REQUIP SIDE EFFECTS
- Generic Name: ropinirole hcl
- Brand Name: Requip
SIDE EFFECTS
The following adverse reactions are described in more detail in other sections of the label:
- Hypersensitivity
- Falling Asleep during Activities of Daily Living and Somnolence
- Syncope
- Hypotension/Orthostatic Hypotension
- Hallucinations/Psychotic-like Behavior
- Dyskinesia
- Impulse Control/Compulsive Behaviors
- Withdrawal-Emergent Hyperpyrexia and Confusion
- Melanoma
- Augmentation and Early-Morning Rebound in RLS
- Fibrotic Complications
- Retinal Pathology
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug (or of another development program of a different formulation of the same drug) and may not reflect the rates observed in practice.
Parkinson’s Disease
During the premarketing development of REQUIP, patients received REQUIP either without L-dopa (early Parkinson’s disease trials) or as concomitant therapy with L-dopa (advanced Parkinson’s disease trials). Because these two populations may have differential risks for various adverse reactions, this section will in general present adverse reaction data for these two populations separately.
Early Parkinson’s Disease (without L-dopa)
In the double-blind, placebo-controlled trials in patients with early-stage Parkinson’s disease, the most commonly observed adverse reactions in patients treated with REQUIP (incidence at least 5% greater than placebo) were nausea, somnolence, dizziness, syncope, asthenic condition (i.e., asthenia, fatigue, and/or malaise), viral infection, leg edema, vomiting, and dyspepsia.
Approximately 24% of patients treated with REQUIP who participated in the double-blind, placebo-controlled early Parkinson’s disease (without L-dopa) trials discontinued treatment due to adverse reactions compared with 13% of patients who received placebo. The most common adverse reactions in patients treated with REQUIP (incidence at least 2% greater than placebo) of sufficient severity to cause discontinuation were nausea and dizziness.
Table 1 lists treatment-emergent adverse reactions that occurred in at least 2% of patients with early Parkinson’s disease (without L-dopa) treated with REQUIP participating in the double-blind, placebo-controlled trials and were numerically more common than the incidence for placebo-treated patients. In these trials, either REQUIP or placebo was used as early therapy (i.e., without L-dopa).
Table 1: Treatment-Emergent Adverse Reaction Incidence in Double-blind, Placebo-Controlled Early Parkinson’s Disease (without L-dopa) Trials (Events ≥2% of Patients Treated with REQUIP and Numerically More Frequent than the Placebo Group)a
| Body System/Adverse Reaction | REQUIP (n = 157) (%) |
Placebo (n = 147) (%) |
| Autonomic nervous system | ||
| Flushing | 3 | 1 |
| Dry mouth | 5 | 3 |
| Increased sweating | 6 | 4 |
| Body as a whole | ||
| Asthenic conditionb | 16 | 5 |
| Chest pain | 4 | 2 |
| Dependent edema | 6 | 3 |
| Leg edema | 7 | 1 |
| Pain | 8 | 4 |
| Cardiovascular general | ||
| Hypertension | 5 | 3 |
| Hypotension | 2 | 0 |
| Orthostatic symptoms | 6 | 5 |
| Syncope | 12 | 1 |
| Central/peripheral nervous system | ||
| Dizziness | 40 | 22 |
| Hyperkinesia | 2 | 1 |
| Hypesthesia | 4 | 2 |
| Vertigo | 2 | 0 |
| Gastrointestinal | ||
| Abdominal pain | 6 | 3 |
| Anorexia | 4 | 1 |
| Dyspepsia | 10 | 5 |
| Flatulence | 3 | 1 |
| Nausea | 60 | 22 |
| Vomiting | 12 | 7 |
| Heart rate/rhythm | ||
| Extrasystoles | 2 | 1 |
| Atrial fibrillation | 2 | 0 |
| Palpitation | 3 | 2 |
| Tachycardia | 2 | 0 |
| Metabolic/nutritional | ||
| Increased alkaline phosphatase | 3 | 1 |
| Psychiatric | ||
| Amnesia | 3 | 1 |
| Impaired concentration | 2 | 0 |
| Confusion | 5 | 1 |
| Hallucination | 5 | 1 |
| Somnolence | 40 | 6 |
| Yawning | 3 | 0 |
| Reproductive male | ||
| Impotence | 3 | 1 |
| Resistance mechanism | ||
| Viral infection | 11 | 3 |
| Respiratory | ||
| Bronchitis | 3 | 1 |
| Dyspnea | 3 | 0 |
| Pharyngitis | 6 | 4 |
| Rhinitis | 4 | 3 |
| Sinusitis | 4 | 3 |
| Urinary | ||
| Urinary tract infection | 5 | 4 |
| Vascular extracardiac | ||
| Peripheral ischemia | 3 | 0 |
| Vision | ||
| Eye abnormality | 3 | 1 |
| Abnormal vision | 6 | 3 |
| Xerophthalmia | 2 | 0 |
| a Patients may have reported multiple adverse reactions during the trial or at discontinuation; thus, patients may be included in more than one category. b Asthenic condition (i.e., asthenia, fatigue, and/or malaise). |
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Advanced Parkinson’s Disease (with L-dopa)
In the double-blind, placebo-controlled trials in patients with advanced-stage Parkinson’s disease, the most commonly observed adverse reactions in patients treated with REQUIP (incidence at least 5% greater than placebo) were dyskinesia, somnolence, nausea, dizziness, confusion, hallucinations, increased sweating, and headache.
