizziness (a spinning sensation), feeling drowsy, mental or physical tiredness, fainting, hallucinations.
If you forget to take ReQuip XL
Do not take a double dose to make up for a
forgotten dose.
If you have missed taking ReQuip XL for one day or more, ask your doctor or nurse for advice on how to start taking it again.
If you stop taking ReQuip XL Don’t stop taking ReQuip XL without advice Take ReQuip XL for as long as your doctor or nurse recommends. Don't stop unless your doctor or nurse advises you to.
If you suddenly stop taking ReQuip XL, your Parkinson's disease symptoms may quickly get much worse. A sudden stop could cause you to develop a medical condition called neuroleptic malignant syndrome which may represent a major health risk. The symptoms include: akinesia (loss of muscle movement), rigid muscles, fever, unstable blood pressure, tachycardia (increased heart rate), confusion, drepressed level of consciousness (e.g. coma).
If you need to stop taking ReQuip XL, your doctor or nurse will reduce your dose gradually.
If you have any further questions on the use of this medicine, ask your doctor, nurse or pharmacist.
Like all medicines, this medicine can have side effects, but not everyone gets them.
The more common side effects of ReQuip XL are more likely to happen when you first start taking it, or when your dose has just been increased. They are usually mild, and may become less troublesome after you've taken the dose for a while. If you're worried about side effects, talk to your doctor or nurse.
Very common side effects:
may affect more than 1 in 10 people
• fainting
• feeling drowsy
• feeling sick (nausea).
Common side effects:
may affect up to 1 in 10 people
• falling asleep very suddenly without feeling sleepy first (sudden sleep onset episodes)
• hallucinations (sensing things that are not real)
• being sick (vomiting)
• feeling dizzy (a spinning sensation)
• heartburn
• stomach pain
• constipation
• swelling of the legs, feet or hands.
Uncommon side effects:
may affect up to 1 in 100 people
• feeling dizzy or faint, especially when you stand up suddenly (this is caused by a drop in blood pressure)
• feeling very sleepy during the day
• mental problems such as delirium (severe confusion), delusions (unreasonable ideas) or paranoia (unreasonable suspicions).
You may experience the following side effects (frequency not known):
• 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 behaviours; they will discuss ways of managing or reducing the symptoms
Very rare side effects:
may affect up to 1 in 10,000 people A very small number of people taking ReQuip XL (less than 1 in 10,000) have experienced:
• changes in liver function, which have shown up in blood tests
• allergic reactions such as red, itchy swellings on the skin (hives), swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing, rash or intense itching.
Some patients may have the following side effects (frequency not known: cannot be estimated from the available data)
• act in an aggressive manner.
• excessive use of ReQuip XL (craving for large doses of dopaminergic drugs in excess of that required to control motor symptoms, known as dopamine dysregulation syndrome)
If you’re taking ReQuip XL with L-dopa
People who are taking ReQuip XL with L-dopa may develop other side effects over time:
POM
PATIENT INFORMATION LEAFLET ReQuip ® XL 8mg prolonged-release tablets
(ropinirole hydrochloride)
• uncontrollable movements (dyskinesias) are a very common side effect. If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first start taking ReQuip XL. Tell your doctor if this happens, as your doctor may need to adjust the dose of the medicines you are taking.
• feeling confused is a common side effect.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:www.mhra.gov.uk/yellowcard By reporting side effects you can help provide more information on the safety of this medicine.
5. HOW TO STORE REQUIP XL
KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.
Do not store above 25°C. Store in the original package to protect from light.
Do not take this medicine after the expiry date shown on the carton label. If your doctor tells you to stop taking the medicine, take any remaining medicine back to the pharmacist for safe disposal. Only keep this medicine if your doctor tells you to. If your medicine becomes discoloured or shows any signs of deterioration, ask your pharmacist who will advise you what to do.
Medicines should not be disposed of via waterwaste or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the enviroment.
6. CONTENTS OF THE PACK AND OTHER INFORMATION
What ReQuip XL contains
The active substance in ReQuip XL is ropinirole. Each prolonged-release tablet contains 8 mg, of ropinirole (as hydrochloride).
The other ingredients are: hypromellose, hydrogenated castor oil, carmellose sodium, povidone (K29-32), maltodextrin, magnesium stearate, lactose monohydrate, colloidal silica anhydrous, mannitol (E421), yellow iron oxide (E172), glycerol dibehenate
• film coats:
8 mg tablet: hypromellose, yellow iron oxide (E172) titanium dioxide (E171), black iron oxide (E172), macrogol 400, red iron oxide (E172)
Manufacturer and Licence Holder
This medicine is manufactured by Glaxo Wellcome GmbH & Co. KG, Industriestrasse 32-36, 23843 Bad Oldesloe, Germany and is procured from within the EU and repackaged by the Product Licence Holder: Lexon (UK) Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE.
If you have any questions or are not sure about anything, ask your doctor or pharmacist. They will have additional information about this medicine and will be able to advise you.
PL 15184/1368 - ReQuip XL 8mg Tablets
ReQuip is a registered trademark of GlaxoSmithKline group of companies
Leaflet revision date: 03/10/16
Blind or partially sighted?
Is this leaflet hard to see or read? Phone Lexon (UK) Limited,
Tel: 01527 505414 for help.
