Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Rotigotine may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
for
Where to stick the patch Put the sticky side of the patch onto clean, dry, healthy skin on the following areas as shown in grey on the pictures opposite:
What Rotigotine Luye is Rotigotine Luye contains the active substance rotigotine. It belongs to a group of medicines called 'dopamine agonists'. Dopamine is a messenger in the brain which is important for movement. What Rotigotine Luye is used for Rotigotine Luye is used in adults to treat the signs and symptoms of:
To avoid skin irritation
e Rotigotine Luye Do not use Rotigotine Luye if:
If you still get problems with your skin because of the patch, please see 'Skin problems caused by the patch' in section 4 for more information. To prevent the patch becoming loose or falling off
Changes in behaviour and abnormal thinking Rotigotine Luye can cause side effects that change your behaviour (how you act). You may find it helpful to tell a member of your family or carer that you are using this medicine and ask them to read this leaflet. This is so that your family or carer can tell you, or your doctor, if they are worried about any changes in your behaviour. Tell your doctor if you or your family/carer notices you are using the drug excessively or developing craving for large doses of Rotigotine Luye or other medicines used to treat Restless Legs Syndrome.
1. To open the sachet, hold the sachet in both hands.
See 'Changes to your behaviour and abnormal thinking' in section 4 for more information. Children and adolescents Do not give this medicine to children below 18 years of age because it is not known if it is safe or effective in this age group.
2. Peel apart the foil
Other medicines and Rotigotine Luye Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription and herbal medicines. Do not take the following medicines while using Rotigotine Luye – because they may decrease its effect:
3. Open the sachet.
Talk to your doctor before using Rotigotine Luye if you are taking:
4. Take the patch out of the sachet. Remove the cover sheet from the top, tan-coloured side of the patch and discard it. A protective transparent liner (release liner) covers the sticky side of the patch.
Pregnancy and breast-feeding Do not use Rotigotine Luye if you are pregnant. This is because the effects of rotigotine on pregnancy and the unborn baby are not known. Do not breast-feed during treatment with Rotigotine Luye. This is because rotigotine may pass into your breast milk and affect your baby. It is also likely to lower the amount of milk you produce. If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine.
5. Hold the patch in both hands with the transparent release liner facing you. Peel off one side of the release liner and do not touch the sticky part of the patch with the fingers.
Driving and using machines Rotigotine Luye may make you feel very sleepy and you may fall asleep very suddenly. If this happens, do not drive. In isolated cases, people have fallen asleep while driving and this has caused accidents. Also do not use tools or machines if you feel very sleepy – or do anything else which may put others or yourself at risk of serious injury.
6. Put the sticky side of the patch on the skin and then peel off the second side of the release liner.
3. How to use Rotigotine Luye Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Which strength patches to use Rotigotine Luye is available in different strength patches which release the medicine over 24 hours. The strengths are 1 mg/24 h, 2 mg/24 h and 3 mg/ 24 h for the treatment of Restless Leg Syndrome.
7. Press the patch down firmly with the palm of your hand. Keep it pressed for about 30 seconds. This makes sure the patch is touching the skin and the edges stick down well. Wash your hands with soap and water straight after handling the patch.
off a used patch
You may feel sick (nausea) and vomit at the start of treatment. These effects are usually mild or moderate and only last for a short time. Talk to your doctor if they last for a long time or if you are worried about them.
Not known: it is not known how often these happen
Skin problems caused by the patch
Talk to your doctor or pharmacist if you notice any of the side effects listed above.
Reporting of side effects
4. Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them. Tell your doctor, pharmacist or nurse if you notice any side effects. Side effects more likely at the start of treatment
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
when using Rotigotine Luye for Restless Legs Syndrome Tell your doctor or pharmacist if you notice any of the following side effects: Very common: may affect more than 1 in 10 people
Rotigotine Luye Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the label and box. This medicine does not require any special storage conditions. What to do with the used and unused patches
What Rotigotine Luye contains The active substance is rotigotine.
feeling agitated
•
feeling dizzy when standing up because of a fall in blood pressure
Rare: may affect up to 1 in 1,000 people •
being aggressive
•
disorientation
PIL_ROT_1_3_UK_v03
Rotigotine Luye 3 mg/24 hours Transdermal patch comes as patch containing 3mg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Rotigotine Luye 3 mg/24 hours Transdermal patch is rotigotine.
