Advice Again


#1
Cowboy101 here again,
My wife`s on 1 Ropinirole 1mg three times a day, which didn`t seem too bad at first but do mean that she takes one at 8:30a.m., another at 1:30p.m.,and the last at 9:30p.m.
She feels that she could do with one around 6p.m. instead of waiting until 9:30p.m., and then another one at some point in the evening in order to see her comfortably through the night.
Obviously she appreciates that the times of taking the tablets have to coincide with meal times, but she would prefer a regime in which at no point is there a lengthy gap in between doses. Does anyone have any ideas?
It looks, to my unseasoned eye as if she needs a slightly higher dose, and if that is the case any suggestions for getting round this? I`m afraid our G.P. seems to know nothing and no hospital appointment is due until September. Very Best of Regards Cowboy101 and Wife.

#2
3mg a day of ropinirole is quite a low dose so your instinct that a higher dose is required sounds reasonable. If I remember correctly your wife has only recently started on meds so I would expect you to be ramping up slowly. No great surprise that your GP is not willing to flex the doseage.
The only surprising bit is the fact that you are not seeing your neuro consultant or Parkinson's nurse specialist until September. I'd be inclined to call them and ask for an earlier appointment to review your meds.

I hope that helps

EF

#3
Hello Cowboy101,

You are quite right as Elegant Fowl has already mentioned it is quite a low dose which will probably be changed when you go to the consultant. The time waiting for appointments is always difficult for pwp's, we were lucky that our consultant saw everybody every three months and when newly diagnosed, she would see them every two weeks until the right regime was managed. If you think about it the length of time for the tablets from 1-30 to 9-30pm is such a long time she is bound to have problems and feel the need for one about 6pm, after all she knows her own body. I would ring the pd nurse and put that to her in the hope that it will be increased.
The object is always to even out the day with the medication so that you do not have the constant up's and down's of the condition. Sadly even the doctors don't really understand how difficult it is to have to wait until the next visit before a change can be made so it always a good idea to ring the pd nurse if you have problems in between.
You don't say if it is ropinirole or ropinirole xl which is the slow releasing form your wife is taking.
I hope all is sorted for her soon.
best wishes
vivian

#4
Why do you say that the medication has to coincide with meal times? If it says on the pill box "take with food" this does not necessarily mean a meal, often a biscuit will do. The advice is largely there to prevent nausea as this is a common side effect.
Ropinerole is a long acting drug (half life of 6-8 hours, compare that with levodopa drugs (1,5 -2,5 hours)In levodopa 's case mealtimes should be avoided, but mealtimes do play a role in the drug times, they have to be taken into account as levodopa drugs are best taken half an hour before meals or one and a half hours after.
I do not take Ropinerole, but have been on Mirapexin for over 10 years and have always taken these(also long half life DAs)tablets 3xday (7.30, 12.15 and 17.30) The long gap over the course of the evening and night was never a problem. I always felt that there was maybe an accumulation(or residue) of the drug in my system by the end of the day that kept me going.