Jantoven and Ropinirole Hydrochloride

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using warfarin together with rOPINIRole may cause you to bleed more easily. You may need a dose adjustment based on your prothrombin time or International Normalized Ratio (INR). Call your doctor promptly if you have any unusual bleeding or bruising, vomiting, blood in your urine or stools, headache, dizziness, or weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Ropinirole may potentiate the hypoprothrombinemic effect of warfarin. The mechanism is unknown but may involve ropinirole displacement of warfarin from plasma protein binding sites. Alternatively, ropinirole may competitively inhibit the metabolism of the biologically less active R(+) enantiomer of warfarin via CYP450 1A2. In one case report, a 63-year-old patient who had been stabilized on warfarin 4 mg once daily for more than a year developed an increased INR nine days after initiation of ropinirole therapy for progression of Parkinson's disease. Other possible causes such as change in diet, alcohol use, or addition of over-the-counter or herbal products were ruled out. Warfarin was withheld for 4 days and restarted at 2 mg/day, then increased to 3 mg/day, whereupon the INR became therapeutic. However, the patient eventually required an increase back to 4 mg/day after ropinirole was discontinued due to gastrointestinal adverse effects.

MANAGEMENT: Given the potential for interaction and the high degree of interpatient variability with respect to warfarin metabolism, patients should be closely monitored during concomitant therapy with ropinirole. The INR should be checked frequently and warfarin dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of ropinirole in patients who are stabilized on their warfarin regimen. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

Jantoven

Generic Name: warfarin

Brand name: Coumadin, Jantoven

Synonyms: n.a.

What is Jantoven?

Ropinirole Hydrochloride

Generic Name: ropinirole

Brand name: Requip, Requip XL, ReQuip Follow on Pack, ReQuip Starter Pack, Repreve, Requip Starter Kit

Synonyms: Ropinirole, ROPINIRole

What is Ropinirole Hydrochloride?