Rotigotine

Transdermal
Monotherapy in Parkinson's disease

Transdermal
Adjunct to levodopa treatment in Parkinson's disease

Transdermal
Restless leg syndrome

Patient w/ severe CV disease, pre-existing dyskinesia. Avoid abrupt withdrawal. Severe hepatic impairment. Pregnancy and lactation.

Nausea, vomiting, somnolence, dizziness, anorexia, insomnia, hyperhidrosis, headache, fatigue, anxiety, dyspepsia, peripheral oedema, dyskinesia, symptomatic hypotension, syncope, compulsive behaviour, application site reactions.

Transdermal: C

This drug may cause somnolence and/or sudden sleep episodes, if affected, do not drive or operate machinery. Remove patch prior to MRI or cardioversion.

Monitor BP, daytime alertness; periodic skin evaluations.

Symptoms: Hypotension, nausea, vomiting, involuntary movements, confusion, hallucinations, convulsions and other signs of central dopaminergic stimulation. Management. General supportive treatment.

Decreased effect w/ dopamine antagonists (e.g. phenothiazines, metoclopramide). Additive sedative effect w/ CNS depressants (e.g. benzodiazepines, antipsychotics). May potentiate the dopaminergic adverse reaction of levodopa and may cause and/or exacerbate pre-existing dyskinesia.

Additive sedative effect w/ alcohol.

Description:
Mechanism of Action: Rotigotine is a nonergot-derivative dopamine receptor agonist. The exact mechanism of action is unclear but appears to be related to stimulation of postsynaptic dopamine D₂-type auto receptors w/in the substantia nigra in the brain, leading to improved dopaminergic transmission in the motor areas of the basal ganglia.
Pharmacokinetics:
Absorption: Absorbed through the skin. Absolute bioavailability: Approx 37%. Time to peak plasma concentration: 24 hr.
Distribution: Volume of distribution: Approx 84 L/kg. Plasma protein binding: Approx 92%.
Metabolism: Undergoes extensive first-pass metabolism via glucuronidation in the gut wall and liver; also undergoes N-dealkylation and conjugation to form inactive metabolites.
Excretion: Mainly via urine (approx 71%); faeces (approx 23%). Elimination half-life: 5-7 hr.

Source: National Center for Biotechnology Information. PubChem Database. Rotigotine, CID=59227, https://pubchem.ncbi.nlm.nih.gov/compound/Rotigotine (accessed on Jan. 23, 2020)

Store between 20-25°C.

Thuốc trị bệnh Parkinson

N04BC09 - rotigotine ; Belongs to the class of dopamine agonists. Used in the management of Parkinson's disease.

Anon. Rotigotine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 09/03/2016.

Buckingham R (ed). Rotigotine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 09/03/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Rotigotine. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 09/03/2016.

Neupro Transdermal System. U.S. FDA. https://www.fda.gov/. Accessed 09/03/2016.