RLS ripinarol

[BTABKWJ4561]

Hi all

Has any one been put on higher dose of Ripinarol than 4 mg my specialist told me there’s a 24 hour tablet which is more than 4mg which she thinks I should try

[Hidden]

There are quite a few drugs with similar names, so to avoid any misinformation I might give, I am assuming you mean ropinirole.

There used to be a 2mg version of extended release (ER) ropinirole i.e. Requip, but the manufacture of all strengths of immediate release ropinirole (Requip) was discontinued by GSK in 2019. They also discontinued the 2mg ER version. However, they didn't discontinue the 4mg version so if your doctor is going to prescribe any Requip, it has to be 4mg Requip ER, nothing less. I'm not aware if there is a generic version of ropinirole ER 2mg, you could check.

If you were thinking of cutting the tablets up to lower the dose, this may not be advisable as it can destroy the release mechanism.

The other thing is that for the immediate release version all of the drug is absorbed into the blood within a couple of hours, whereas with the ER version it is absorbed more slowly and over a longer time, therefore the level of the drug in your blood stream will never get as high as it would be for the same dose of the immediate version as it's spread out over 24 hours. I haven't done the calculations, but I wouldn't be surprised if the level in your blood by taking 2mg immediate release ropinirole is ever less than taking 4mg ER ropinirole. It's just there over a longer time.

The other consideration is why?

I can't really see any good reason for putting you on ER ropinirole.

If you've never taken any medication for RLS at all before, then ropinirole or any other dopamine agonist, (pramipexole or rotigotine) is not recommended.

If you have taken a dopamine agonist before either ropinirole immediate release, pramipexole or rotigotine there's probably no real benefit to switching to ER ropinirole.

I wonder what your doctor's reasoning for this is?