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Drugs & Medications

Neupro transdermal

GENERIC NAME(S): ROTIGOTINE

Uses

Rotigotine is used alone or with other medications to treat Parkinson's disease. It can improve your ability to move and decrease shakiness (tremor), stiffness, slowed movement, and unsteadiness. Rotigotine is also used to treat restless legs syndrome (RLS).

Rotigotine is a dopamine agonist that works by helping to restore the balance of a certain natural substance (dopamine) in the brain.

How to use Neupro transdermal

Read the Patient Information Leaflet if available from your pharmacist before you start using rotigotine and each time you get a refill. Learn how to use this patch properly. If you have any questions, ask your doctor or pharmacist.

Do not open the sealed pouch until ready to use. Do not cut the patch or use the patch if it appears broken, cut, or damaged. Open the pouch and remove the patch. Peel off the backing from the patch as directed and apply the patch to a clean, dry, and hairless area of the skin on the front of the abdomen, thigh, hip, side of the lower back (flank), shoulder, or upper arm. Press the patch firmly in place for about 30 seconds to make sure it stays on. Do not apply the patch on oily, broken, or irritated skin. Do not use creams, lotions, ointments, oils, or powders on skin where you are applying the patch. Avoid applying the patch to areas of the skin where it might be easily rubbed off (such as on skin folds or under tight clothing). If applying to a hairy area, shave the area at least 3 days before applying the patch. Wash your hands with soap and water after handling the patch. Do not touch your eyes or other objects until your hands are washed.

The patch is usually worn for 1 day and replaced. Apply the patch to a different area on your body each time to avoid irritation. Wait at least 14 days before applying the patch to the same area. If the patch irritates the skin, protect the area from direct sunlight until the skin is completely healed. Sunlight may cause the irritated skin to change color.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects (such as nausea, dizziness), your doctor may direct you to start at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.

Use this medication regularly to get the most benefit from it. To help you remember, change your patch at the same time each day.

To prevent the patch from coming off, use care while showering, bathing, and exercising. If the edges of the patch start to loosen, you may tape it in place with bandage tape. If the patch falls off, apply a new patch to a different area, and change the patch at your usual time the next day.

When changing your patch, carefully remove the old patch, fold it in half with the sticky side together, and throw it away in the trash away from children and pets. Do not touch the sticky side with your fingers. Wash the application area with soap and water. Use baby oil or mineral oil to remove any leftover stickiness. Do not use solvents such as alcohol or nail polish remover. Always wash your hands after handling the patch, being careful not to touch your eyes or other objects until after you have washed your hands.

Do not stop using this medication without consulting your doctor. Rarely, a serious reaction (such as fever, muscle stiffness, confusion) may occur if you suddenly stop using this drug. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms immediately.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Nausea, vomiting, loss of appetite, dizziness, drowsiness, lightheadedness, tiredness, trouble sleeping, increased sweating, headache, or redness/itching/swelling at the application site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as confusion, agitation, depression, hallucinations), severe dizziness, fainting, compulsive behaviors (such as gambling, increased sexual urges), swelling ankles/feet, unusual weight gain, fast heartbeat, new or worsening uncontrolled movements.

Some people using rotigotine have fallen asleep suddenly during their usual daily activities (such as talking on the phone, driving). In some cases, sleep occurred without any feelings of drowsiness beforehand. This sleep effect may occur anytime during treatment with rotigotine, including up to 1 year after starting the medication. Therefore, you should not drive or take part in other possibly dangerous activities until you are certain that this medication will not cause drowsiness or sudden sleep. If you experience increased sleepiness or fall asleep during the day, do not drive or take part in other possibly dangerous activities until you have discussed this effect with your doctor. Your risk of this sleep effect is increased by using alcohol or other medications that can make you drowsy.

You may also develop a sudden drop in blood pressure that can cause dizziness, lightheadedness, nausea, sweating, and fainting. This is more likely when you first start the medication, when your dose is increased, or when you get up suddenly. To reduce your risk, get up slowly when rising from a sitting or lying position.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using rotigotine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as sulfites), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, sleep disorders (such as sleep apnea, narcolepsy), low/high blood pressure, heart disease (such as heart failure), kidney disease, mental/mood disorders (such as schizophrenia).

This medication may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.

While wearing your patch, avoid exposing it to direct heat (such as heating pads, electric blankets, heat lamps, saunas, hot tubs, heated waterbeds, or prolonged direct sunlight). Heat may cause more drug to be released into your body, increasing the risk of side effects.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

If you are going to have an MRI test or cardioversion, tell the health care provider that you are using this patch. Some patches may contain metals that can cause serious burns during an MRI or cardioversion. Ask your doctor whether you will need to remove your patch before the procedure and apply a new patch afterward, and how to do so properly.

Older adults may be more sensitive to the side effects of this drug, especially mental/mood changes (such as hallucinations)

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Overdose

This medication patch may be harmful if chewed or swallowed. If overdose or swallowing is suspected, remove the patch if possible, and contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: mental/mood changes (such as confusion, hallucinations), uncontrolled movements, seizures.

Notes

Do not share this medication with others.

People with Parkinson's disease may have an increased risk for developing skin cancer (melanoma). Tell your doctor promptly if you notice a change in the appearance or size of moles or other unusual skin changes. Ask your doctor if you should have regular skin exams.

Missed Dose

If you forget to change the patch, change it as soon as you remember. Do not double the dose to catch up. Resume your usual schedule for changing your patch.

Storage

Store the patches in their original pouch at room temperature. Do not open the pouch until you are ready to use the patch. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. (See also How to Use section.)

Information last revised March 2013. Copyright(c) 2013 First Databank, Inc.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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