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Rotigotine Transdermal Patch (Neupro)
⚠️ Missed doses of Parkinson’s medications can: Impair swallow → aspiration risk, Cause immobility → falls, fractures, Trigger a Neuroleptic Malignant-Like Syndrome (rigidity, fever, delirium) → coma & death
💻 Dose conversion tools: pdmedcalc.co.uk | parkinsonscalculator.com
📖 About Rotigotine
- BNF entry here – always check for latest prescribing advice.
- Rotigotine = dopamine agonist delivered via 24-hour transdermal patch.
- Useful when patients cannot take enteral PD meds (e.g. NBM, NG/PEG not possible).
🧪 Mode of Action
- Dopamine agonist at D1, D2, D3 receptors → continuous dopaminergic stimulation.
💷 Cost (2025 BNF)
- Neupro® 8 mg patch ≈ £150 for 28 days.
💊 Indications & Dosing
- Use when oral/NG/NJ/PEG PD meds cannot be given.
- Start dose: 2 mg/24 h.
- Usual dose range: 4–8 mg/24 h.
- Max dose: 16 mg/24 h.
- Patches must not be cut ✂️❌ – but ≥2 patches can be applied simultaneously.
📊 Dose Summary
| Name | Starting Dose | Typical Dose | Max Dose | Route |
|---|---|---|---|---|
| Rotigotine patch | 2 mg/24 h | 4–6 mg/24 h | 16 mg/24 h | Transdermal patch (OD) |
⚠️ Practical Cautions
- If using >8 mg/24 h, start 2 mg lower than calculated and review daily.
- If patient remains stiff/drowsy → titrate ↑ by 2 mg cautiously.
- Check skin integrity at patch site (rotate placement).
🚫 Contraindications
- As per BNF.
🔀 Interactions
- Check BNF – esp. additive CNS depression & antihypertensives.
💥 Side Effects
- Impulse control disorders: gambling, hypersexuality, compulsive shopping – often under-reported, so ask directly.
- Nausea/vomiting: prescribe domperidone 10 mg TDS (avoid metoclopramide/prochlorperazine).
- Sedation: often transient; caution with driving.
- Confusion/hallucinations: especially in elderly/frail patients.
📚 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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