Medicines with the same active substance, strength and form include: Neupro 3mg/24h Transdermal patch. They are interchangeable only if your prescriber or pharmacist says so.
This leaflet reproduces the patient information leaflet approved for Rotigotine Luye 3 mg/24 hours Transdermal patch, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
Rotigotine Luye is indicated for the symptomatic treatment of moderate to severe idiopathic Restless Legs Syndrome (RLS) in adults.
Posology
The dose recommendations made are in nominal dose.
A single daily dose should be initiated at 1 mg/24 h. Depending on the individual patient response, the dose may be increased in weekly increments of 1 mg/24 h to a maximum dose of 3 mg/24 h. The need for treatment continuation should be reconsidered every 6 months.
Rotigotine Luye is applied once a day. The patch should be applied at approximately the same time every day. The patch remains on the skin for 24 hours and will then be replaced by a new one at a different site of application.
If the patient forgets to apply the patch at the usual time of the day or if the patch becomes detached, another patch should be applied for the remainder of the day.
Treatment discontinuation
Rotigotine Luye should be discontinued gradually. The daily dose should be reduced in steps of 1 mg/24 h with a dose reduction preferably every other day, until complete withdrawal of Rotigotine Luye (see section 4.4). Following this procedure, rebound (worsening of symptoms beyond initial intensity after discontinuation of treatment) has not been observed.
Special populations
Hepatic impairment
Adjustment of the dose is not necessary in patients with mild to moderate hepatic impairment. Caution is advised when treating patients with severe hepatic impairment, which may result in lower rotigotine clearance. Rotigotine has not been investigated in this patient group. A dose reduction might be needed in case of worsening of the hepatic impairment.
Renal impairment
Adjustment of the dose is not necessary in patients with mild to severe renal impairment, including those requiring dialysis. Unexpected accumulation of rotigotine levels may also occur at acute worsening of renal function (see section 5.2).
Paediatric population
The safety and efficacy of rotigotine in children and adolescents have not yet been established. Currently available data are described in section 5.2 but no recommendation on a posology can be made.
Method of administration
Rotigotine Luye is for transdermal use.
The patch should be applied to clean, dry, intact healthy skin on the abdomen, thigh, hip, flank, shoulder, or upper arm. Reapplication to the same site within 14 days should be avoided. Rotigotine Luye should not be placed on skin that is red, irritated or damaged (see section 4.4).
Use and handling
Each patch is packed in a sachet and should be applied directly after the sachet has been opened. One half of the release liner should be removed and the sticky side should be applied and pressed firmly to the skin. Then, the patch is fold back and the second part of the release liner is removed. The sticky side of the patch should not be touched. The patch should be pressed down firmly with the palm of the hand for about 30 seconds, so that it sticks well.
The patch should not be cut into pieces.
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
Magnetic resonance imaging or cardioversion (see section 4.4).
Magnetic resonance imaging and cardioversion
The backing layer of Rotigotine Luye contains aluminium. To avoid skin burns, Rotigotine Luye should be removed if the patient has to undergo magnetic resonance imaging (MRI) or cardioversion.
Orthostatic hypotension
Dopamine agonists are known to impair the systemic regulation of the blood pressure resulting in postural/ orthostatic hypotension. These events have also been observed during treatment with rotigotine, but the incidence was similar to that observed in placebo-treated patients.
It is recommended to monitor blood pressure, especially at the beginning of treatment, due to the general risk of orthostatic hypotension associated with dopaminergic therapy.