Approximately 24% of patients who received REQUIP in the double-blind, placebo-controlled advanced Parkinson’s disease (with L-dopa) trials discontinued treatment due to adverse reactions compared with 18% of patients who received placebo. The most common adverse reaction in patients treated with REQUIP (incidence at least 2% greater than placebo) of sufficient severity to cause discontinuation was dizziness.
Table 2 lists treatment-emergent adverse reactions that occurred in at least 2% of patients with advanced Parkinson’s disease (with L-dopa) treated with REQUIP who participated in the double-blind, placebo-controlled trials and were numerically more common than the incidence for placebo-treated patients. In these trials, either REQUIP or placebo was used as an adjunct to L-dopa.
Table 2: Treatment-Emergent Adverse Reaction Incidence in Double-blind, Placebo-Controlled Advanced Parkinson’s Disease (with L-dopa) Trials (Events ≥2% of Patients Treated with REQUIP and Numerically More Frequent than the Placebo Group)a
| Body System/Adverse Reaction | REQUIP (n = 208) (%) |
Placebo (n = 120) (%) |
| Autonomic nervous system | ||
| Dry mouth | 5 | 1 |
| Increased sweating | 7 | 2 |
| Body as a whole | ||
| Increased drug level | 7 | 3 |
| Pain | 5 | 3 |
| Cardiovascular general | ||
| Hypotension | 2 | 1 |
| Syncope | 3 | 2 |
| Central/peripheral nervous system | ||
| Dizziness | 26 | 16 |
| Dyskinesia | 34 | 13 |
| Falls | 10 | 7 |
| Headache | 17 | 12 |
| Hypokinesia | 5 | 4 |
| Paresis | 3 | 0 |
| Paresthesia | 5 | 3 |
| Tremor | 6 | 3 |
| Gastrointestinal | ||
| Abdominal pain | 9 | 8 |
| Constipation | 6 | 3 |
| Diarrhea | 5 | 3 |
| Dysphagia | 2 | 1 |
| Flatulence | 2 | 1 |
| Nausea | 30 | 18 |
| Increased saliva | 2 | 1 |
| Vomiting | 7 | 4 |
| Metabolic/nutritional | ||
| Weight decrease | 2 | 1 |
| Musculoskeletal | ||
| Arthralgia | 7 | 5 |
| Arthritis | 3 | 1 |
| Psychiatric | ||
| Amnesia | 5 | 1 |
| Anxiety | 6 | 3 |
| Confusion | 9 | 2 |
| Abnormal dreaming | 3 | 2 |
| Hallucination | 10 | 4 |
| Nervousness | 5 | 3 |
| Somnolence | 20 | 8 |
| Red blood cell | ||
| Anemia | 2 | 0 |
| Resistance mechanism | ||
| Upper respiratory tract infection | 9 | 8 |
| Respiratory | ||
| Dyspnea | 3 | 2 |
| Urinary | ||
| Pyuria | 2 | 1 |
| Urinary incontinence | 2 | 1 |
| Urinary tract infection | 6 | 3 |
| Vision | ||
| Diplopia | 2 | 1 |
| a Patients may have reported multiple adverse reactions during the trial or at discontinuation; thus, patients may be included in more than one category. | ||
Restless Legs Syndrome
In the double-blind, placebo-controlled trials in patients with RLS, the most commonly observed adverse reactions in patients treated with REQUIP (incidence at least 5% greater than placebo) were nausea, vomiting, somnolence, dizziness, and asthenic condition (i.e., asthenia, fatigue, and/or malaise).
Approximately 5% of patients treated with REQUIP who participated in the double-blind, placebo-controlled trials in the treatment of RLS discontinued treatment due to adverse reactions compared with 4% of patients who received placebo. The most common adverse reaction in patients treated with REQUIP (incidence at least 2% greater than placebo) of sufficient severity to cause discontinuation was nausea.
Table 3 lists treatment-emergent adverse reactions that occurred in at least 2% of patients with RLS treated with REQUIP participating in the 12-week, double-blind, placebo-controlled trials and were numerically more common than the incidence for placebo-treated patients.
Table 3: Treatment-Emergent Adverse Reaction Incidence in Double-blind, Placebo-Controlled RLS Trials (Events ≥2% of Patients Treated with REQUIP and Numerically More Frequent than the Placebo Group)a
| Body System/Adverse Reaction | REQUIP (n = 496) (%) |
Placebo (n =500) (%) |
| Ear and labyrinth | ||
| Vertigo | 2 | 1 |
| Gastrointestinal | ||
| Nausea | 40 | 8 |
| Vomiting | 11 | 2 |
| Diarrhea | 5 | 3 |
| Dyspepsia | 4 | 3 |
| Dry mouth | 3 | 2 |
| Abdominal pain upper | 3 | 1 |
| General disorders and administration site conditions | ||
| Asthenic conditionb | 9 | 4 |
| Edema peripheral | 2 | 1 |
| Infections and infestations | ||
| Nasopharyngitis | 9 | 8 |
| Influenza | 3 | 2 |
| Musculoskeletal and connective tissue | ||
| Arthralgia | 4 | 3 |
| Muscle cramps | 3 | 2 |
| Pain in extremity | 3 | 2 |
| Nervous system | ||
| Somnolence | 12 | 6 |
| Dizziness | 11 | 5 |
| Paresthesia | 3 | 1 |
| Respiratory, thoracic, and mediastinal | ||
| Cough | 3 | 2 |
| Nasal congestion | 2 | 1 |
| Skin and subcutaneous tissue | ||
| Hyperhidrosis | 3 | 1 |
| a Patients may have reported multiple adverse reactions during the trial or at discontinuation; thus, patients may be included in more than one category. b Asthenic condition (i.e., asthenia, fatigue, and/or malaise). |
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SRC: NLM .