Apply one patch every day.
Please keep all your regular appointments with your doctor. You will need tests from time to time to check on your progress.
Occasionally, people using rotigotine have fallen asleep suddenly during the day with little warning of being tired. If you experience this, please do not drive, and make an appointment to see your doctor as soon as possible. Rotigotine can also cause impulsive types of behaviour in some people.
About rotigotine patches
|Type of medicine||A dopamine-receptor agonist|
|Used for||Parkinson's disease; restless legs syndrome|
|Available as||Skin patches|
Rotigotine is usually prescribed to treat Parkinson's disease. Parkinson's disease affects the way your brain co-ordinates the movements of your muscles. A number of cells in a small part of your brain, called the substantia nigra, become damaged and die. These brain cells pass messages down nerves in the spinal cord by producing a chemical called dopamine, and it is these messages which control the muscles of the body. As the cells in the brain are damaged, the amount of dopamine that is produced is reduced. A combination of the reduction of cells and a low level of dopamine in the cells in this part of the brain, causes nerve messages to the muscles to become slowed and abnormal. This produces the main symptoms of Parkinson's disease, which are stiffness, shaking (tremor), and slowness of movement.
Rotigotine is a dopamine-receptor agonist which means that it acts on the same receptors in your brain as dopamine. In effect, it acts like a substitute for dopamine and this helps to ease your symptoms. It may be used alone, or in combination with other medicines to treat Parkinson's disease.
Rotigotine is also used to treat restless legs syndrome (RLS). This is an uncomfortable feeling in your legs, which gives you the urge to move your legs to get relief. Rotigotine can help when these symptoms are severe enough to cause distress.
Before using rotigotine patches
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start using the patches it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you have any problems with the way your liver works.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to use rotigotine patches
- Before you apply a patch, read the manufacturer's printed information leaflet from inside the pack and any additional information your doctor has given to you. These will give you more information about rotigotine and how to use the patches correctly, and it will also provide you with a full list of the side-effects which you may experience.
- There are several different strengths of rotigotine patch. Each time you collect a prescription, please check the strength on the box to make sure that you have been given the strength you are expecting. Ask your pharmacist to check for you if you are unsure about anything.
- When you first start using the patches you will be given a low-dose patch. The strength of the patch will then be increased each week until your symptoms are controlled.
- Apply one patch every day. Try to get into the habit of applying the patches at the same time of day each day. Also, it's important that you remember to remove the 'old' patch before you apply the 'new' patch.
- You can put the patches on areas of your body such as the sides of your body, your thighs, hips, tummy (abdomen), shoulder and upper arms.
- To make sure the patch sticks well, press the patch down firmly with the palm of your hand for about 30 seconds.
- Each time you apply a patch, use a different area of skin to apply the new patch to. Do not use the same area again for at least 14 days.
- If you forget to change your patch at your usual time, do it when you remember, and then change this new patch on the next day at your usual time. If a patch comes off accidentally, apply a new patch but then continue to change it at your usual time.
Getting the most from your treatment
- Try to keep all your regular appointments with your doctor. This is so your doctor can check on your progress. During the first few weeks of treatment in particular, your dose may require adjusting. Rotigotine can cause your blood pressure to fall (particularly in the early days of your treatment) and your doctor will want to check for this. Your doctor could also recommend you have eyesight tests from time to time.
- Try to make sure that when you are wearing a patch it does not come into with a heat source such as a heating pad, hot water bottle, electric blanket, or a heated water bed. Heated items like these may increase the amount of medicine that is released from the patch. Having long hot baths or sunbathing for long periods of time are also best avoided.
- Sometimes people taking medicines like rotigotine can fall asleep suddenly during the day with little or no warning of being tired beforehand. Until you know how you react, take extra care if you drive or operate machinery. If you do find yourself falling asleep suddenly, you should see your doctor as soon as possible for advice, and avoid driving or using tools and machines in the meantime.
- Treatment with medicines like rotigotine can sometimes cause problems with impulsive types of behaviour. If you notice any changes in your behaviour, such as an increased desire to gamble, binge eat, or spend excessively, or an increased sex drive, you must let your doctor know as soon as possible.
- Stay as active as possible and exercise regularly as much as you are able. You may walk more slowly than before, but a daily walk is good exercise and may help to loosen up stiff muscles.
- If you are a driver you should tell the DVLA and your insurance company if you have Parkinson's disease. Depending on the severity of symptoms and the medicines that you are taking, you may still be allowed to drive following a medical assessment.
- If you are due to have an operation or any medical treatment, please tell the person carrying out the treatment that you are using skin patches. This is particularly important if you are due to have MRI (magnetic resonance imaging) or cardioversion, as any patches will need to be removed before these procedures.
- There is a small increased risk of skin problems developing in people with Parkinson's disease, although the cause of this is unclear. It is a good idea to check your skin from time to time for any unusual areas of skin, and to speak with your doctor if you are concerned.
- Keep using the patches until your doctor tells you otherwise. Stopping suddenly can cause problems and your doctor will want you to reduce the strength of the patches gradually if you need to stop treatment.
Can rotigotine patches cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the common ones associated with rotigotine. You will find a full list in the manufacturer's information leaflet supplied with the patches. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common rotigotine side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Headache||Drink plenty of water and ask your doctor or pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know|
|Feeling sick (nausea) or being sick (vomiting)||Stick to simple or bland meals (avoid rich and spicy foods)|
|Skin reactions or itching where the patch has been applied||Protect the area from sunshine until it has healed|
|Common rotigotine side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Feeling drowsy or sleepy, falling asleep suddenly||If this happens, do not drive and do not use tools or machines. Speak with your doctor|
|Feeling dizzy or faint (due to changes in your blood pressure)||Getting up and moving around more slowly may help. If you begin to feel dizzy, lie down so that you do not faint; then sit for a few moments before standing. This usually passes as your body gets used to the patches, but in the meantime do not drive and do not use tools or machines|
|Difficulties sleeping, abnormal thinking and behaviour, the sensation of having a 'thumping heart' (palpitations), hiccups, constipation, loss of weight, swollen legs and ankles, feeling irritable, indigestion||If any of these become troublesome, speak with your doctor|
|Allergic reactions||If severe, speak with a doctor straightaway|
|Impulsive types of behaviour||Let your doctor know about this as soon as possible|
If you experience any other symptoms which you think may be due to the patches, please speak with your doctor or pharmacist for further advice.
How to store rotigotine patches
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
If you suspect that you or someone else might have had an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Do not give it to other people even if their condition appears to be the same as yours.
If you buy any medicines, always check with a pharmacist that they are safe to take with your other medicines.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine, please ask your pharmacist for advice.
Further reading and references
Manufacturer's PIL, Neupro® 4 mg, 6 mg, 8mg/24 hr Transdermal Patch; UCB Pharma Limited, The electronic Medicines Compendium. Dated June 2018.
British National Formulary, 76th Edition (Sep 2018); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.