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Ropinirol

Klassificering: A

Preparat: ADARTREL, Requip, Requip Depot, Requip®, Ropinirol 2care4, Ropinirol Ebb, Ropinirol Krka, Ropinirol Mylan, Ropinirol Sandoz, Ropinirol Stada, Ropinirole Orifarm, Ropinirole Teva

ATC kod: N04BC04

Substanser: ropinirol, ropinirolhydroklorid

Sammanfattning

Det saknas studier om skillnader mellan könen avseende effekt av ropinirol.

Vissa studier rapporterar en ökad risk för impulskontrollstörning hos män jämfört med kvinnor vid behandling med parkinsonläkemedel, medan andra studier inte visar några könsskillnader.

Additional information

The reported incidence and prevalence of Parkinson’s disease (PD) is slightly higher in men than in women. It seems that men develop PD earlier in life compared to women. Several possible explanations behind these sex differences have been suggested; the protective role of estrogens in premenopausal women, and different profiles of risk factors (environmental and/or genetic). Sex differences in clinical presentations of PD have also been reported. Since the activities of daily living might differ between men and women with PD, different treatment strategies can be recommended to men and women with PD [1].

Pharmacokinetics and dosing

Oral clearance of ropinirole have shown to be similar in men and women [7]. Ropinirole is indicated for treatment of Parkinson’s disease and for treatment of Restless Legs Syndrome. Therapy with ropinirole is initiated at a low dose and gradually titrated upward according to clinical tolerability to obtain the optimum therapeutic effect. It is not necessary to adjust the initial dose based on patient’s sex, weight or age [7].

Effects

No studies with a clinically relevant sex analysis regarding the effects of ropinirole have been found.

Adverse effects

Ropinirole have shown to have no dose- or exposure-related effect on mean QT intervals in healthy men and women titrated to doses up to 4 mg/day [7].The increased risk of impulse control disorder with use of dopamine agonists is well known [2-6]. One observational study on dopamine agonists (n=642, approx. 2/3 men) reports a higher frequency of impulse control disorder in men compared to women in patients using dopamine agonists [4].However, in a transversal study of patients on a single nonergolinic dopamine agonist (pramipexole, ropinirole, or rotigotine) (145 men, 88 women) no difference in risk between men and women was reported [6].

Reproductive health issues

Regarding teratogenic aspects, please consult Janusmed Drugs and Birth Defects (in Swedish, Janusmed fosterpåverkan).

Other information

At oral doses as low as 0.2 mg, ropinirol suppressed serum prolactin concentrations in healthy men [7].

Försäljning på recept

Något fler män än kvinnor hämtade ut tabletter innehållande ropinirol (ATC-kod N04BC04) på recept i Sverige år 2019, totalt 1 698 män och 1 566 kvinnor. Det motsvarar 0,3 respektive 0,3 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 70-84 år hos båda könen. I åldersgruppen 54 år och yngre var tabletter innehållande ropinirol i genomsnitt 1,4 gånger vanligare bland kvinnor och i åldersgruppen 55 år och äldre i genomsnitt 1,2 gånger vanligare bland män [8].

Uppdaterat: 2020-09-08

Litteratursökningsdatum: 2019-11-07

Referenser

  1. Georgiev D, Hamberg K, Hariz M, Forsgren L, Hariz GM. Gender differences in Parkinson's disease: A clinical perspective. Acta Neurol Scand. 2017;136(6):570-584. PubMed
  2. Weintraub D, Siderowf AD, Potenza MN, Goveas J, Morales KH, Duda JE, Moberg PJ, Stern MB. Association of dopamine agonist use with impulse control disorders in Parkinson disease. Arch Neurol. 2006;63(7):969-73. länk
  3. Schreglmann SR, Gantenbein AR, Eisele G, Baumann CR. Transdermal rotigotine causes impulse control disorders in patients with restless legs syndrome. Parkinsonism Relat Disord. 2012;18:207-9. PubMed
  4. Carrière N, Kreisler A, Dujardin K, Destée A, Defebvre L. [Impulse control disorders in Parkinson's disease: A cohort of 35 patients]. Rev Neurol (Paris). 2012;168:143-51. PubMed
  5. Poletti M, Logi C, Lucetti C, Del Dotto P, Baldacci F, Vergallo A, Ulivi M, Del Sarto S, Rossi G, Ceravolo R, Bonuccelli U. A single-center, cross-sectional prevalence study of impulse control disorders in Parkinson disease: association with dopaminergic drugs. J Clin Psychopharmacol. 2013;33(5):691-4. PubMed
  6. Garcia-Ruiz, P J Martinez Castrillo JC, Alonso-Canovas A, Herranz Barcenas A, Vela L, Sanchez Alonso P, Mata M, Olmedilla Gonzalez N, Mahillo Fernandez I. Impulse control disorder in patients with Parkinson's disease under dopamine agonist therapy: a multicentre study. J Neurol Neurosurg Psychiatry. 2014;85(8):840-4. länk
  7. Requip (ropinirole). DailyMed [www]. US National Library of Medicine. [updated 2018-01-19, cited 2019-11-07]. länk
  8. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2019 [cited 2020-03-10.] länk

Författare: Linnéa Karlsson Lind

Faktagranskat av: Mia von Euler, Diana Rydberg

Godkänt av: Karin Schenck-Gustafsson