Signs & symptoms of advanced idiopathic Parkinson's disease as monotherapy or in combination w/ l-dopa. Symptomatic treatment of idiopathic restless legs syndrome (RLS).
Parkinson's disease 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. If necessary, increased by 0.75 mg at wkly intervals to max: 4.5 mg daily. Maintenance: 0.375-4.5 mg daily. During dose escalation in pivotal studies, efficacy was observed starting at 1.5 mg daily dose. 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). RLS 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, abnormal behaviour (reflecting symptoms of impulse control disorders & compulsive behaviours) eg, binge eating, compulsive shopping, hypersexuality & pathological gambling); psychotic disorders; severe CV disease; dystonia; melanoma; rhabdomyolysis. Closely monitor during & after discontinuation due to dopamine agonist w/drawal syndrome (DAWS). Regularly monitor ophth & BP during treatment. Avoid abrupt w/drawal. Augmentation in RLS. Not recommended to co-administer w/ antipsychotics. Concomitant use w/ other sedatives or alcohol. May affect ability to drive & use machines. Renal impairment. Pregnancy. Not to be used during lactation. Paed patients.
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