Syncope
In clinical studies with rotigotine, syncope has been observed at a rate that was similar to that observed in patients treated with placebo. Because patients with clinically relevant cardiovascular disease were excluded in these studies, patients with severe cardiovascular disease should be asked about symptoms of syncope and pre-syncope.
Sudden onset of sleep and somnolence
Rotigotine has been associated with somnolence and episodes of sudden sleep onset. Sudden onset of sleep during daily activities, in some cases without awareness of any warning signs, has been reported. Prescribers should continually reassess patients for drowsiness or sleepiness, as patients may not acknowledge drowsiness or sleepiness until directly questioned. A reduction of dosage or termination of therapy should be carefully considered.
Impulse control and other related disorders
Patients should be regularly monitored for the development of impulse control disorders and related disorders including dopamine dysregulation syndrome. Patients and carers should be made aware that behavioural symptoms of impulse control disorders including pathologic gambling, increased libido, hypersexuality, compulsive spending or buying, binge eating and compulsive eating can occur in patients treated with dopamine agonists, including rotigotine. In some patients, dopamine dysregulation syndrome was observed under the treatment with rotigotine. Dose reduction/tapered discontinuation should be considered if such symptoms develop.
Neuroleptic malignant syndrome
Symptoms suggestive of neuroleptic malignant syndrome have been reported with abrupt withdrawal of dopaminergic therapy. Therefore, it is recommended to taper treatment (see section 4.2).
Dopamine agonist withdrawal syndrome
Symptoms suggestive of dopamine agonist withdrawal syndrome (for example, pain, fatigue, depression, sweating, and anxiety) have been reported with abrupt withdrawal of dopaminergic therapy, therefore, it is recommended to taper treatment (see section 4.2).
Abnormal thinking and behaviour
Abnormal thinking and behaviour have been reported and can consist of a variety of manifestations including paranoid ideation, delusions, hallucinations, confusion, psychotic-like behaviour, disorientation, aggressive behaviour, agitation, and delirium.
Fibrotic complications
Cases of retroperitoneal fibrosis, pulmonary infiltrates, pleural effusion, pleural thickening, pericarditis and cardiac valvulopathy have been reported in some patients treated with ergot-derived dopaminergic agents. While these complications may resolve when treatment is discontinued, complete resolution does not always occur. Although these adverse reactions are believed to be related to the ergoline structure of these compounds, whether other, nonergot derived dopamine agonists can cause them is unknown.
Neuroleptics
Neuroleptics given as antiemetic should not be given to patients taking dopamine agonists (see also section 4.5).
Ophthalmologic monitoring
Ophthalmologic monitoring is recommended at regular intervals or if vision abnormalities occur.
Heat application
External heat (excessive sunlight, heating pads and other sources of heat such as sauna, hot bath) should not be applied to the area of the patch.
Application site reactions
Application site skin reactions may occur and are usually mild or moderate in intensity. It is recommended that the application site should be rotated on a daily basis (e.g. from the right side to the left side and from the upper body to the lower body). The same site should not be used within 14 days. If application site reactions occur which last for more than a few days or are persistent, if there is an increase in severity, or if the skin reaction spreads outside the application site, an assessment of the risk/benefit balance for the individual patient should be conducted.
If there is a skin rash or irritation from the transdermal system, direct sunlight on the area should be avoided until the skin heals, as exposure could lead to changes in the skin color.
If a generalised skin reaction (e.g. allergic rash, including erythematous, macular, papular rash or pruritus) associated with the use of Rotigotine Luye is observed, Rotigotine Luye should be discontinued.
Peripheral oedema
Peripheral oedema has been observed in clinical trials conducted in patients with RLS.
Augmentation
Augmentation may occur. Augmentation refers to the earlier onset of symptoms in the evening (or even the afternoon), increase in severity of symptoms, and spread of symptoms to involve other body parts. In long-term clinical studies with rotigotine, the majority of augmentation episodes were seen in the first and second years of treatment. Doses higher than the approved dose range for RLS should be avoided as this may lead to higher rates of augmentation (see section 5.1).