A number of groups exist to provide further information and support to Parkinson's disease patients and their carers. The main one is the Parkinson's Disease Society, who you can contact at the address given below: Parkinson's Disease Society 215 Vauxhall Bridge Road London SW1V 1EJ
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor, nurse specialist or pharmacist.
This medicine has been prescribed for you only. Don't pass it on to others. It may harm them, even if their signs of illness are the same as yours.
If you get any side effects, talk to your doctor, nurse or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
Your medicine is called ReQuip XL 8mg prolonged-release tablets but will be referred to as ReQuip XL throughout this leaflet.
Please note that the leaflet also contains information about other strengths of the medicine ReQuip XL 2mg and ReQuip XL 4mg
What is in this leaflet:
1. What ReQuip XL is and what it is used for
2. What you need to know before you take ReQuip XL
3. How to take ReQuip XL
4. Possible side effects
5. How to store ReQuip XL
6. Contents of the pack and other information
1. WHAT REQUIP XL IS AND WHAT IT IS USED FOR
ReQuip XL is used to treat Parkinson’s disease.
The active ingredient in ReQuip XL is ropinirole, which belongs to a group of medicines called dopamine agonists. Dopamine agonists affect the brain in a similar way to a natural substance called dopamine.
People with Parkinson's disease have low levels of dopamine in some parts of their brains. Ropinirole has effects similar to those of natural dopamine, so it helps to reduce the symptoms of Parkinson's disease.
You can take ReQuip XL (like ReQuip) either on its own or along with L-dopa (see section 4 of this leaflet for more details). ReQuip XL should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson's disease.
Warnings and Precautions
Talk to your doctor or pharmacist before taking ReQuip XL:
• if you are pregnant or think you may be pregnant
• if you are breast-feeding
• if you are under 18 years old
• if you have a serious heart complaint
• if you have a history of or currently have a serious mental health problem
• if you have a history of or have experienced any unusual urges and/or behaviours (such as excessive gambling or excessive sexual behaviour, see section 4)
• if you have an intolerance to some sugars (such as lactose).
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.
■+ Tell your doctor or nurse if you think any of these may apply to you. Your doctor or nurse may decide that ReQuip XL isn't suitable for you, or that you need extra check-ups while you're taking it.
You also need to be careful with ReQuip XL if you drive or operate machinery. Please read the warning in section 3 of this leaflet.
Other medicines and ReQuip XL
Tell your doctor, nurse or pharmacist if you are taking, have recently taken, or might take any other medicines - including any herbal remedies or medicines you bought without a prescription.
Some medicines can affect the way ReQuip XL works, or make it more likely that you'll have side effects. ReQuip XL can also affect the way some other medicines work.
What ReQuip XL looks like and contents of the pack
ReQuip XL 8mg prolonged-release tablets are Red capsule-shaped, film-coated tablets marked “GS” on one side and “5CC” on the other.
2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE REQUIP XL
Do not take ReQuip XL
• if you're allergic to ropinirole or any of the other ingredients of this medicine (listed in section 6)
• if you have serious kidney disease
• if you have liver disease
These include:
• the anti-depressant, fluvoxamine
• HRT (hormone replacement therapy)
• medication for other mental health problems, for example sulpiride
• metoclopramide, which is used to treat nausea and heartburn
• cimetidine, used in the treatment of stomach ulcers
• the antibiotics, ciprofloxacin or enoxacin
• any other medicine for Parkinson’s disease.
4. POSSIBLE SIDE EFFECTS
Remember to tell your doctor or nurse if you
start taking any other medicine while you're taking ReQuip XL.
ReQuip XL with food and drink
You can take ReQuip XL with or without food, as you prefer. Because high fat foods might increase the amount of ropinirole absorbed by your body, it is recommended that you do not take ReQuip XL at the same time as a high fat meal.
Pregnancy and breast-feeding ReQuip XL is not recommended if you are pregnant, unless your doctor advises that the benefit of you taking ReQuip XL is greater than the risk to your unborn baby.
ReQuip XL is not recommended if you are breastfeeding, as it can affect your milk production.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Driving and using machines
ReQuip XL can make you feel drowsy or dizzy.
It can make people feel extremely sleepy, and it
sometimes makes people fall asleep very suddenly without warning.
If you could be affected: don't drive, don’t operate machines and don’t put yourself in any situation where feeling sleepy or falling asleep could put you (or other people) at risk of serious injury or death. Don't take part in these activities until you are sure you're not affected.
^ Talk to your doctor or nurse if this causes problems for you.
ReQuip XL contains lactose and sunset yellow
ReQuip XL tablets contain a sugar called lactose. If you have been told that you have an intolerance to some sugars, contact your doctor or nurse before taking ReQuip XL.
The 4 mg tablets contain a colouring called sunset yellow (E110), which may cause allergic reactions.
Smoking and ReQuip XL
Tell your doctor or nurse if you start smoking, or give up smoking, while you're taking ReQuip XL. Your doctor or nurse may need to adjust your dose.
3. HOW TO TAKE REQUIP XL
Always take this medicine exactly as your
doctor or nurse or pharmacist has told you.
Check with your doctor, nurse or pharmacist if you are not sure.
You may be given ReQuip XL on its own to treat the symptoms of your Parkinson's disease. Or you may be given ReQuip XL as well as another medicine called L-dopa (also called levodopa). ReQuip XL should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson's disease.
