Patient leaflet - RAPONER XL 2 MG PROLONGED-RELEASE TABLETS
Raponer XL 2mg, 4mg and 8mg Prolonged-release Tablets
Ropinirole I
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
- If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
- The full name of this medicine is Raponer XL 2mg, 4mg and 8mg Prolonged-release Tablets but within the leaflet it will be referred to as Raponer XL tablets.
What is in this leaflet:
l
T What Raponer XL tablets are and what they are used for
^1 What you need to know before you take Raponer XL tablets
13 How to take Raponer XL tablets Possible side effects
~5
How to store Raponer XL tablets
16 Contents of the pack and other information
T| What Raponer XL tablets are and what they are used for
The active ingredient in Raponer XL tablets is ropinirole, which belongs to a group of medicines called dopamine agonists. Dopamine agonists affect the brain in a similar way to a natural substance called dopamine.
Raponer XL prolonged-release tablets are used to treat Parkinson’s disease. People with Parkinson’s disease have low levels of dopamine in some parts of their brains. Ropinirole has effects similar to those of natural dopamine, so it helps to reduce the symptoms of Parkinson’s disease.
^1 What you need to know before you take Raponer XL tablets
- Do not take Raponer XL tablets if you are allergic to ropinirole or any of the other ingredients of this medicine (listed in section 6)
- have a serious kidney disease
- have a liver disease
Tell your doctor if you think any of these may apply to you.
Warnings and precautions
Talk to your doctor or pharmacist before taking Raponer XL tablets if you
- are pregnant or think you may be pregnant
- are breast-feeding
- are under 18 years old
- have a serious heart complaint
- have or have had a serious mental health problem
- have experienced any unusual urges and/or behaviours (see section 4)
Tell your doctor if you experience symptoms such as depression, apathy, anxiety, fatigue, sweating or pain after stopping or reducing your ropinirole treatment (called dopamine agonist withdrawal syndrome or DAWS). If the problems persist more than a few weeks, your doctor may need to adjust your dose.
While you are taking Raponer XL tablets
Tell your doctor if you or your family/carer notices that you are developing urges or cravings to behave in ways that are unusual for you and you cannot resist the impulse, drive or temptation to carry out certain activities that could harm yourself or others. These are called impulse control disorders and can include behaviours such as addictive gambling, excessive eating or spending, an abnormally high sex drive or an increase in sexual thoughts or feelings. Your doctor may need to adjust or stop your dose.
Tell your doctor if you or your family/carer notices that you are developing episodes of overactivity, elation or irritability (symptoms of mania). These may occur with or without the symptoms of impulse control disorders (see above). Your doctor may need to adjust or stop your dose.
Tell your doctor if you think any of these may apply to you. Your doctor may decide that Raponer XL is not suitable for you, or that you need extra check-ups while you are taking it.
Smoking and Raponer XL tablets
Tell your doctor if you start smoking, or give up smoking, while you are taking Raponer XL tablets. Your doctor may need to adjust your dose.
Children and adolescents
Do not give Raponer XL tablets to children. Raponer XL tablets are not normally prescribed for people under 18 years of age.
Other medicines and Raponer XL tablets Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including any herbal medicines or other medicines you obtained without a prescription. Also remember to tell your doctor or pharmacist if you begin taking a new medicine while you are taking Raponer XL tablets.
Some medicines can affect the way Raponer XL tablets work, or make it more likely that you will have side effects. Raponer XL tablets can also affect the way some other medicines work.
These include:
- the anti-depressant fluvoxamine
- HRT (hormone replacement therapy)
- medication for other mental health problems, for example sulpiride
- metoclopramide, which is used to treat nausea and heartburn
Continued top of next column
- cimetidine, used in the treatment of stomach ulcers
- the antibiotics ciprofloxacin or enoxacin
- any other medicine for Parkinson’s disease.
Raponer XL tablets with food and drink
You can take Raponer XL tablets with or without food, as you prefer. Because high fat foods might increase the amount of ropinirole absorbed by your body, it is recommended that you do not take Raponer XL tablets at the same time as a high fat meal.
Pregnancy and breast-feeding
Raponer XL tablets are not recommended if you are pregnant, unless your doctor advises that the benefit to you of taking Raponer XL tablets is greater than the risk to your unborn baby.
Raponer XL is not recommended if you are breast-feeding, as it can affect your milk production.