Because rotigotine is a dopamine agonist, it is assumed that dopamine antagonists, such as neuroleptics (e.g. phenothiazines, butyrophenones, thioxanthenes) or metoclopramide, may diminish the effectiveness of Rotigotine Luye, and co-administration should be avoided. Because of possible additive effects, caution should be advised when patients are taking sedating medicinal products or other CNS (central nervous system) depressants (e.g. benzodiazepines, antipsychotics, antidepressants) or alcohol in combination with rotigotine.
Co-administration of L-dopa and carbidopa with rotigotine had no effect on the pharmacokinetics of rotigotine, and rotigotine had no effect on the pharmacokinetics of L-dopa and carbidopa.
Co-administration of domperidone with rotigotine had no effect on the pharmacokinetics of rotigotine.
Co-administration of omeprazole (inhibitor of CYP2C19), in doses of 40 mg/day, had no effect on the pharmacokinetics and metabolism of rotigotine in healthy volunteers.
Co-administration of rotigotine (3 mg/24 h) did not affect the pharmacodynamics and pharmacokinetics of oral contraceptives (0.03 mg ethinylestradiol, 0.15 mg levonorgestrel).
Interactions with other forms of hormonal contraception have not been investigated.
Women of childbearing potential, contraception in females
Women of childbearing potential should use effective contraception to prevent pregnancy during treatment with rotigotine.
Pregnancy
There are no adequate data from the use of rotigotine in pregnant women. Animal studies do not indicate any teratogenic effects in rats and rabbits, but embryo-toxicity was observed in rats and mice at materno-toxic doses (see section 5.3). The potential risk for humans is unknown. Rotigotine should not be used during pregnancy.
Breast-feeding
Because rotigotine decreases prolactin secretion in humans, inhibition of lactation is expected. Studies in rats have shown that rotigotine and/or its metabolite(s) are excreted in breast milk. In the absence of human data, breast-feeding should be discontinued.
Fertility
For information on fertility studies, please see section 5.3.
Rotigotine may have major influence on the ability to drive and use machines.
Patients being treated with rotigotine and presenting with somnolence and/or sudden sleep episodes must be informed not to drive or engage in activities (e.g. operating machines) where impaired alertness may put themselves or others at risk of serious injury or death until such recurrent episodes and somnolence have resolved (see also sections 4.4 and 4.5).
Summary of the safety profile
Based on the analysis of pooled placebo-controlled clinical trials comprising a total of 748 patients treated with rotigotine transdermal patch and 214 placebo-treated patients, 65.5% of the patients on rotigotine transdermal patch and 33.2% of patients on placebo reported at least one adverse reaction.
At the beginning of therapy dopaminergic adverse reactions such as nausea and vomiting may occur. These are usually mild or moderate in intensity and transient even if treatment is continued.
Adverse drug reactions (ADRs) reported in more than 10% of patients treated with rotigotine transdermal patch are nausea, application site reactions, asthenic conditions and headache.
In trials where the application sites were rotated as reflected in the instructions provided in the SmPC and package leaflet, 34.2% of 748 patients using rotigotine transdermal patch, experienced application site reactions. The majority of application site reactions were mild or moderate in intensity, limited to the application areas and resulted in discontinuation of rotigotine transdermal patch in 7.2% of subjects.
Discontinuation rate
The discontinuation rate was studied in 3 clinical trials ranging up to 3 years in duration. The percentage of subjects discontinuing was 25-38% over the first year, 10% in the second year, and 11% in the third year. Periodic assessment of efficacy should be performed, along with evaluation of safety, including augmentation.
Tabulated list of adverse reactions
The following table covers adverse drug reactions from the pooled studies mentioned above in patients with Restless Legs Syndrome and from post-marketing experience. Within the system organ classes, adverse reactions are listed under headings of frequency (number of patients expected to experience the reaction), using the following categories: very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000); not known (cannot be estimated from the available data). Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness.