If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first start taking ReQuip XL. Tell your doctor if this happens, as your doctor may need to adjust the dose of the medicines you are taking.
Tell your doctor if you or your family notices that you are developing any unusual behaviours (such as an unusual urge to gamble or increased sexual urges and/or behaviours) while you are taking ReQuip XL. Your doctor may need to adjust your dose.
If you are switching from ReQuip film-coated (immediate-release) tablets
Your doctor or nurse will base your dose of ReQuip XL on the dose of ReQuip you were taking. You will take the same or similar daily dose of ReQuip XL to your previous dose of ReQuip but you will only take ReQuip XL once a day.
Take your ReQuip as normal the day before you switch. Then take your ReQuip XL on the next day and don't take any more ReQuip.
Your doctor or nurse will be monitoring your progress closely after switching to ReQuip XL.
If there is any change in the control of your symptoms before your next appointment, talk to your doctor or nurse as soon as possible in case dose adjustment is needed.
How much ReQuip XL will you need to take?
It may take a while to find out the best dose of ReQuip XL for you.
The recommended starting dose of ReQuip XL tablets is 2 mg once daily for the first week.
Your doctor may increase your dose to 4 mg of ReQuip XL tablets once daily, from the second week of treatment. If you are very elderly your doctor may increase your dose more slowly. After that, the doctor may adjust your dose until you are taking the dose that is best for you. Some people take up to 24 mg of ReQuip XL tablets each day.
If at the start of your treatment, you experience side effects that you find difficult to tolerate, speak to your doctor. Your doctor may advise you to switch to a lower dose of ReQuip film-coated (immediate-release) tablets which you will take three times a day.
Don’t take more ReQuip XL than your doctor or nurse has recommended.
It may take a few weeks for ReQuip XL to work for you.
Taking your dose of ReQuip XL
Take ReQuip XL once a day, at the same time each day.
Swallow your ReQuip XL tablets whole, with a glass of water.
Don’t break, chew or crush the tablets - if you do, there's a danger you could overdose, because the medicine will be released into your body too quickly.
ReQuip XL tablets are designed to release the drug into your body over a 24 hour period. If the tablets pass through your body in less than 24 hours the medicine may not be completely released. You may see tablets in your stool. If this happens, let your doctor know.
If you take more ReQuip XL than you should Contact a doctor, nurse or pharmacist immediately. If possible, show them the ReQuip XL pack.
Someone who has taken an overdose of ReQuip XL may have any of these symptoms: feeling sick (nausea), being sick (vomiting), dizziness (a spinning sensation), feeling drowsy, mental or physical tiredness, fainting, hallucinations.
If you forget to take ReQuip XL
Do not take a double dose to make up for a
forgotten dose.
If you have missed taking ReQuip XL for one day or more, ask your doctor or nurse for advice on how to start taking it again.
If you stop taking ReQuip XL Don’t stop taking ReQuip XL without advice Take ReQuip XL for as long as your doctor or nurse recommends. Don't stop unless your doctor or nurse advises you to.
If you suddenly stop taking ReQuip XL, your Parkinson's disease symptoms may quickly get much worse. A sudden stop could cause you to develop a medical condition called neuroleptic malignant syndrome which may represent a major health risk. The symptoms include: akinesia (loss of muscle movement), rigid muscles, fever, unstable blood pressure, tachycardia (increased heart rate), confusion, drepressed level of consciousness (e.g. coma).
If you need to stop taking ReQuip XL, your doctor or nurse will reduce your dose gradually.
If you have any further questions on the use of this medicine, ask your doctor, nurse or pharmacist.
Like all medicines, this medicine can have side effects, but not everyone gets them.
The more common side effects of ReQuip XL are more likely to happen when you first start taking it, or when your dose has just been increased. They are usually mild, and may become less troublesome after you've taken the dose for a while. If you're worried about side effects, talk to your doctor or nurse.
Very common side effects:
may affect more than 1 in 10 people
• fainting
• feeling drowsy
• feeling sick (nausea).
Common side effects:
may affect up to 1 in 10 people
• falling asleep very suddenly without feeling sleepy first (sudden sleep onset episodes)
• hallucinations (sensing things that are not real)
• being sick (vomiting)
• feeling dizzy (a spinning sensation)
• heartburn
• stomach pain
• constipation
• swelling of the legs, feet or hands.
Uncommon side effects:
may affect up to 1 in 100 people
• feeling dizzy or faint, especially when you stand up suddenly (this is caused by a drop in blood pressure)
• feeling very sleepy during the day
• mental problems such as delirium (severe confusion), delusions (unreasonable ideas) or paranoia (unreasonable suspicions).
You may experience the following side effects (frequency not known):
• 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 behaviours; they will discuss ways of managing or reducing the symptoms
Very rare side effects:
may affect up to 1 in 10,000 people A very small number of people taking ReQuip XL (less than 1 in 10,000) have experienced:
• changes in liver function, which have shown up in blood tests
• allergic reactions such as red, itchy swellings on the skin (hives), swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing, rash or intense itching.
Some patients may have the following side effects (frequency not known: cannot be estimated from the available data)
• act in an aggressive manner.