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Driving and using machines
Raponer XL tablets can make you feel drowsy or dizzy. It can make people feel extremely sleepy, and it sometimes makes people fall asleep very suddenly without warning.
Ropinirole can cause hallucinations (seeing, hearing or feeling things that are not there). If affected, do not drive or use machines.
If you could be affected: do not drive, do not operate machines and do not put yourself in any situation where feeling sleepy or falling asleep could put you (or other people) at risk of serious injury or death. Do not take part in these activities until you are no longer affected.
Talk to your doctor if this causes problems for you.
Raponer XL tablets contain lactose and castor oil
This medicine contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.
Castor oil may cause stomach upset and diarrhoea.
Information on sodium content
This medicine contains less than 1 mmol sodium
-
( 23mg) per tablet, that is to say essentially ‘sodium-free’.
Q How to take Raponer XL tablets
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Raponer XL tablets are designed to release 1 drug over a 24hr period. If you have a 1
condition where your medicine passes through your body too quickly, e.g., 1
diarrhoea, the tablet(s) may not dissolve completely and may not work properly.
You may see tablet(s) in your stool. If this happens, let your doctor know as soon as possible.
You may be given Raponer XL tablets on its own to treat the symptoms of your Parkinson’s disease. You may also be given Raponer XL tablets with another medicine called L-dopa (also called levodopa). If you are taking L-dopa you may experience some uncontrolled jerky movements when you first start taking Raponer XL tablets. Tell your doctor if this happens, as your doctor may need to adjust the dose of L-dopa you are taking.
How many Raponer XL tablets will you need to take?
It may take a while to find out the best dose of Raponer XL tablets for you.
The recommended starting dose of Raponer XL prolonged-release tablets is 2mg once daily for the first week. Your doctor may increase your dose to 4mg of Raponer XL prolonged-release tablets once daily, from the second week of treatment. If you are very elderly, your doctor may increase your dose more slowly. After that, the doctor may adjust your dose until you are taking the dose that is best for you. Some people take up to 24mg of Raponer XL prolonged-release tablets each day.
If at the start of your treatment, you experience side effects that you find difficult to tolerate, speak to your doctor. Your doctor may advise you to switch to a lower dose of ropinirole film-coated (immediate-release) tablets which you will take three times a day.
It may take a few weeks for Raponer XL tablets to work for you. Do not take any more Raponer XL tablets than your doctor has recommended.
Use in children and adolescents
Do not give Raponer XL tablets to children. Raponer XL tablets are not normally prescribed for people under 18 years of age.
Method of administration
Take Raponer XL tablets once a day, at the same time each day.
Swallow your Raponer XL prolonged-release tablet(s) whole, with a glass of water. Do not break, chew or crush them. If you do so, there is a danger you could overdose, because the medicine will be released into your body too quickly.
If you are switching from ropinirole film-coated (immediate-release) tablets
Your doctor will base your dose of Raponer XL prolonged-release tablets on the dose of ropinirole film-coated (immediate-release) tablets you were taking. Continued over page Take your ropinirole film-coated (immediate-release) tablets as normal the day before you switch. Then take your Raponer XL prolonged-release tablets next morning and do not take any more ropinirole film-coated (immediate-release) tablets.
I
If you take more Raponer XL tablets than you should
Contact a doctor or pharmacist immediately. If possible, show them the Raponer XL tablets pack. Someone who has taken an overdose of Raponer XL tablets may have any of these symptoms: feeling sick (nausea), being sick (vomiting), dizziness (a spinning sensation), feeling drowsy, mental or physical tiredness, fainting, hallucinations.
If you forget to take Raponer XL tablets
Do not take a double dose to make up for a forgotten tablet.
If you have missed taking Raponer XL tablets for one day or more, ask your doctor for advice on how to start taking it again.
If you stop taking Raponer XL tablets
Do not stop taking Raponer XL tablets without advice. Take Raponer XL tablets for as long as your doctor recommends.
Do not stop unless your doctor advises you to. If you suddenly stop taking Raponer XL tablets, your Parkinson’s disease symptoms may quickly get much worse.
If you need to stop taking Raponer XL tablets, your doctor will reduce your dose gradually.
