Neupro Medication Guide

Neupro (Rotigotine)

Complete patient guide for uses, dosage, side effects, and safety information

Prescription Required

Quick Facts

Generic Name
rotigotine
Drug Class
non-ergot dopamine agonist
Used For
Parkinson’s disease and Restless Legs Syndrome (RLS)
How Taken
transdermal patch applied to skin once daily for 24 hours

What Is Neupro Used For?

Neupro contains rotigotine, which belongs to a group of medicines called non-ergot dopamine agonists. These medicines work by stimulating dopamine receptors in the brain to increase the effects of dopamine.

Primary Uses

Neupro is used to treat two main conditions: Parkinson’s disease – a nervous system disease that mainly affects body movement, causing symptoms like shaking (tremor), muscle stiffness, and slow unsteady movement; and Restless Legs Syndrome (RLS) – a condition with unpleasant sensations in the legs and an irresistible urge to move to relieve these feelings, often accompanied by uneasiness, restlessness, itching, twitching, and pain when sitting or lying down.

How It Works

Parkinson’s disease occurs when the brain doesn’t make enough dopamine, a chemical that helps control muscle movement. When too little dopamine is produced, slowness of movement results. RLS is also thought to be due to insufficient dopamine levels in the brain. Neupro helps by increasing dopamine activity in the brain.

Good to know: This medicine helps control your condition but does not cure it. It’s important to keep using your medicine even if you feel well.

How to Take Neupro

Neupro is a patch that you apply to your skin once a day. You should leave the patch on for 24 hours and then replace it with a new one at around the same time every day.

Dosage Instructions

For Parkinson’s Disease: The usual starting dose is one 2 mg/24-hour patch or one 4mg/24-hour patch daily, increased gradually in steps of 2 mg/24 hours until the right dose is reached. For Restless Legs Syndrome: The usual starting dose is one 1 mg/24 hour patch, increased gradually in steps of 1 mg/24 hours if needed, with a maximum dose of 3 mg/24 hour. Apply the patch to clean, dry, healthy skin on your shoulder, upper arm, belly, thigh, hip, or flank. Rotate application sites daily and don’t use the same area twice within 14 days.

What If You Miss a Dose?

If you miss your dose at the usual time, remove the old patch and use a new patch as soon as you remember. If you forgot to stick on a new patch after removing the old one, use a new patch as soon as you remember, then use a new patch at the usual time the following day.

Important: Do not take a double dose to make up for the dose you missed. Do not cut Neupro patches into pieces.

Available Tablet Strengths

2 mg/24 h
2 mg/24 h Tablet Tan-colored, Square with rounded edges • Neupro 2 mg/24 h
4 mg/24 h
4 mg/24 h Tablet Tan-colored, Square with rounded edges • Neupro 4 mg/24 h
6 mg/24 h
6 mg/24 h Tablet Tan-colored, Square with rounded edges • Neupro 6 mg/24 h
8 mg/24 h
8 mg/24 h Tablet Tan-colored, Square with rounded edges • Neupro 8 mg/24 h

Side Effects

Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.

Common Side Effects

These side effects occur relatively frequently and usually don’t require emergency care:

  • Dizziness, lightheadedness, vertigo
  • Abnormal movements like muscle twitching or spasms
  • Sleep issues, unusual dreams, nightmares
  • Application site reactions (itching or redness)
  • Sweating
  • Feeling tired or weak
  • Hiccups
  • Nausea, vomiting
  • Constipation
  • Indigestion, dry mouth
  • Headache
  • Swelling of legs or feet
  • Weight loss
  • Anxiety, agitation

Seek immediate medical attention if you experience:

  • Hallucinations (seeing or hearing things that are not real)
  • Compulsive behavior such as excessive gambling, repetitive actions, increased sex drive, compulsive spending
  • Psychotic disorders including abnormal thinking about reality and behavior
  • Confusion, disorientation
  • Allergic reaction (shortness of breath, wheezing, difficulty breathing, swelling of face and lips)
  • Irregular heartbeat, increased heart rate (palpitations)
  • Involuntary muscle spasms (seizure, convulsion)
  • Loss of consciousness
  • Visual disturbances such as seeing colors or lights or blurred vision
  • Falling, fainting

Impulse Control Issues

Neupro may cause compulsive behaviors such as an unusual urge to carry out certain activities including excessive gambling, repetitive meaningless actions, increased sex drive, and compulsive spending, buying, or eating. Contact your doctor if you notice these behaviors.

