Ropinirol

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].