Patient leaflet - REPINEX XL 2 MG PROLONGED-RELEASE TABLETS
1. what repinex xl is and what it is used for
The active substance in Repinex XL 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.
Repinex XL is 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.
You can take this medicine either on its own or along with L-dopa (see section 4 of this leaflet for more details).
This medicine should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson’s disease.
2. what you need to know before you take repinex xl
Do not take Repinex XL:
- if you are allergic to ropinirole or any of the other ingredients of this medicine (listed in section 6).
- if you have serious kidney disease.
- if you have liver disease.
Tell your doctor or nurse if you think any of these may apply to you.
Warnings and precautions
Talk to your doctor or pharmacist before taking this medicine:
- if you are pregnant or think you may be pregnant.
- if you are breast-feeding.
- if you are under 18 years old.
- if you have a serious heart complaint.
- if you have a history of or currently have a serious mental health problem.
- if you have a history of or have experienced any unusual urges and/or behaviours (such as excessive gambling or excessive sexual behaviour) (see section 4).
- if you have an intolerance to some sugars (such as lactose).
Tell your doctor if you experience symptoms such as depression, apathy, anxiety, lack of energy, sweating or pain after stopping or reducing your Repinex XL 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.
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 or nurse if you think any of these may apply to you. Your doctor or nurse may decide that this medicine is not suitable for you or that you need extra check-ups while you are taking it.
Other medicines and Repinex XL
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Some medicines can affect the way Repinex XL works, or make it more likely that you will have side effects. Repinex XL can also affect the way some other medicines work.
These include:
- the anti-depressant fluvoxamine
- medicine for other mental health problems, for example sulpiride
- HRT (hormone replacement therapy)
- metoclopramide, which is used to treat nausea and heartburn
- cimetidine, used in the treatment of stomach ulcers
- the antibiotics ciprofloxacin or enoxacin
- any other medicine for Parkinson’s disease
Tell your doctor or nurse if you are taking, or have recently taken, any of these.
Remember to tell your doctor or nurse if you start taking any other medicine while you are taking Repinex XL.
Smoking and Repinex XL
Tell your doctor or nurse if you start smoking, or give up smoking, while you are taking this medicine. Your doctor or nurse may need to adjust your dose.
Repinex XL with food and drink
You can take this medicine 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 this medicine atthe same time as a high fat meal.
Pregnancy and breast-feeding
Repinex XL is not recommended if you are pregnant, unless your doctor advises that the benefit of you taking this medicine is greater than the risk to your unborn baby.
Repinex 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
This medicine 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.
This medicine 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 sure you are not affected.
Talk to your doctor or nurse if this causes problems for you.
Repinex XL contains lactose
Repinex XL 2mg
This medicine contains a sugar called lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.
Repinex XL contains sunset yellow (E110)
Repinex XL 4mg
This medicine contains a colouring agent called sunset yellow (E110), which may cause allergic reactions.
Repinex XL contains sodium
This medicine contains less than 1 mmol sodium (23mg) per prolonged-release tablet, that is to say essentially ‘sodium-free’.
3. how to take repinex xl
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
You may be given this medicine on its own to treat the symptoms of your Parkinson’s disease. Or you may be given Repinex XL as well as another medicine called L-dopa (also called levodopa). This medicine should be prescribed and your progress monitored by a doctor with experience in the treatment of Parkinson’s disease.
If you are taking L-dopa, you may experience some uncontrollable movements (dyskinesias) when you first start taking this medicine. Tell your doctor if this happens, as your doctor may need to adjust the dose of the medicines you are taking.
Tell your doctor if you or your family notices that you are developing any unusual behaviours (such as an unusual urge to gamble or increased sexual urges and/or behaviours) while you are taking this medicine. Your doctor may need to adjust your dose.
If you are switching from ropinirole film-coated (immediate-release) tablets
Your doctor or nurse will base your dose of Repinex XL prolonged-release tablets on the dose of ropinirole film-coated (immediate-release) tablets you were taking. You will take the same or similar daily dose of Repinex XL prolonged-release tablets to your previous dose of ropinirole film-coated (immediate-release) tablets but you will only take Repinex XL prolonged-release tablets once a day.
Take your ropinirole film-coated (immediate-release) tablets as normal the day before you switch. Then take your Repinex XL prolonged-release tablets on the next day and do not take any more ropinirole film-coated (immediate-release) tablets.