Important Warnings

There are several important warnings and precautions you should know about before using Neupro.

Who Should Not Take Neupro

Do not use Neupro if you are allergic to rotigotine, sodium metabisulfite, or any other ingredients; if you need to have magnetic resonance imaging (MRI) or cardioversion (you must remove the patch before these procedures); or if the packaging is torn or shows signs of tampering.

Medical Conditions to Discuss

Check with your doctor if you have liver problems, low or high blood pressure, heart problems, mental or sleep disorders, compulsive disorders such as gambling or high sex drive, or problems with your sight.

Pregnancy and Breastfeeding

Neupro should not be used during pregnancy as the effects on pregnancy and the unborn child are not known. Neupro is not recommended if you are breastfeeding, as it is likely to reduce the amount of milk you produce and may pass into breast milk and affect your baby. If your doctor says you need to use Neupro, you should stop breastfeeding.

Children and Adolescents: Do not give this medicine to a child or adolescent. The safety and effectiveness in children and adolescents has not been established.

Drug Interactions

Some medicines may interfere with Neupro and affect how it works. Tell your doctor about all medicines you are taking.

  • Other medicines used to treat Parkinson’s disease or Restless Legs Syndrome
  • Medicines used to treat depression or mental illness
  • Medicines used to calm you or help you sleep
  • Metoclopramide (a medicine used to treat nausea and vomiting)

Alcohol & Driving

Neupro can affect your ability to drive and may interact with alcohol, so special precautions are needed.

Alcohol

Tell your doctor if you drink alcohol. Combining Neupro and alcohol can make you more drowsy. Your doctor may suggest you avoid alcohol while being treated with Neupro.

Driving and Operating Machinery

Be careful before you drive or use any machines or tools until you know how Neupro affects you. Neupro may make you feel very drowsy and may cause some people to fall asleep suddenly without any apparent warning. If you feel very drowsy or experience episodes of falling asleep suddenly without feeling sleepy, do not drive or operate machinery and contact your doctor.

Temperature Regulation

You should avoid external heat (such as excessive sunlight, saunas, hot baths, heating pads, or hot-water bottles) on the area of the patch. If the patch has irritated your skin, keep that area covered from sun and solarium exposure, as it may cause changes in skin color.

Storage

Keep your patches in their package until it’s time to use them. Store below 30°C in a cool dry place away from moisture, heat, or sunlight. Do not store in the bathroom, near a sink, in the car, or on window sills. Keep Neupro out of reach of children. Used patches still contain active ingredient and should be folded with the sticky side inwards, put in the original sachet, and thrown away safely out of reach of children.

Overdose Information

If you think you have used too much Neupro (for example, more patches than prescribed), you may need urgent medical attention. Using higher dosages than prescribed may cause nausea, vomiting, low blood pressure, fast heart beats, hallucinations, confusion, or extreme sleepiness. Immediately phone the Poisons Information Centre (13 11 26), contact your doctor, or go to the Emergency Department at your nearest hospital, even if there are no signs of discomfort or poisoning.

Frequently Asked Questions

Your doctor may start you on a low dose and slowly increase the amount until you are taking enough to control your condition. The dose varies from patient to patient and is increased gradually until the right maintenance dose is reached.

Yes, bathing, showering, swimming, and exercising should not affect how Neupro works. There is no need to remove the patch during these activities, but check that the patch hasn’t fallen off afterward.

If the patch falls off, apply a new patch for the rest of the day, then replace the patch at the same time as usual the next day.

No, do not cut Neupro patches into pieces. Use only the prescribed strength as directed by your doctor.

Do not stop using this medicine or lower the dose without first checking with your doctor. If you stop taking it suddenly, your condition may worsen or you may have unwanted side effects.

Tell your doctor if you drink alcohol. Combining Neupro and alcohol can make you more drowsy. Your doctor may suggest you avoid alcohol while being treated with Neupro.

Apply the patch to clean, dry, healthy skin on your shoulder, upper arm, belly, thigh, hip, or flank. Rotate application sites daily and don’t use the same area twice within 14 days to help avoid skin irritation.

Important Disclaimer

This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.

If you think you may have a medical emergency, call your doctor or emergency services immediately.