Precautions and Warnings With Rotigotine
If you have heart disease, kidney problems, or any allergies, talk to your healthcare provider before using the rotigotine patch. This product can be an effective product for treating symptoms of Parkinson's disease or restless legs syndrome, but it is not appropriate for everyone. To help ensure a safe treatment with rotigotine, fully discuss the warnings and precautions for the drug with your healthcare provider.
What Should I Tell My Healthcare Provider?You should talk with your healthcare provider prior to using rotigotine (Neupro®) if you have:
- Heart disease
- High blood pressure (hypertension)
- Low blood pressure (hypotension)
- Congestive heart failure (CHF)
- Kidney problems, such as kidney failure (renal failure)
- Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Specific Rotigotine Precautions and WarningsSome warnings and precautions to be aware of prior to using this medication include the following:
- Rotigotine contains a sulfite and could cause dangerous reactions in people with sulfite allergies (a sulfite allergy is not the same as a sulfa allergy).
- Rotigotine may interfere with your ability to drive or operate heavy machinery. Make sure you know how this medicine affects you before performing these activities.
- The medication can cause hallucinations and other psychotic problems or behaviors. Let your healthcare provider know if you develop these problems while using this drug. Also, let your friends, family, or caretakers know about this potential side effect, as they may be better able to identify the problem.
- Rotigotine can interfere with the body's ability to regulate blood pressure. This can cause low blood pressure that occurs when standing or sitting up (known medically as postural hypotension).
- Rotigotine can also cause high blood pressure (hypertension) and/or an increased heart rate.
- Medications like rotigotine have been known to cause fainting.
- There have been a few reports of unusual compulsive behaviors, such as gambling, binge eating, or hypersexuality, in people using rotigotine or other similar medications. Let your healthcare provider know if you develop any of these behaviors while using this drug. Also, let your friends, family, or caretakers know about this potential side effect, as they may be better able to identify the problem.
- Rotigotine can worsen dyskinesia (a movement disorder that is a common side effect of levodopa, another Parkinson's medication). If you use rotigotine with a medication that contains levodopa (Parcopa®, Sinemet®, Sinemet® CR, Stalevo®), your healthcare provider may need to adjust your doses of both medications, or perhaps discontinue one or both of the drugs if this problem occurs.
- Rotigotine can cause water retention and weight gain. While this is generally not serious, it can cause problems in some people, such as those with congestive heart failure or kidney problems.
- Rotigotine can cause skin reactions. In the case of severe, prolonged, or widespread skin reactions, you might need to stop using the drug.
- People with Parkinson's disease have a higher risk of melanoma (a type of skin cancer). It is not known if this is due to Parkinson's disease medications or to other factors. Regular skin cancer screenings are recommended for anyone using rotigotine for any condition.
- Rotigotine patches contain aluminum. As a result, they should be removed for magnetic resonance imagining (MRI) or cardioversion (an electroshock to the heart) in order to prevent burns.
- When used to treat restless legs syndrome (RLS), rotigotine can actually cause RLS symptoms to become worse in some cases.
- Avoid exposing the applied patches to heat sources, such as saunas, hot tubs, heating pads, or water beds, as this could possibly increase absorption of the drug.
- Medications similar to rotigotine can cause serious lung, chest, and heart problems as the result of excessive formation of fibrous connective tissue.
- Rotigotine may react with a number of other medications (see Drug Interactions With Rotigotine).
- Rotigotine is a pregnancy Category C medication. This means that it might not be safe for use during pregnancy, although the full risks are currently unknown (see Neupro and Pregnancy).
- It is not known whether rotigotine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to using the drug (see Neupro and Breastfeeding).