Signs & symptoms of advanced idiopathic Parkinson's disease as monotherapy or in combination w/ l-dopa. Symptomatic treatment of idiopathic restless legs syndrome.
Parkinson's disease Initially 0.375 mg daily in 3 divided doses increased every 5-7 days. Dose escalation: 0.125 mg tds on wk 1, followed by 0.25 mg tds on wk 2 then 0.5 mg tds on wk 3. May be increased by 0.75 mg at wkly intervals if necessary. Maintenance: 0.375-4.5 mg daily. Patient on l-dopa Reduce dose. Renal impairment CrCl 20-50 mL/min Initially 0.125 mg bd (max: 2.25 mg daily), <20 mL/min Initially 0.125 mg daily as single dose (max: 1.5 mg daily). Restless legs syndrome Initially 0.125 mg once daily 2-3 hr before bedtime, may be increased every 4-7 days to max: 0.75 mg daily.
Sudden sleep onset & somnolence. Hallucinations; dyskinesia; dystonia; behavioural symptoms of impulse control disorders eg, pathological gambling, increased libido, hypersexuality, compulsive spending or buying, binge & compulsive eating; psychotic disorders; mania & delirium; severe CV disease. May cause serious allergic-type reactions due to Na metabisulphite. Closely monitor during & after discontinuation due to dopamine agonist w/drawal syndrome. Regularly monitor ophth & BP during treatment. Avoid abrupt w/drawal. Augmentation in restless legs syndrome. Avoid co-administration w/ antipsychotics. May affect ability to drive & use machines. Renal impairment. Not to be used during pregnancy & lactation. Childn & adolescents up to 18 yr.
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