System/organ classes acc. To MedDRA
Very common
Common
Uncommon
Rare
Not known
Immune system disorders
Hypersensitivity, which may include angioedema, tongue oedema and lip oedema
Psychiatric disorders
Sleep attacks/ sudden onset of sleep, sexual desire disordersa (incl. hypersexuality, libido increased), insomnia, sleep disorder, abnormal dreams, impulse- control disordersa,d (incl. pathological gambling, stereotypy/ punding, binge eating/eating disorderb, compulsive shoppingc)
Obsessive-compulsive disorder, agitationd
Aggressive behaviour/ aggressionb, disorientationd
Dopamine dysregulation syndromec, perception disturbancese (incl. hallucination, hallucination visual, hallucination auditory, illusion), nightmaree, paranoiae, confusional statee, psychotic disordere, delusione, deliriume
Nervous system disorders
Headache
Somnolence
Dizzinesse, disturbances in consciousness NECe (incl. syncope, syncope vasovagal, loss of consciousness), dyskinesiae, dizziness posturale, lethargye, convulsione
Eye disorders
Vision blurrede, visual impairmente, photopsiae
Ear and labyrinth disorders
Vertigoe
Cardiac disorders
Palpitationse, atrial fibrillatione, supraventricular tachycardiae
Vascular disorders
Hypertension
Orthostatic hypotension
Hypotensione
Respiratory, thoracic and mediastinal disorders
Hiccupse
Gastrointestinal disorders
Nausea
Vomiting, dyspepsia
Constipatione, dry mouthe, abdominal paine, diarrhoeac
Skin and subcutaneous tissue disorders
Pruritus
Erythemae, hyperhidrosise, pruritus generalisede, skin irritatione, dermatitis contacte, rash generalisede
Reproductive system and breast disorder
Erectile dysfunctione
General disorders and administration site conditions
Application and instillation site reactionsa (incl. erythema, pruritus, irritation, rash, dermatitis, vesicles, pain, eczema, inflammation, swelling, discolouration, papules, exfoliation, urticaria, hypersensitivity), asthenic conditionsa (incl. fatigue, asthenia, malaise)
Irritability, oedema peripheral
Investigations
Weight decreasede, hepatic enzyme increasede (incl. AST, ALT, GGT), weight increasede, heart rate increasede, CPK increasedd,e
Injury, poisoning and procedural complications
Falle
Musculoskeletal and connective tissue disorders
Rhabdomyolysisc
a High Level Term
b Observed in open-label studies
c Observed during post-marketing
d Observed in 2011 data pool of double-blind placebo-controlled studies
e Observed in studies performed in patients with Parkinson's disease
Description of selected adverse reactions
Sudden onset of sleep and somnolence
Rotigotine has been associated with somnolence including excessive daytime somnolence and sudden sleep onset episodes. In isolated cases “sudden onset of sleep” occurred while driving and resulted in motor vehicle accidents (see also sections 4.4 and 4.7).
Impulse control disorders
Pathological gambling, increased libido, hypersexuality, compulsive spending or buying, binge eating and compulsive eating can occur in patients treated with dopamine agonists, including rotigotine (see section 4.4).
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Symptoms
The most likely adverse reactions would be those related to the pharmacodynamic profile of a dopamine agonist, including nausea, vomiting, hypotension, involuntary movements, hallucinations, confusion, convulsions and other signs of central dopaminergic stimulation.
Management
There is no known antidote for overdose of dopamine agonists. In case of suspected overdose, removal of the patch(es) should be considered because after removal of the patch(es) the active substance input is stopped and the plasma concentration of rotigotine decreases rapidly. The patient should be monitored closely, including heart rate, heart rhythm and blood pressure.
Treatment of overdose may require general supportive measures to maintain the vital signs. Dialysis would not be expected to be beneficial as rotigotine is not eliminated by dialysis.
If it is necessary to discontinue rotigotine, this should be done gradually to prevent neuroleptic malignant syndrome.
Ask anything about Rotigotine Luye 3 mg/24 hours Transdermal patch. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
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