Rotigotine

Chemical formula: C₁₉H₂₅NOS  Molecular mass: 315.48 g/mol  PubChem compound: 59227

Interactions

Rotigotine interacts in the following cases:

Central nervous system (CNS) depressants, alcohol

Because of possible additive effects, caution should be advised when patients are taking sedating medicinal products or other CNS (central nervous system) depressants (e.g. benzodiazepines, antipsychotics, antidepressants) or alcohol in combination with rotigotine.

Severe hepatic impairment

Caution is advised when treating patients with severe hepatic impairment, which may result in lower rotigotine clearance. Rotigotine has not been investigated in this patient group. A dose reduction might be needed in case of worsening of the hepatic impairment.

Neuroleptics, metoclopramide

Neuroleptics given as antiemetic should not be given to patients taking dopamine agonists.

Because rotigotine is a dopamine agonist, it is assumed that dopamine antagonists, such as neuroleptics (e.g. phenothiazines, butyrophenones, thioxanthenes) or metoclopramide, may diminish the effectiveness of Neupro, and co-administration should be avoided.

Pregnancy

There are no adequate data from the use of rotigotine in pregnant women. Animal studies do not indicate any teratogenic effects in rats and rabbits, but embryo-toxicity was observed in rats and mice at materno-toxic doses. The potential risk for humans is unknown. Rotigotine should not be used during pregnancy.

Nursing mothers

Because rotigotine decreases prolactin secretion in humans, inhibition of lactation is expected. Studies in rats have shown that rotigotine and/or its metabolite(s) are excreted in breast milk. In the absence of human data, breast-feeding should be discontinued.

Carcinogenesis, mutagenesis and fertility

Women of childbearing potential, contraception in females

Women of childbearing potential should use effective contraception to prevent pregnancy during treatment with rotigotine.

Effects on ability to drive and use machines

Rotigotine may have major influence on the ability to drive and use machines. Patients being treated with rotigotine and presenting with somnolence and/or sudden sleep episodes must be informed not to drive or engage in activities (e.g. operating machines) where impaired alertness may put themselves or others at risk of serious injury or death until such recurrent episodes and somnolence have resolved.

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