Ropinirole
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| Routes of administration | Oral |
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| Bioavailability | 50%[1] |
| Metabolism | Hepatic (CYP1A2)[1] |
| Elimination half-life | 5-6 hours[1] |
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| ECHA InfoCard | 100.110.353 |
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| Formula | C16H24N2O |
| Molar mass | 260.375 g/mol g·mol−1 |
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Ropinirole (INN; trade names Requip, Ropark, Adartrel) is a non-ergoline dopamine agonist. It is manufactured by GlaxoSmithKline (GSK), Cipla and Sun Pharmaceutical. It is used in the treatment of Parkinson's disease. Ropinirole is also one of two medications in the United States (U.S.) with a Food and Drug Administration (FDA) approved indication for the treatment of restless legs syndrome (RLS), the other being pramipexole (Mirapex). The discovery of the drug's utility in RLS has been used as a successful example of drug repurposing.[2]
Ropinirole's patent expired in May 2008, and the drug is now available in generic form.[3]
Dosage
Ropinirole in the Requip form is available in various preparations, ranging from a 0.25 mg tablet to a 5 mg tablet. The primary reason for such is dose titration. This implies that the person taking Requip has to closely interact and communicate with the primary care physician with regard to how much should actually be taken by the patient.
For restless legs syndrome (RLS), the maximum recommended dose is 4 mg per day, taken 1 to 3 hours before bedtime. A 52-week open label study had a mean dosage of 1.90 mg, once daily 1 to 3 hours before bedtime.[4]
For Parkinson's disease (PD), the maximum recommended dose is 24 mg per day, taken in three separate doses spread throughout the day. The maximum dose recommendations of ropinirole for subjects with ESRD should be reduced by 25% compared with those recommended for subjects with normal renal function. A 25% dose reduction represents a more straightforward dosage regimen in terms of available tablet strength, compared with a 30% dose reduction.[5]
Pharmacology
Ropinirole acts as a D2, D3, and D4 dopamine receptor agonist with highest affinity for D3. It is weakly active at the 5-HT2, and α2 receptors and is said to have virtually no affinity for the 5-HT1, benzodiazepine, GABA, muscarinic, α1, and β-adrenoreceptors.[6]
Ropinirole is metabolized primarily by cytochrome P450 CYP1A2 to form two metabolites; SK&F-104557 and SK&F-89124, both of which are renally excreted[5], and at doses higher than clinical, is also metabolized by CYP3A4. At doses greater than 24 mg, CYP2D6 may be inhibited, although this has only been tested in vitro.[1]
Side effects
Ropinirole can cause nausea, dizziness, hallucinations, orthostatic hypotension, and sudden sleep attacks during the daytime. Rarer and more unusual side effects specific to D3-preferring agonists such as ropinirole and pramipexole can include hypersexuality and compulsive gambling, even in patients without a prior history of these behaviours.[7]
See also
References
- ^ a b c d Tompson, Debra J.; et al. (2007). "Steady-State Pharmacokinetic Properties of a 24-Hour Prolonged-Release Formulation of Ropinirole: Results of Two Randomized Studies in Patients with Parkinson's Disease". Clinical Pharmacokinetics. 29 (12): 2654. doi:10.1016/j.clinthera.2007.12.010. PMID 18201581.
{{cite journal}}: Explicit use of et al. in:|author=(help) - ^ Lipp, Elizabeth (2008-08-01). "Novel Approaches to Lead Optimization". Genetic Engineering & Biotechnology News. Drug Discovery. Vol. 28, no. 14. Mary Ann Liebert. p. 20. ISSN 1935-472X. Retrieved 2008-09-28.
{{cite news}}: CS1 maint: date and year (link) Note: The opinion that ropinirole's use in RLS was a successful example of drug repurposes was reported as being that of Josef Scheiber, a post-doctoral fellow at the Novartis Institutes for BioMedical Research. - ^ New pharmaceutical products: Ceftriaxon-Rocephin, Granisetron-Kytril, Ipratropium-Albuterol
- ^ Garcia-Borreguero D, Grunstein R, Sridhar G; et al. (2007). "A 52-week open-label study of the long-term safety of ropinirole in patients with restless legs syndrome". Sleep Med. 8 (7–8): 742–52. doi:10.1016/j.sleep.2006.09.009. PMID 17512789.
{{cite journal}}: Explicit use of et al. in:|author=(help); Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ a b An open-label, parallel-group, repeat-dose study to investigate the effects of end-stage renal disease and haemodialysis on the pharmacokinetics of ropinirole | Authors: Debra J. Tompson, Deborah Hewens, Nancy Earl, David Oliveira, Jorg Taubel, Suzanne Swan, Luigi Giorgi | 13th International Congress of Parkinson’s Disease and Movement Disorders, Paris, France, June 7–11, 2009
- ^ Eden, R. J.; et al. (1991). "Preclinical Pharmacology of Ropinirole (SK&F 101468-A) a Novel Dopamine D 2 Agonist". Pharmacology Biochemistry & Behavior. 38: 147–154. doi:10.1016/0091-3057(91)90603-Y.
{{cite journal}}: Explicit use of et al. in:|author=(help) - ^ Bostwick JM, Hecksel KA, Stevens SR, Bower JH, Ahlskog JE (2009). "Frequency of new-onset pathologic compulsive gambling or hypersexuality after drug treatment of idiopathic Parkinson disease". Mayo Clinic Proceedings. 84 (4): 310–6. doi:10.4065/84.4.310. PMC 2665974. PMID 19339647.
{{cite journal}}: CS1 maint: multiple names: authors list (link)
External links