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Pronounced: REE-kwip
Generic name: Ropinirole hydrochloride

Why is this drug prescribed: Requip helps relieve the signs and symptoms of Parkinson's disease. Caused by a deficit of dopamine (one of the brain's chief chemical messengers), this disorder is marked by progressive muscle stiffness, tremor, and fatigue. Requip works by stimulating dopamine receptors in the brain, thus promoting better, easier movement. Requip can be taken with or without levodopa (usually prescribed as Sinemet), another drug used to treat the symptoms of Parkinson's disease.

Most important fact about this drug: Requip is not a cure for Parkinson's disease. However, it does alleviate symptoms of the disease, and it can shorten the "off" periods of immobility that patients on long-term levodopa therapy often begin to experience.

How should you take this medication: Take 3 doses a day, with or without food. If the drug upsets your stomach, combining it with food may relieve the problem. If you are also taking levodopa, its dosage may be gradually decreased when you start therapy with Requip. --If you miss a dose... Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once. --Storage instructions... Store at room temperature away from light.

What side effects may occur: Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Requip. More common side effects may include: Abdominal pain, abnormal dreaming, abnormal muscle movements, abnormal vision, amnesia, anxiety, arthritis, bronchitis, confusion, constipation, decreased muscle movements, diarrhea, difficulty breathing, dizziness, drowsiness, dry mouth, eye problems, fainting, falling, fatigue, hallucinations, headache, increased sweating, indigestion, joint pain, leg swelling, nausea, nervousness, pain, paralysis, respiratory tract infection, runny nose, sinus inflammation, skin tingling, sore throat, swelling, tremor, urinary tract infection, viral infections, vomiting, weakness Less common side effects may include: Back pain, blood in the urine, chills, cough, decreased heart rate, depression, difficulty swallowing, dry eyes, falling asleep during daily activities, gas, gout, gum inflammation, high blood sugar, hot flashes, increased salivation, insomnia, leg cramps, low blood pressure, muscle aches, muscle spasms, muscle tone problems, nerve pain, rash, weight loss, worsening of Parkinson's disease symptoms Rare side effects may include: Abnormal coordination, acid indigestion, agitation, aggressive reaction, altered heart rate, asthma, boils, chest pain, conjunctivitis (pinkeye), convulsions, dandruff, decreased hearing, delirium, delusions, dementia, diabetes, disorders of the penis, earache, ear infection, eye inflammation, eye pain, enlarged abdomen, enlarged breasts, feeling of well-being, fever, flu-like symptoms, fungal infections, genital infections, hair loss, heart failure, hemorrhoids, herpes infections, hiccups, high cholesterol levels, hives, impaired concentration, increased or decreased sex drive, increased thirst, laryngitis, low blood sugar, loss of bowel control, loss of menstruation, loss of understanding, migraine, nosebleeds, osteoporosis, paranoid reaction, personality disorder, prostate disorder, psoriasis, purple skin patches, ringing in the ears, sensitivity to light, skin discoloration, skin itching, skin ulcers, stomach ulcers, thyroid problems, tongue swelling, toothache, twitching, urinary disorders, vaginal bleeding, varicose veins, vein inflammation, weight gain

Why should this drug not be prescribed: If Requip gives you an allergic reaction, you will not be able to continue using it.

Special warnings about this medication: At the start of Requip therapy and whenever the dose is increased, you face a slightly increased risk of a fainting spell or other symptoms of low blood pressure such as dizziness, nausea, sweating, and light-headedness, particularly when you get up suddenly after sitting or reclining for a prolonged period. To avoid such symptoms, be careful to stand up slowly. A few patients--especially older ones--also develop hallucinations. Let your doctor know if this occurs. You may have to stop Requip therapy. Use Requip with caution if you have heart disease. There is also a slight chance of developing respiratory difficulties or problems with your eyesight. If you find it hard to breathe, have any swelling, or develop problems with your vision, alert your doctor at once. If you are taking Sinemet with Requip, you may experience jerking muscle movements. Tell your doctor. He will need to decrease your dose of Sinemet. With other Parkinson's medications, a sudden dose reduction has been known to cause high fever, muscle stiffness, and loss of consciousness. Although this has not happened with Requip, be alert for such problems and contact your doctor immediately if they occur. Requip may cause drowsiness, and some people have reported falling asleep without warning during their daily activities. Do not drive a car or operate machinery until you know how the drug affects you. If you find that Requip makes you sleepy or that you're suddenly falling asleep in the middle of routine activities, tell your doctor; he will probably discontinue the drug. Requip may also cause darkening of your skin and eye color. Tell your doctor if you notice any change.

Possible food and drug interactions when taking this medication: If Requip is taken with certain other drugs, the effects of either can be increased, decreased, or altered. It is especially important to check with your doctor before combining Requip with the following: Alcohol Antidepressants such as Elavil, Pamelor, and Tofranil Ciprofloxacin (Cipro) Drugs that contain levodopa such as Dopar, Larodopa, and Sinemet Estrogen medications such as ethinyl estradiol (Estinyl) Major tranquilizers such as Haldol, Mellaril, Navane, Prolixin, and Thorazine Metoclopramide (Reglan) Tranquilizers such as the benzodiazepines Ativan, Librium, Valium, and Xanax

Special information if you are pregnant or breastfeeding: Although the effects of Requip during pregnancy have not been adequately studied in humans, birth defects have occurred in animals. If you are pregnant or plan to become pregnant, inform your doctor immediately. Requip may inhibit production of breast milk. There is also a possibility that it will appear in breast milk and affect the nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding.

Recommended dosage: Requip is taken 3 times a day. During the first week of therapy, each dose is 0.25 milligram. During the second week, the amount rises to 0.5 milligram. In the third week, it increases to 0.75 milligram, and in the fourth week reaches 1 milligram (3 milligrams daily). If necessary, your doctor will gradually increase the dosage further, up to a maximum of 24 milligrams per day. If you need to stop Requip therapy, the doctor will discontinue the drug gradually over a 7-day period, reducing the number of doses from 3 to 2 per day for the first 4 days, then to once a day for the remaining 3 days.

Overdosage: Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical treatment immediately. Symptoms of Requip overdose may include: Agitation, chest pain, confusion, drowsiness, facial muscle movements, grogginess, increased jerkiness of movement, symptoms of low blood pressure (dizziness, light-headedness) upon standing, nausea, vomiting

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