• excessive use of ReQuip XL (craving for large doses of dopaminergic drugs in excess of that required to control motor symptoms, known as dopamine dysregulation syndrome)
If you’re taking ReQuip XL with L-dopa
People who are taking ReQuip XL with L-dopa may develop other side effects over time:
POM
(ropinirole hydrochloride)
• uncontrollable movements (dyskinesias) are a very common side effect. If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first start taking ReQuip XL. Tell your doctor if this happens, as your doctor may need to adjust the dose of the medicines you are taking.
• feeling confused is a common side effect.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:www.mhra.gov.uk/yellowcard By reporting side effects you can help provide more information on the safety of this medicine.
5. HOW TO STORE REQUIP XL
KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.
Do not store above 25°C. Store in the original package to protect from light.
Do not take this medicine after the expiry date shown on the carton label. If your doctor tells you to stop taking the medicine, take any remaining medicine back to the pharmacist for safe disposal. Only keep this medicine if your doctor tells you to. If your medicine becomes discoloured or shows any signs of deterioration, ask your pharmacist who will advise you what to do.
Medicines should not be disposed of via waterwaste or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the enviroment.
6. CONTENTS OF THE PACK AND OTHER INFORMATION
What ReQuip XL contains
The active substance in ReQuip XL is ropinirole. Each prolonged-release tablet contains 8 mg, of ropinirole (as hydrochloride).
The other ingredients are: hypromellose, hydrogenated castor oil, carmellose sodium, povidone (K29-32), maltodextrin, magnesium stearate, lactose monohydrate, colloidal silica anhydrous, mannitol (E421), yellow iron oxide (E172), glycerol dibehenate • film coats:
8 mg tablet: hypromellose, yellow iron oxide (E172) titanium dioxide (E171), black iron oxide (E172), macrogol 400, red iron oxide (E172)
Manufacturer and Licence Holder
This medicine is manufactured by GlaxoSmithKline Pharmaceuticals SA, UI. Grunwaldzka, 61-322, Poznan, Poland and is procured from within the EU and repackaged by the Product Licence Holder: Lexon (UK) Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch, Worcestershire, B98 0RE.
If you have any questions or are not sure about anything, ask your doctor or pharmacist. They will have additional information about this medicine and will be able to advise you.
PL 15184/1368 - ReQuip XL 8mg Tablets
ReQuip is a registered trademark of GlaxoSmithKline group of companies
Leaflet revision date: 03/10/16
Blind or partially sighted?
Is this leaflet hard to see or read? Phone Lexon (UK) Limited,
Tel: 01527 505414 for help.
A number of groups exist to provide further information and support to Parkinson's disease patients and their carers. The main one is the Parkinson's Disease Society, who you can contact at the address given below: Parkinson's Disease Society 215 Vauxhall Bridge Road London SW1V 1EJ
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor, nurse specialist or pharmacist.
This medicine has been prescribed for you only. Don't pass it on to others. It may harm them, even if their signs of illness are the same as yours.
If you get any side effects, talk to your doctor, nurse or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
Your medicine is called ReQuip XL 8mg prolonged-release tablets but will be referred to as ReQuip XL throughout this leaflet.
Please note that the leaflet also contains information about other strengths of the medicine ReQuip XL 2mg and ReQuip XL 4mg
What is in this leaflet:
1. What ReQuip XL is and what it is used for
2. What you need to know before you take ReQuip XL
3. How to take ReQuip XL
4. Possible side effects
5. How to store ReQuip XL
6. Contents of the pack and other information
1. WHAT REQUIP XL IS AND WHAT IT IS USED FOR
ReQuip XL is used to treat Parkinson’s disease.
The active ingredient in ReQuip XL is ropinirole, which belongs to a group of medicines called dopamine agonists. Dopamine agonists affect the brain in a similar way to a natural substance called dopamine.
People with Parkinson's disease have low levels of dopamine in some parts of their brains. Ropinirole has effects similar to those of natural dopamine, so it helps to reduce the symptoms of Parkinson's disease.
You can take ReQuip XL (like ReQuip) either on its own or along with L-dopa (see section 4 of this leaflet for more details). ReQuip XL should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson's disease.
Warnings and Precautions
Talk to your doctor or pharmacist before taking ReQuip XL:
• if you are pregnant or think you may be pregnant
• if you are breast-feeding
• if you are under 18 years old
• if you have a serious heart complaint
• if you have a history of or currently have a serious mental health problem
• if you have a history of or have experienced any unusual urges and/or behaviours (such as excessive gambling or excessive sexual behaviour, see section 4)
• if you have an intolerance to some sugars (such as lactose).
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.
■+ Tell your doctor or nurse if you think any of these may apply to you. Your doctor or nurse may decide that ReQuip XL isn't suitable for you, or that you need extra check-ups while you're taking it.
You also need to be careful with ReQuip XL if you drive or operate machinery. Please read the warning in section 3 of this leaflet.
Other medicines and ReQuip XL
Tell your doctor, nurse or pharmacist if you are taking, have recently taken, or might take any other medicines - including any herbal remedies or medicines you bought without a prescription.
Some medicines can affect the way ReQuip XL works, or make it more likely that you'll have side effects. ReQuip XL can also affect the way some other medicines work.
What ReQuip XL looks like and contents of the pack
ReQuip XL 8mg prolonged-release tablets are Red capsule-shaped, film-coated tablets marked “GS” on one side and “5CC” on the other.
