Rotigotine (roe-TIG-oh-teen)

Treats Parkinson disease and restless legs syndrome (RLS).

Brand Name(s):

Neupro

When This Medicine Should Not Be Used:

How to Use This Medicine:

Patch

• Your doctor will tell you how many patches to use, where to apply them, and how often to apply them. Do not use more patches or apply them more often than your doctor tells you to. Try to change the patch at the same time each day.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Wash your hands with soap and water before and after applying a patch.
• Leave the patch in its sealed wrapper until you are ready to put it on. Tear the wrapper open carefully. NEVER CUT the wrapper or the patch with scissors. Do not use any patch that has been cut by accident. Remove the protective liner, and put the patch on right away after you open the package.
• The patient instructions will show the body areas where you can wear the patch. When putting on each new patch, choose a different place within these areas. Do not put the new patch on the same place you wore the last one. Be sure to remove the old patch before applying a new one. Do not put a new patch in the same place for at least 14 days.
• Apply the patch to clean, dry skin on your stomach, thigh, hip, flank (side of the body between the ribs and the pelvis), shoulder, or upper arm that has very little or no hair. Do not put the patch over burns, cuts, irritated, or oily skin. Avoid putting the patch on skin folds, under a waistband, or on areas where it could be rubbed by tight clothing. If you need to put the patch on a hairy area, the area should be shaved at least 3 days before you apply the patch.
• Press the patch firmly in place with the palm of your hand for about 30 seconds. Make sure there is good contact with your skin, especially around the edges of the patch.
• Do not put cream, lotion, ointment, oil, or powder on the skin area where the patch will be placed.
• Put on a new patch if the old one has fallen off and cannot be reapplied.
• After you remove the patch, wash the site with soap and water to remove any drug or adhesive. You may also use baby or mineral oil to remove any excess medicine. Do not use alcohol or other solvents (eg, nail polish remover) to avoid skin irritation.
• Missed dose: If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.
• If the patch comes off, stick it back on. You can use medical tape to keep the edges taped down, if needed. If the patch comes off and you cannot find it, put on a new patch. Continue to change patches on your regular schedule.
• Store the patches at room temperature in a closed container, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how rotigotine works. Tell your doctor if you are using metoclopramide, benzodiazepine medicine, or medicine to treat depression or mental health problems.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.
• Use caution when drinking alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, high or low blood pressure, heart or blood vessel disease, lung or breathing problem (including asthma), dyskinesia (trouble with muscle control), sleeping problems, or mental problems. Tell your doctor if you had an allergy to sulfites.
• This medicine may cause the following problems:
  • Hallucinations
  • Unusual changes in thoughts or behavior, including an urge to gamble, spend money, binge eat, or an increased sex drive
  • Changes in blood pressure or heart rate
  • Increased weight or fluid retention (excess body fluids)
  • Skin site reactions
• This medicine may make you dizzy, drowsy, lightheaded, or faint. It may even cause you to fall asleep without warning while you drive, talk, or eat. Do not drive or do anything that could be dangerous until you know how this medicine affects you. Stand up slowly if you feel dizzy or lightheaded.
• Remove this patch before you have a medical procedure that involves electricity, including MRI or cardioversion, because the patch contains aluminum. Make sure any doctor who treats you knows that you have this patch.
• Keep the patch away from heat, especially from heating pads, electric blankets, hot tubs, or direct sunlight. Direct sunlight may cause skin discoloration.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Changes in vision
• Fever, sweating, confusion, uneven heartbeat, muscle stiffness, pain, tenderness, or weakness
• Headache
• Lightheadedness, dizziness, fainting
• Rapid weight gain, swelling in your hands, ankles, or feet
• Twitching or muscle movements you cannot control (either new or worse than usual)
• Unusual changes in mood or behavior, behaviors you cannot control, seeing or hearing things that are not there

If you notice these less serious side effects, talk with your doctor:

• Nausea, vomiting, loss of appetite, upset stomach
• Skin rash, itching, swelling, or redness where the patch is applied
• Trouble sleeping
• Unusual drowsiness or sleepiness

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088