Rotigotine Disease Interactions

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension at any time, but especially during dose escalation. Additionally, patients with Parkinson's disease may have an impaired capacity to respond to an orthostatic challenge. For these reasons, patients with Parkinson's disease (or restless legs syndrome) who are being treated with dopaminergic agonists typically require careful monitoring for signs/symptoms of orthostatic hypotension, especially during dose escalation, and should be advised of this risk.

Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinsonian agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs. The use of bromocriptine in patients with severe psychotic disorders is not recommended.

Rotigotine (transdermal patch) contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life threatening or less severe asthmatic episodes in certain susceptible people. Sulfite sensitivity is seen more frequently in people with asthma than people without it.

Some patients treated with rotigotine exhibited an increased pulse, greater than 100 beats per minute, while supine or standing. Also, like other dopaminergic agents, rotigotine might impair the systemic regulation of blood pressure causing postural/orthostatic hypotension, especially during dose escalation. These findings of blood pressure and heart rate elevations should be considered when treating patients with cardiovascular disease.

Patients taking rotigotine had a higher incidence of weight gain associated with fluid retention, when compared with patients taking placebo. Weight gain and fluid retention should be monitored in patients using rotigotine, specially in those with concomitant illnesses as congestive heart failure and renal insufficiency.