2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE REQUIP XL
Do not take ReQuip XL
• if you're allergic to ropinirole or any of the other ingredients of this medicine (listed in section 6)
• if you have serious kidney disease
• if you have liver disease
These include:
• the anti-depressant, fluvoxamine
• HRT (hormone replacement therapy)
• medication for other mental health problems, for example sulpiride
• metoclopramide, which is used to treat nausea and heartburn
• cimetidine, used in the treatment of stomach ulcers
• the antibiotics, ciprofloxacin or enoxacin
• any other medicine for Parkinson’s disease.
4. POSSIBLE SIDE EFFECTS
Remember to tell your doctor or nurse if you
start taking any other medicine while you're taking ReQuip XL.
ReQuip XL with food and drink
You can take ReQuip XL with or without food, as you prefer. Because high fat foods might increase the amount of ropinirole absorbed by your body, it is recommended that you do not take ReQuip XL at the same time as a high fat meal.
Pregnancy and breast-feeding ReQuip XL is not recommended if you are pregnant, unless your doctor advises that the benefit of you taking ReQuip XL is greater than the risk to your unborn baby.
ReQuip XL is not recommended if you are breastfeeding, as it can affect your milk production.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Driving and using machines
ReQuip XL can make you feel drowsy or dizzy.
It can make people feel extremely sleepy, and it
sometimes makes people fall asleep very suddenly without warning.
If you could be affected: don't drive, don’t operate machines and don’t put yourself in any situation where feeling sleepy or falling asleep could put you (or other people) at risk of serious injury or death. Don't take part in these activities until you are sure you're not affected.
^ Talk to your doctor or nurse if this causes problems for you.
ReQuip XL contains lactose and sunset yellow
ReQuip XL tablets contain a sugar called lactose. If you have been told that you have an intolerance to some sugars, contact your doctor or nurse before taking ReQuip XL.
The 4 mg tablets contain a colouring called sunset yellow (E110), which may cause allergic reactions.
Smoking and ReQuip XL
Tell your doctor or nurse if you start smoking, or give up smoking, while you're taking ReQuip XL. Your doctor or nurse may need to adjust your dose.
3. HOW TO TAKE REQUIP XL
Always take this medicine exactly as your
doctor or nurse or pharmacist has told you.
Check with your doctor, nurse or pharmacist if you are not sure.
You may be given ReQuip XL on its own to treat the symptoms of your Parkinson's disease. Or you may be given ReQuip XL as well as another medicine called L-dopa (also called levodopa). ReQuip XL should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson's disease.
If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first start taking ReQuip XL. Tell your doctor if this happens, as your doctor may need to adjust the dose of the medicines you are taking.
Tell your doctor if you or your family notices that you are developing any unusual behaviours (such as an unusual urge to gamble or increased sexual urges and/or behaviours) while you are taking ReQuip XL. Your doctor may need to adjust your dose.
If you are switching from ReQuip film-coated (immediate-release) tablets
Your doctor or nurse will base your dose of ReQuip XL on the dose of ReQuip you were taking. You will take the same or similar daily dose of ReQuip XL to your previous dose of ReQuip but you will only take ReQuip XL once a day.
Take your ReQuip as normal the day before you switch. Then take your ReQuip XL on the next day and don't take any more ReQuip.
Your doctor or nurse will be monitoring your progress closely after switching to ReQuip XL.
If there is any change in the control of your symptoms before your next appointment, talk to your doctor or nurse as soon as possible in case dose adjustment is needed.
How much ReQuip XL will you need to take?
It may take a while to find out the best dose of ReQuip XL for you.
The recommended starting dose of ReQuip XL tablets is 2 mg once daily for the first week.
Your doctor may increase your dose to 4 mg of ReQuip XL tablets once daily, from the second week of treatment. If you are very elderly your doctor may increase your dose more slowly. After that, the doctor may adjust your dose until you are taking the dose that is best for you. Some people take up to 24 mg of ReQuip XL tablets each day.
If at the start of your treatment, you experience side effects that you find difficult to tolerate, speak to your doctor. Your doctor may advise you to switch to a lower dose of ReQuip film-coated (immediate-release) tablets which you will take three times a day.
Don’t take more ReQuip XL than your doctor or nurse has recommended.
It may take a few weeks for ReQuip XL to work for you.
Taking your dose of ReQuip XL
Take ReQuip XL once a day, at the same time each day.
Swallow your ReQuip XL tablets whole, with a glass of water.
Don’t break, chew or crush the tablets - if you do, there's a danger you could overdose, because the medicine will be released into your body too quickly.
ReQuip XL tablets are designed to release the drug into your body over a 24 hour period. If the tablets pass through your body in less than 24 hours the medicine may not be completely released. You may see tablets in your stool. If this happens, let your doctor know.
If you take more ReQuip XL than you should Contact a doctor, nurse or pharmacist immediately. If possible, show them the ReQuip XL pack.
Someone who has taken an overdose of ReQuip XL may have any of these symptoms: feeling sick (nausea), being sick (vomiting), dizziness (a spinning sensation), feeling drowsy, mental or physical tiredness, fainting, hallucinations.
If you forget to take ReQuip XL
Do not take a double dose to make up for a
forgotten dose.
If you have missed taking ReQuip XL for one day or more, ask your doctor or nurse for advice on how to start taking it again.
