Anyone using Requip for Parkinsons?

[RS313]

I am currently on C/L 25/100 ER 3 times day but i have been having more off times lately so my movement specialist wants me to add one 2mg requip with my first dose in the morning.Anyone using this and how does it work for you? thanks everyone!

[johntPM]

Are you on CR or ER (Rytary)?

To put the proposed change into perspective, the levodopa equivalent dose of:

25/100mg C/L CR is 70mg (scaling factor is 0.7), TMAX = 120 minutes

2mg ropinirole (Requip) is 40mg (scaling factor is 20), TMAX = 90 minutes

Whether the proposal is a good idea depends on what you're trying to achieve. If it's to give you a boost in the morning a small dose of C/L immediate release (TMAX = 60 minutes) may be a better option. If it's to get a firm foundation in order to get less variable relief, ropinirole extended relief may be a better option than the IR version.

John

[park_bear]

Requip is a dopamine agonist. Before you get started down this road be aware that dopamine agonists cause impulse control disorders in up to 50% of patients - compulsive gambling, shopping, eating or sexuality. Dopamine agonists also cause orthostatic hypotension in about one third of patients – orthostatic hypotension means loss of blood pressure upon standing with possible fainting and uncontrolled falls.

You are by no means maxed out on your C/L. You could try adding an additional dose, or starting an MAO-B inhibitor such as Azilect.

[Niggs in reply to park_bear]

Having had the complete Requip xl experience for the last 9y, with most of its nasties I can only agree. Plus in my case, it doesn't bring much to the party anyway.

[RS313 in reply to park_bear]

Parkbear what is better about azilect rather than Requip?

Can i take it with C/L CR? My Movement disorder Dr said there are more people wo have good results rather than bad on requip. I have had trouble with dyskensia in the past thats why she really didnt want to raise my dose

[park_bear in reply to RS313]

Azilect is a different class of drug, an MAO-B inhibitor. That means is that it inhibits the enzyme that breaks down dopamine. It does not cause the adverse effects of dopamine agonists. It works synergistically with C/L. If it does not work for you, you can stop taking it without adverse consequences.

[RS313 in reply to park_bear]

park bear can i take it with my C/L?

[park_bear in reply to RS313]

Yes

[RS313 in reply to park_bear]

I will ask about it..as i said to someone else on here it really angers me that these Dr's want to use us like lab rats.they know the effects of these meds and still try to force us to take them. If azilect works better and with less side effects why not put me on that?

[park_bear in reply to RS313]

Medical journals are full of propaganda planted by big Pharmas. Some doctors have bought into the system, or least do not know any better - they have been propagandized ever since med school. See my writing here for further discussion of this issue:

When Good Doctors Prescribe Bad Medicine

tinyurl.com/zvgcu79

[MBAnderson in reply to RS313]

park_bear's link below is an excellent read, but so discouraging.

[ruff1]

consider adding MIAB inhibitor- I see Asilect was suggested, the newer Xadago has worked better for my husband and us neuroprotective.😀

[RS313 in reply to ruff1]

ruff1 but is it expensive? and how long has he been taking it? Can it be taken with C/L

[ruff1 in reply to RS313]

We live in Britain so don’t know how much it costs but I know it’s more expensive than Asilect. He’s only been on it for a month but noticed the difference in on / off time from day one , very rarely has any down time , looking to reduced his other meds 😀he also takes Ropinerole and Stelevo 😀

[RS313 in reply to ruff1]

Ruff1

well thank you for the wonderful advice! i live in US so maybe it would be very expensive here

[MBAnderson in reply to RS313]

Every developed, Western democracy provides free healthcare, except the US, but politics aside, rasagiline is 50% off with a GoodRx coupon/discount. (Plus, 90 day prescriptions are cheaper.)

[jackedmonston]

I have been on three drugs since first diagnosed by a movement disorder specialist: carbidopa/levodopa, roprinerole and Rasagelene (Azilect). I am on my third movement disorders doc (they change jobs) and they all agree on the three-drug combo. I have questioned them. Over time dose of first two has been raised to reduce off times. i have not experienced any serious side effects from roprinerole.

[RS313 in reply to jackedmonston]

Thank you for the info Jackedmonston!

[gypsy]

Hi RobynS, I personally had a bad experience with Dopermine agonist meds. What I would say to you is if you up the dosage please ask your family or friends to to keep a careful watch over you They need to tell you if they see any changes in personality, mood ect, DA's can cause excessive behaviours in some people. I experienced it first hand and my excessive behavior caused us to go bankrupt. Take care and good luck.

[RS313 in reply to gypsy]

Gypsy i am sorry to hear of this i dont know why these Dr's want to experiment with us like lab rats! it angers me.I have been taking it for 2 days and feel very sleepy almost like a zombie! i work full time and cant work like this.I have heard more bad things than good so i may tell her i dont want to take it.

[ruff1 in reply to RS313]

If you do decide not to use it any more be careful take advice about stopping don’t just stop you could get withdrawal symptoms.

[gypsy]

Hi RobynS I too was like a zombie while I took it, I was working full time on the Isle of Man as a social worker. I can recall almost driving off a cliff edge whilst on my way home one night. I had to keep apologizing to clients because I couldn't keep my eyes open while I interviewed them. Hope you can sort it, did your doctor warn you of the possibility of having some very complex side effects?

[Hikoi]

Robyn

I have been on agonists for 10 years, and they have worked for me. You of course will hear the negatives more than the positives, people with negative experiences are often more vocal, but agonists are not all bad though i dont dismiss the experiences like gypsy had. They are very real too.

Requip made me very sleepy at first but in time my body adjusted. If taking long acting you can take it at night. Im on pramipexole now. L dopa too can also cause compulsive behaviour but it is rare.

I dont think doctors are experimenting on us, agonists have been used for some time but they should warn you particularly of compulsive behaviour. Also you should begin on a starter pack slowly increasing to 2 mg.

I like having the mix of agonist, l dopa and COMT inhibitor that I take, it gives me 5 hours on time between doses.

Its a hard decision to make and there are no right or wrongs.

[RS313 in reply to Hikoi]

TY so much for the great advice maybe starting me at 2mg right off the bat is too much? i have only been taking for 3 days but i know i cant work like this so maybe i need to call her to get some advice

[Hikoi]

The slow titration is for the short acting version. I’m guessing you are on the long acting XL.

It takes perserverance to get used to the med but as younger onset it is worth considering. Its not tolerated so well in older people so most doctors dont begin this med for over 70s.

[meadowlark6581]

Requip is the devils drug IMHO. The side effects are significant and nearly cost me a 40+ year marriage. I’d do anything and everything to avoid taking ropinirole. The sexual impulsivity is no joke.