What is it and how is it used?
Neupro belongs to a group of medicines called dopamine agonists which stimulate a certain type of cells that bind with dopamine receptors in the brain.
Neupro is used to treat:
What do you have to consider before using it?
Do not use Neupro
Take special care with Neupro
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
You should not take the following medicines while using Neupro, because they may decrease its effect: anti-psychotics (used to treat certain mental conditions) or metoclopramide (used to treat nausea and vomiting).
If you are treated with Neupro and levodopa at the same time, some side effects may get more serious, such as seeing or hearing things that are not real (hallucinations), involuntary movements related to Parkinson’s disease (dyskinesia), and swelling of legs and feet.
Please ask your doctor whether it is safe for you to:
Using Neupro with food and drink
Because rotigotine enters your bloodstream through your skin, food or drink does not affect the way this medicine works. You should discuss with your doctor if it is safe for you to drink alcohol while using Neupro.
Pregnancy and breast-feeding
You should not use Neupro if you are pregnant, as the effects of rotigotine on pregnancy and the unborn baby are not known. Tell your doctor if you are pregnant or planning to become pregnant.
Breast-feeding is not recommended during treatment with Neupro. Rotigotine may pass into your breast milk and affect your baby and is also likely to reduce the amount of milk you produce.
Ask your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
Neupro may make you feel very drowsy, and you may fall asleep very suddenly. If this affects you, you should not drive or take part in activities where not being alert may put you or others at risk of serious injury, for example, using machines.
In isolated cases people have fallen asleep while driving and this has caused accidents.
Important information about some of the ingredients of Neupro
Neupro contains sodium metabisulphite (E223), a substance that may rarely cause severe hypersensitivity reactions and bronchospasm.
How is it used?
Dose
Always use Neupro exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
Neupro is generally used as a long term treatment. Normally, you will start your treatment with a low dose and, if necessary, increase it week by week, as told by your doctor, until reaching the right dose for you. You will then continue treatment with this dose, also called the maintenance dose.
The Neupro treatment initiation pack contains 4 different packages (one for each strength) with 7 patches in each package. These packages are usually needed for the first four weeks of therapy, but depending on your response to Neupro, you may not need to use all of the dose packages included or you may need additional higher doses after week 4, which are not covered by this package.
On the first day of treatment, start with Neupro 2 mg (package marked “ Week 1)“, and use one Neupro 2 mg transdermal patch daily. You should take Neupro 2 mg for 7 days
(e.g. if you start on a Sunday, switch to the next dose on the following Sunday.).
At the beginning of the second week, you should take Neupro 4 mg (package marked with “ Week 2“). At the beginning of the third week, you should take Neupro 6 mg (package marked with “ Week 3“). At the beginning of the fourth week, you should take Neupro 8 mg (package marked with ” Week 4“).
The right dose for you will depend on your needs.
4 mg of Neupro every day may be an effective dose for some patients. For most patients with early stage Parkinson’s disease, the right dose is reached within 3 or 4 weeks, at doses of 6 mg per day or 8 mg per day respectively. The maximum dose is 8 mg per day. For most patients with advanced-stage Parkinson’s disease the right dose is reached within 3 to 7 weeks, at doses of 8 mg per day up to a maximum dose of 16 mg per day.
If you have to stop taking this medicine, see Section 3, ‘If you stop using Neupro‘.
FOLLOW THESE INSTRUCTIONS WHEN USING NEUPRO:
You should stick a new Neupro patch onto the skin once a day. Leave the patch on your skin for 24 hours, then remove it and apply a new one. Make sure that you take the old patch off before applying a new one; place the new patch on a different area of skin.
You should change your patch at around the same time every day.
Do not cut the Neupro patches into pieces.
Where to stick the patch
To help avoid skin irritation:
To prevent the patch becoming loose or falling off
NOTE
How to use the patch
Each patch is packed in a separate sachet. You should stick Neupro onto your skin as soon as you have opened the sachet and removed the protective liner.
Wash your hands with soap and water immediately after handling the patch.
How to remove a used patch
Slowly and carefully peel off the used patch.
Gently washing the area with warm water and mild soap should remove any adhesive that stays on your skin after you remove the patch. You can also use a small amount of baby oil to remove any adhesive that won’t wash off.
Do not use alcohol or other dissolving liquids such as nail polish remover as these may irritate your skin.
Choose a new area of skin where you will apply a new patch, then follow the instructions above.
If you use more Neupro than you should
Using higher doses of Neupro than your doctor has prescribed may cause side effects such as nausea (feeling sick), vomiting, low blood pressure, hallucinations (seeing or hearing things that are not real), confusion or extreme sleepiness.
If you have used more patches than your doctor told you to, remove the extra patches and contact your doctor or hospital for advice immediately.
If you have used a different patch (e.g. Neupro 4 mg/24 h instead of Neupro 2 mg/24 h) than your doctor told you to, remove the different patch and apply the accurate one.
If you have any unpleasant reactions, contact your doctor.
If you have forgotten to change the patch at the usual time
If you have forgotten to change the patch at your usual time, change it as soon as you remember: remove the old patch and use a new one. If you have forgotten to stick on a new patch after removing the old one, use a new patch as soon as you remember.
In both cases, on the following day you should use a new patch at the usual time. Do not use a double dose to make up for a forgotten dose.
If you stop using Neupro
Do not stop using Neupro suddenly without talking to your doctor. A sudden stop could cause you to develop a medical condition called neuroleptic malignant syndrome which may represent a major health risk. The symptoms include: akinesia (loss of muscle movement), rigid muscles, fever, unstable blood pressure, tachycardia (increased heart rate), confusion, depressed level of consciousness (e.g. coma).
Your daily dose of Neupro should be reduced gradually
If you have any further questions on the use of this product, ask your doctor or pharmacist.
What are possible side effects?
Like all medicines, Neupro can cause side effects, although not everybody gets them.
You may experience nausea (feeling sick) and vomiting at the beginning of treatment. These effects are usually mild or moderate and only last for a short time. You should contact your doctor if they last for a long time or if you worry about them.
Skin problems caused by the patch
You may get skin reactions from the patch such as redness, itching. They are usually mild or moderate and only affect the area of skin the patch has been on. The reactions normally disappear after a few hours when you remove the patch.
If you have a skin reaction that lasts longer than a few days, is severe, or spreads outside the area of skin that was covered by the patch, you should contact your doctor.
The frequency of possible side effects listed below is defined using the following convention: very common (affects more than 1 user in 10)
common (affects 1 to 10 users in 100)
uncommon (affects 1 to 10 users in 1,000)
rare (affects 1 to 10 users in 10,000)
very rare (affects less than 1 user in 10,000)
not known (frequency cannot be estimated from the available data)
If you are using Neupro for Parkinson’s disease the following side effects may occur:
Very common side effects
Common side effects
Uncommon side effects
Rare side effects
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
How should it be stored?
Keep out of the reach and sight of children.
Do not use Neupro after the expiry date which is stated on the label and carton.
Store in a refrigerator (2°C – 8°C).
What to do with the used and unused patches
Used patches still contain active substance, which may be harmful to others. Fold the used patch with the sticky side inwards. Put the patch in the original sachet and then throw it away safely, out of the reach of children.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines not longer required. These measures will help to protect the environment.