If you stop taking ReQuip XL Don’t stop taking ReQuip XL without advice Take ReQuip XL for as long as your doctor or nurse recommends. Don't stop unless your doctor or nurse advises you to.
If you suddenly stop taking ReQuip XL, your Parkinson's disease symptoms may quickly get much worse. A sudden stop could cause you to develop a medical condition called neuroleptic malignant syndrome which may represent a major health risk. The symptoms include: akinesia (loss of muscle movement), rigid muscles, fever, unstable blood pressure, tachycardia (increased heart rate), confusion, drepressed level of consciousness (e.g. coma).
If you need to stop taking ReQuip XL, your doctor or nurse will reduce your dose gradually.
If you have any further questions on the use of this medicine, ask your doctor, nurse or pharmacist.
Like all medicines, this medicine can have side effects, but not everyone gets them.
The more common side effects of ReQuip XL are more likely to happen when you first start taking it, or when your dose has just been increased. They are usually mild, and may become less troublesome after you've taken the dose for a while. If you're worried about side effects, talk to your doctor or nurse.
Very common side effects:
may affect more than 1 in 10 people
• fainting
• feeling drowsy
• feeling sick (nausea).
Common side effects:
may affect up to 1 in 10 people
• falling asleep very suddenly without feeling sleepy first (sudden sleep onset episodes)
• hallucinations (sensing things that are not real)
• being sick (vomiting)
• feeling dizzy (a spinning sensation)
• heartburn
• stomach pain
• constipation
• swelling of the legs, feet or hands.
Uncommon side effects:
may affect up to 1 in 100 people
• feeling dizzy or faint, especially when you stand up suddenly (this is caused by a drop in blood pressure)
• feeling very sleepy during the day
• mental problems such as delirium (severe confusion), delusions (unreasonable ideas) or paranoia (unreasonable suspicions).
You may experience the following side effects (frequency not known):
• 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 behaviours; they will discuss ways of managing or reducing the symptoms
Very rare side effects:
may affect up to 1 in 10,000 people A very small number of people taking ReQuip XL (less than 1 in 10,000) have experienced:
• changes in liver function, which have shown up in blood tests
• allergic reactions such as red, itchy swellings on the skin (hives), swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing, rash or intense itching.
Some patients may have the following side effects (frequency not known: cannot be estimated from the available data)
• act in an aggressive manner.
• excessive use of ReQuip XL (craving for large doses of dopaminergic drugs in excess of that required to control motor symptoms, known as dopamine dysregulation syndrome)
If you’re taking ReQuip XL with L-dopa
People who are taking ReQuip XL with L-dopa may develop other side effects over time:
POM
(ropinirole hydrochloride)
• uncontrollable movements (dyskinesias) are a very common side effect. If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first start taking ReQuip XL. Tell your doctor if this happens, as your doctor may need to adjust the dose of the medicines you are taking.
• feeling confused is a common side effect.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:www.mhra.gov.uk/yellowcard By reporting side effects you can help provide more information on the safety of this medicine.
5. HOW TO STORE REQUIP XL
KEEP OUT OF THE SIGHT AND REACH OF CHILDREN.
Do not store above 25°C. Store in the original package to protect from light.
Do not take this medicine after the expiry date shown on the carton label. If your doctor tells you to stop taking the medicine, take any remaining medicine back to the pharmacist for safe disposal. Only keep this medicine if your doctor tells you to. If your medicine becomes discoloured or shows any signs of deterioration, ask your pharmacist who will advise you what to do.
Medicines should not be disposed of via waterwaste or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the enviroment.
6. CONTENTS OF THE PACK AND OTHER INFORMATION
What ReQuip XL contains
The active substance in ReQuip XL is ropinirole. Each prolonged-release tablet contains 8 mg, of ropinirole (as hydrochloride).
The other ingredients are: hypromellose, hydrogenated castor oil, carmellose sodium, povidone (K29-32), maltodextrin, magnesium stearate, lactose monohydrate, colloidal silica anhydrous, mannitol (E421), yellow iron oxide (E172), glycerol dibehenate • film coats:
8 mg tablet: hypromellose, yellow iron oxide (E172) titanium dioxide (E171), black iron oxide (E172), macrogol 400, red iron oxide (E172)
Manufacturer and Licence Holder
This medicine is manufactured by Glaxo Wellcome S.A., Avenida de Extremadura, 3, Aranda de Duero (Burgos), Spain and is procured from within the EU and repackaged by the Product Licence Holder: Lexon (UK) Limited, Unit 18, Oxleasow Road, East Moons Moat, Redditch,
Worcestershire, B98 0RE.
If you have any questions or are not sure about anything, ask your doctor or pharmacist. They will have additional information about this medicine and will be able to advise you.
PL 15184/1368 - ReQuip XL 8mg Tablets
ReQuip is a registered trademark of GlaxoSmithKline group of companies
Leaflet revision date: 03/10/16
Blind or partially sighted?
Is this leaflet hard to see or read? Phone Lexon (UK) Limited,
Tel: 01527 505414 for help.
A number of groups exist to provide further information and support to Parkinson's disease patients and their carers. The main one is the Parkinson's Disease Society, who you can contact at the address given below: Parkinson's Disease Society 215 Vauxhall Bridge Road London SW1V 1EJ
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor, nurse specialist or pharmacist.
This medicine has been prescribed for you only. Don't pass it on to others. It may harm them, even if their signs of illness are the same as yours.