Do not stop using Raponer XL tablets suddenly without talking to your doctor. A sudden stop could cause you to develop a medical condition called neuroleptic malignant syndrome which may represent a major health risk. The symptoms include: akinesia (loss of muscle movement), rigid muscles, fever, unstable blood pressure, tachycardia (increased heart rate), confusion, and depressed level of consciousness (e.g. coma).
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
The side effects of Raponer XL tablets are more likely to happen when you first start taking it, or when your dose has just been increased. They are usually mild, and may become less troublesome after you have taken the dose for a while. If you are worried about side effects, talk to your doctor.
Very common side effects (may affect more than
1 in 10 people):
- fainting
- feeling drowsy
- feeling sick (nausea)
Common side effects (may affect up to 1 in 10 people):
- falling asleep very suddenly without feeling sleepy first (sudden sleep onset episodes)
- hallucinations (“seeing” things that are not really there)
- being sick (vomiting)
- feeling dizzy (a spinning sensation)
- heartburn
- stomach pain
- constipation
- swelling of the legs, feet or hands
Uncommon side effects (may affect up to 1 in 100 people):
- feeling dizzy or faint, especially when you stand up suddenly (this is caused by a drop in blood pressure)
- feeling very sleepy during the day
- mental problems such as delirium (severe confusion), delusions (unreasonable ideas) or paranoia (unreasonable suspicions)
Not known (frequency cannot be estimated from the available data):
- allergic reactions such as red, itchy swellings on the skin (hives), swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing, rash or intense itching.
- changes in liver function, which have shown up in blood tests
- acting in an aggressive manner
- excessive use of Raponer XL tablets (craving for large dose of dopaminergic drugs in excess of that required to control motor symptoms, known as dopamine dysregulation syndrome)
- inability to resist the impulse, drive or temptation to perform an action that could be harmful to you or others, which may include:
-
– strong impulse to gamble excessively despite serious personal or family consequences
-
– altered or increased sexual interest and behaviour of significant concern to you or to others, for example, an increased sexual drive
-
– uncontrollable excessive shopping or spending – binge eating (eating large amounts of food in a short time period) or compulsive eating (eating more food than normal and more than is needed to satisfy your hunger).
- episodes of overactivity, elation or irritability
- depression, apathy, anxiety, fatigue, sweating or pain may occur (called dopamine agonist withdrawal syndrome or DAWS).
Tell your doctor if you experience any of these behaviours; they will discuss ways of managing or reducing the symptoms.
If you are taking Raponer XL tablets with L-dopa People who are taking Raponer XL tablets with L-dopa may develop other side effects over time:
- uncontrolled jerky movements are a very common side effect. If you are taking L-dopa you may experience some uncontrollable movements when you first start taking Raponer XL tablets. Tell your doctor if this happens, as your doctor may need to adjust the doses of the medicines you are taking.
- feeling confused is a common side effect.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report Continued top of next column
side effects directly via the Yellow Card
Scheme Website:
or search for MHRA Yellow Card in the Google Play or Apple App Store.
By reporting side effects you can help provide more information on the safety of this medicine.
E5 How to store Raponer XL tablets
Keep this medicine out of the sight and reach of children.
Do not take this medicine after the expiry date which is stated on the carton and blister foil after EXP. The expiry date refers to the last day of that month.
Do not store above 30°C.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
□ Contents of the pack and other information
What Raponer XL tablets contain
- The active substance is ropinirole. Each prolonged-release tablet contains 2mg, 4mg or 8mg of ropinirole (as hydrochloride).
- The other ingredients are: hypromellose, croscarmellose sodium, maltodextrin, lactose monohydrate, hydrogenated castor oil, colloidal anhydrous silica, magnesium stearate;
pigment blend: (2mg tablets: iron oxide red (E172), iron oxide yellow (E172), lactose monohydrate), (4mg & 8mg tablets: iron oxide red (E172), iron oxide yellow (E172), lactose monohydrate, iron oxide black (E172)).
What Raponer XL tablets look like and contents of the pack
Raponer XL 2mg prolonged-release tablets are pink, mottled, oval shaped, biconvex, uncoated
-
t ablets, debossed with “CC1” on one side and plain on the other side. The size of the tablet is approximately 16.00 × 8.20 mm.
Raponer XL 4mg prolonged-release tablets are brown, mottled, oval shaped, biconvex, uncoated
-
t ablets, debossed with “CC2” on one side and plain on the other side. The size of the tablet is approximately 16.00 × 8.20 mm.