Your doctor or nurse will be monitoring your progress closely after switching to Repinex XL prolonged-release tablets. If there is any change in the control of your symptoms before your next appointment, talk to your doctor or nurse as soon as possible in case dose adjustment is needed.
How much Repinex XL will you need to take?
It may take a while to find out the best dose of Repinex XL for you.
The recommended starting dose is 2mg once daily for the first week. Your doctor may increase your dose to 4mg of Repinex 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 Repinex 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.
Do not take more Repinex XL than your doctor or nurse has recommended.
It may take a few weeks for Repinex XL to work for you.
Taking your dose of Repinex XL
Take Repinex XL once a day, at the same time each day. Swallow your Repinex XL prolonged-release tablet(s) whole, with a glass of water.
Do not break, chew or crush the prolonged-release tablet(s) – if you do, there is a danger you could overdose, because the medicine will be released into your body too quickly.
Repinex XL prolonged-release tablets are designed to release the medicine into your body over a 24 hour period. If the tablets pass through your body in less than 24 hours, the medicine may not be completely released. You may see tablets in your stool. If this happens, let your doctor know.
Use in children and adolescents
Do not give this medicine to children. Repinex XL is not normally prescribed for people under 18.
If you take more Repinex XL than you should
Contact a doctor, pharmacist or nurse immediately. If possible, show them the Repinex XL pack.
Someone who has taken an overdose of Repinex XL may have any ofthese symptoms: feeling sick (nausea), being sick (vomiting), dizziness (a spinning sensation), feeling drowsy, mental or physical tiredness, fainting, hallucinations.
If you forget to take Repinex XL
Do not take a double dose to make up for a forgotten dose.
If you have missed taking Repinex XL for one day or more, ask your doctor or nurse for advice on how to start taking it again.
If you stop taking Repinex XL
Do not stop taking Repinex XL without advice.
Take Repinex XL for as long as your doctor or nurse recommends.
Do not stop unless your doctor or nurse advises you to.
If you suddenly stop taking this medicine, your Parkinson’s disease symptoms may quickly get much worse. 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 ofmuscle movement), rigid muscles, fever, unstable blood pressure, tachycardia (increased heart rate), confusion, depressed level of consciousness (e.g. coma).
If you need to stop taking this medicine, your doctor or nurse will reduce your dose gradually.
If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.
4. possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
The most common side effects of this medicine 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 or nurse.
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 (sensing things that are not real)
- 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 (extreme somnolence)
- mental problems such as delirium (severe confusion), delusions (unreasonable ideas) or paranoia (unreasonable suspicions)
Very rare side effects (may affect up to 1 in 10,000 people)
A very small number of people taking ropinirole (less than 1 in 10,000) have experienced:
- changes in liver function, which have shown up in blood tests
- 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
You may experience the following side effects (frequency not known: cannot be estimated from the available data)
- 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).
Tell your doctor if you experience any of these behaviours; they will discuss ways of managing or reducing the symptoms.
Some patients may have the following side effects (frequency not known)
- act in an aggressive manner
- excessive use of this medicine (craving for large doses of dopaminergic medicines in excess of that required to control motor symptoms, known as dopamine dysregulation syndrome)
Depression, apathy, anxiety, lack of energy, sweating or pain may occur (called dopamine agonist withdrawal syndrome or DAWS) after stopping or reducing your Repinex XL treatment.
If you are taking Repinex XL with L-dopa
People who are taking Repinex XL with L-dopa may develop other side effects over time:
- uncontrollable movements (dyskinesias) are a very common side effect. If you are taking L-dopa, you may experience some uncontrollable movements (dyskinesias) when you first start taking Repinex XL. Tell your doctor if this happens, as your doctor may need to adjust the dose 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 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.
5. how to store repinex xl
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the blister, the bottle and the carton after ‘EXP’. The expiry date refers to the last day of that month.
Do not store above 25°C.
HDPE bottle: after first opening, use within 60 days.
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.
6. contents of the pack and other information
What Repinex XL contains
The active substance is ropinirole.
Each prolonged-release tablet contains 2mg, 4mg or 8mg ropinirole (as hydrochloride).
The other ingredients are:
- tablet cores: Ammonio Methacrylate Copolymer Type B, Hypromellose, Sodium lauryl sulfate (E487), Copovidone, Magnesium stearate.
Aspire
2810237/6 1010112-P10.2 PHARMA