If you get any side effects, talk to your doctor, nurse or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
Your medicine is called ReQuip XL 8mg prolonged-release tablets but will be referred to as ReQuip XL throughout this leaflet.
Please note that the leaflet also contains information about other strengths of the medicine ReQuip XL 2mg and ReQuip XL 4mg
What is in this leaflet:
1. What ReQuip XL is and what it is used for
2. What you need to know before you take ReQuip XL
3. How to take ReQuip XL
4. Possible side effects
5. How to store ReQuip XL
6. Contents of the pack and other information
1. WHAT REQUIP XL IS AND WHAT IT IS USED FOR
ReQuip XL is used to treat Parkinson’s disease.
The active ingredient in ReQuip XL is ropinirole, which belongs to a group of medicines called dopamine agonists. Dopamine agonists affect the brain in a similar way to a natural substance called dopamine.
People with Parkinson's disease have low levels of dopamine in some parts of their brains. Ropinirole has effects similar to those of natural dopamine, so it helps to reduce the symptoms of Parkinson's disease.
You can take ReQuip XL (like ReQuip) either on its own or along with L-dopa (see section 4 of this leaflet for more details). ReQuip XL should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson's disease.
Warnings and Precautions
Talk to your doctor or pharmacist before taking ReQuip XL:
• if you are pregnant or think you may be pregnant
• if you are breast-feeding
• if you are under 18 years old
• if you have a serious heart complaint
• if you have a history of or currently have a serious mental health problem
• if you have a history of or have experienced any unusual urges and/or behaviours (such as excessive gambling or excessive sexual behaviour, see section 4)
• if you have an intolerance to some sugars (such as lactose).
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.
■+ Tell your doctor or nurse if you think any of these may apply to you. Your doctor or nurse may decide that ReQuip XL isn't suitable for you, or that you need extra check-ups while you're taking it.
You also need to be careful with ReQuip XL if you drive or operate machinery. Please read the warning in section 3 of this leaflet.
Other medicines and ReQuip XL
Tell your doctor, nurse or pharmacist if you are taking, have recently taken, or might take any other medicines - including any herbal remedies or medicines you bought without a prescription.
Some medicines can affect the way ReQuip XL works, or make it more likely that you'll have side effects. ReQuip XL can also affect the way some other medicines work.
What ReQuip XL looks like and contents of the pack
ReQuip XL 8mg prolonged-release tablets are Red capsule-shaped, film-coated tablets marked “GS” on one side and “5CC” on the other.
2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE REQUIP XL
Do not take ReQuip XL
• if you're allergic to ropinirole or any of the other ingredients of this medicine (listed in section 6)
• if you have serious kidney disease
• if you have liver disease
These include:
• the anti-depressant, fluvoxamine
• HRT (hormone replacement therapy)
• medication for other mental health problems, for example sulpiride
• metoclopramide, which is used to treat nausea and heartburn
• cimetidine, used in the treatment of stomach ulcers
• the antibiotics, ciprofloxacin or enoxacin
• any other medicine for Parkinson’s disease.
4. POSSIBLE SIDE EFFECTS
Remember to tell your doctor or nurse if you
start taking any other medicine while you're taking ReQuip XL.
ReQuip XL with food and drink
You can take ReQuip XL with or without food, as you prefer. Because high fat foods might increase the amount of ropinirole absorbed by your body, it is recommended that you do not take ReQuip XL at the same time as a high fat meal.
Pregnancy and breast-feeding ReQuip XL is not recommended if you are pregnant, unless your doctor advises that the benefit of you taking ReQuip XL is greater than the risk to your unborn baby.
ReQuip XL is not recommended if you are breastfeeding, as it can affect your milk production.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Driving and using machines
ReQuip XL can make you feel drowsy or dizzy.
It can make people feel extremely sleepy, and it
sometimes makes people fall asleep very suddenly without warning.
If you could be affected: don't drive, don’t operate machines and don’t put yourself in any situation where feeling sleepy or falling asleep could put you (or other people) at risk of serious injury or death. Don't take part in these activities until you are sure you're not affected.
^ Talk to your doctor or nurse if this causes problems for you.
ReQuip XL contains lactose and sunset yellow
ReQuip XL tablets contain a sugar called lactose. If you have been told that you have an intolerance to some sugars, contact your doctor or nurse before taking ReQuip XL.
The 4 mg tablets contain a colouring called sunset yellow (E110), which may cause allergic reactions.
Smoking and ReQuip XL
Tell your doctor or nurse if you start smoking, or give up smoking, while you're taking ReQuip XL. Your doctor or nurse may need to adjust your dose.
3. HOW TO TAKE REQUIP XL
Always take this medicine exactly as your
doctor or nurse or pharmacist has told you.
Check with your doctor, nurse or pharmacist if you are not sure.
You may be given ReQuip XL on its own to treat the symptoms of your Parkinson's disease. Or you may be given ReQuip XL as well as another medicine called L-dopa (also called levodopa). ReQuip XL should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson's disease.
If you are taking L-dopa you may experience some uncontrollable movements (dyskinesias) when you first start taking ReQuip XL. Tell your doctor if this happens, as your doctor may need to adjust the dose of the medicines you are taking.
Tell your doctor if you or your family notices that you are developing any unusual behaviours (such as an unusual urge to gamble or increased sexual urges and/or behaviours) while you are taking ReQuip XL. Your doctor may need to adjust your dose.
If you are switching from ReQuip film-coated (immediate-release) tablets
Your doctor or nurse will base your dose of ReQuip XL on the dose of ReQuip you were taking. You will take the same or similar daily dose of ReQuip XL to your previous dose of ReQuip but you will only take ReQuip XL once a day.
Take your ReQuip as normal the day before you switch. Then take your ReQuip XL on the next day and don't take any more ReQuip.
Your doctor or nurse will be monitoring your progress closely after switching to ReQuip XL.
If there is any change in the control of your symptoms before your next appointment, talk to your doctor or nurse as soon as possible in case dose adjustment is needed.
How much ReQuip XL will you need to take?
It may take a while to find out the best dose of ReQuip XL for you.
The recommended starting dose of ReQuip XL tablets is 2 mg once daily for the first week.
Your doctor may increase your dose to 4 mg of ReQuip XL tablets once daily, from the second week of treatment. If you are very elderly your doctor may increase your dose more slowly. After that, the doctor may adjust your dose until you are taking the dose that is best for you. Some people take up to 24 mg of ReQuip XL tablets each day.
If at the start of your treatment, you experience side effects that you find difficult to tolerate, speak to your doctor. Your doctor may advise you to switch to a lower dose of ReQuip film-coated (immediate-release) tablets which you will take three times a day.
Don’t take more ReQuip XL than your doctor or nurse has recommended.
It may take a few weeks for ReQuip XL to work for you.
Taking your dose of ReQuip XL
Take ReQuip XL once a day, at the same time each day.
Swallow your ReQuip XL tablets whole, with a glass of water.
Don’t break, chew or crush the tablets - if you do, there's a danger you could overdose, because the medicine will be released into your body too quickly.
ReQuip XL tablets are designed to release the drug into your body over a 24 hour period. If the tablets pass through your body in less than 24 hours the medicine may not be completely released. You may see tablets in your stool. If this happens, let your doctor know.
If you take more ReQuip XL than you should Contact a doctor, nurse or pharmacist immediately. If possible, show them the ReQuip XL pack.
Someone who has taken an overdose of ReQuip XL may have any of these symptoms: feeling sick (nausea), being sick (vomiting), dizziness (a spinning sensation), feeling drowsy, mental or physical tiredness, fainting, hallucinations.
If you forget to take ReQuip XL
Do not take a double dose to make up for a
forgotten dose.
If you have missed taking ReQuip XL for one day or more, ask your doctor or nurse for advice on how to start taking it again.
If you stop taking ReQuip XL Don’t stop taking ReQuip XL without advice Take ReQuip XL for as long as your doctor or nurse recommends. Don't stop unless your doctor or nurse advises you to.
If you suddenly stop taking ReQuip XL, your Parkinson's disease symptoms may quickly get much worse. A sudden stop could cause you to develop a medical condition called neuroleptic malignant syndrome which may represent a major health risk. The symptoms include: akinesia (loss of muscle movement), rigid muscles, fever, unstable blood pressure, tachycardia (increased heart rate), confusion, drepressed level of consciousness (e.g. coma).
If you need to stop taking ReQuip XL, your doctor or nurse will reduce your dose gradually.
If you have any further questions on the use of this medicine, ask your doctor, nurse or pharmacist.
Like all medicines, this medicine can have side effects, but not everyone gets them.
The more common side effects of ReQuip XL are more likely to happen when you first start taking it, or when your dose has just been increased. They are usually mild, and may become less troublesome after you've taken the dose for a while. If you're worried about side effects, talk to your doctor or nurse.
Very common side effects:
may affect more than 1 in 10 people
• fainting
• feeling drowsy
• feeling sick (nausea).
Common side effects:
may affect up to 1 in 10 people
• falling asleep very suddenly without feeling sleepy first (sudden sleep onset episodes)
• hallucinations (sensing things that are not real)
• being sick (vomiting)
• feeling dizzy (a spinning sensation)
• heartburn
• stomach pain
• constipation
• swelling of the legs, feet or hands.
Uncommon side effects:
may affect up to 1 in 100 people
• feeling dizzy or faint, especially when you stand up suddenly (this is caused by a drop in blood pressure)
• feeling very sleepy during the day
• mental problems such as delirium (severe confusion), delusions (unreasonable ideas) or paranoia (unreasonable suspicions).
You may experience the following side effects (frequency not known):
• 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 behaviours; they will discuss ways of managing or reducing the symptoms
Very rare side effects:
may affect up to 1 in 10,000 people A very small number of people taking ReQuip XL (less than 1 in 10,000) have experienced:
• changes in liver function, which have shown up in blood tests
• allergic reactions such as red, itchy swellings on the skin (hives), swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing, rash or intense itching.
Some patients may have the following side effects (frequency not known: cannot be estimated from the available data)
• act in an aggressive manner.
• excessive use of ReQuip XL (craving for large doses of dopaminergic drugs in excess of that required to control motor symptoms, known as dopamine dysregulation syndrome)
If you’re taking ReQuip XL with L-dopa
People who are taking ReQuip XL with L-dopa may develop other side effects over time:
Do not give ReQuip XL to children. ReQuip XL
is not normally prescribed for people under 18.
Ref: 1368/031016/4/B