Indications 

Neupro is a transdermal patch indicated for the treatment of Parkinson’s disease (PD), a neurological disorder that causes movement and balance problems such as tremors, stiffness, slow movements, and impaired balance. 

Neupro is also indicated for the treatment of moderate-to-severe primary restless legs syndrome (RLS), a condition characterized by leg discomfort and an irresistible urge to move the legs, particularly at night and during periods of rest. 

Categorized as a non-ergoline dopamine agonist, Neupro is thought to aid in rebalancing dopamine levels in the brain, which are essential for regulating movement. 

Uses and Dosage 

Before taking Neupro and with each prescription refill, carefully review its medication guide and patient information leaflet. Seek advice from your physician or pharmacist if you have questions or concerns. 

The dosage of Neupro is determined based on the patient’s medical condition and response to the treatment.  

To minimize the likelihood of side effects, such as nausea and dizziness, your doctor may advise starting with a low dose and gradually increasing it. Follow your doctor’s directions precisely. 

Typically, Neupro is worn for a day and then replaced. To prevent irritation, apply the patch to a different body area each time, like the stomach, thigh, hip, flank (side of the body between the ribs and the pelvis), shoulder, or upper arm. Allow a minimum of 14 days before reapplying to the same spot. 

Prior to applying Neuro to a hairy area, ensure it has been shaved at least 3 days beforehand. Avoid placing the patch in areas where it may rub against tight clothing or under a waistband, as well as skin folds. 

Do not apply the patch on irritated, red, or injured skin. Moreover, avoid using creams, lotions, ointments, oils, or powders in the intended patch area. 

Neupro patches are packaged in protective pouches to ensure their safety until application. Apply the patch immediately after removing it from the pouch and avoid damaging or cutting it into smaller pieces. 

To ensure the proper application of Neupro, follow these steps: 

1. Grasp the two sides of the pouch and gently pull them apart to open it. 
2. Take out the patch from the pouch. 
3. Hold the patch with both hands, ensuring the protective liner is on top. 
4. Bend the edges of the patch away from you to open the S-shaped cut in the liner. 
5. Peel off one half of the protective liner. 
   • Be careful not to touch the sticky surface of the patch, as it may cause the medication to transfer onto your fingers. 
6. Apply the sticky half of the patch onto a clean area of your skin, and then remove the remaining liner. 
7. Apply firm pressure to the patch with your palm for 30 seconds to ensure proper skin contact, particularly along the edges.  
   • The warmth from your hand will aid in activating the adhesive, securing the patch firmly in place.  
   • Ensure that the patch lies flat against your skin, free of any creases or bumps. 
8. Make sure to remove the previous day’s patch after applying the new one.  
   • Gently peel it off using your fingers, fold it in half, and firmly seal it shut. 
   • Dispose of it safely, away from children and pets. 
   • To remove any remaining adhesive on the skin, use warm water and mild soap or baby/mineral oil to gently rub the area. 
9. After handling the patch, wash your hands thoroughly with soap and water to remove any residual medication. 
   • Refrain from touching your eyes until you have washed your hands. 

For optimal results, use Neupro regularly exactly as directed and change it at a consistent time each day. 

While wearing Neupro, bathing, showering, or swimming is permissible. However, water can weaken the patch’s adhesive.  

If the edges of the patch lift, secure them with bandaging tape. If the patch falls off, replace it for the remainder of the day and apply a new patch at your usual time the next day. 

Consult your doctor before discontinuing this medication, as sudden cessation may exacerbate certain conditions and lead to withdrawal symptoms such as anxiety, depression, confusion, fever, and muscle stiffness. To mitigate the risk of withdrawal symptoms, your doctor may gradually decrease your dosage. 

Side Effects 

Listed below are the potential adverse effects of Neupro. Inform your doctor promptly if any of them last or worsen. 

Common Side Effects 

• Nausea, vomiting, or loss of appetite 
• Headache, dizziness, or drowsiness 
• Vision problems 
• Swelling in hands or feet, rapid weight gain 
• Increased sweating 
• Sleep problems (insomnia) 
• Redness, itching, or swelling at the patch application site 

Serious Side Effects 

• Persistent skin irritation that persists for hours after patch removal 
• Excessive drowsiness and sudden onset of sleepiness 
• Feeling light-headed or prone to fainting 
• Agitation, confusion, hallucinations, or paranoia (more common in older adults) 
• Rapid heartbeat 
• Heightened sexual urges, unusual gambling impulses, or intense urges 
• Unusual thoughts or behavior 
• Uncontrolled muscle movements 

Inform your doctor immediately if any of the severe side effects listed above are experienced. 

Allergic Reactions 

Although rare, a severe allergic reaction to Neupro may occur. If any of the symptoms below occur, promptly seek medical assistance: 

• Rash 
• Severe dizziness 
• Itching or swelling of the face, lips, tongue, or throat 
• Trouble breathing  

Not all side effects of Neupro are included in this list. In case of any unlisted effects, tell your doctor immediately. 

Cautions 

Before starting treatment with Neupro, inform your doctor and pharmacist of any known allergies, particularly to rotigotine, other drugs, or any components contained in Neupro patches. 

To ensure Neupro is safe for you, disclose to your physician your medical background, especially if you have a history of: 

• Asthma 
• Sleep disorders (e.g., sleep apnea or narcolepsy) 
• Low or high blood pressure 
• Heart disease (e.g., heart failure) 
• Kidney disease 
• Mental or mood disorders (e.g., schizophrenia) 

Inform your doctor and pharmacist of all prescription and non-prescription drugs, vitamins, and herbal supplements you are taking to prevent the risk of drug interaction with Neupro. 

Tell your doctor or pharmacist of any drowsiness-inducing products you are using, including: 

• Alcohol 
• Marijuana (cannabis) 
• Antihistamines (e.g., cetirizine, diphenhydramine) 
• Sleep or anxiety medications (e.g., alprazolam, diazepam, zolpidem) 
• Muscle relaxants 
• Opioid pain relievers (e.g., codeine) 

Ensure to review the labels of all your medications, including allergy or cough-and-cold remedies, as they may comprise sleep-inducing elements. Consult with your pharmacist to ensure the safe usage of such products. 

Notify your doctor if you are using Neupro and are scheduled for magnetic resonance imaging (MRI) or cardioversion, as this patch can potentially cause skin burns during these procedures. 

To prevent potential side effects, refrain from exposing Neupro to direct heat sources like heating pads, electric blankets, saunas, hot tubs, heat lamps, heated waterbeds, or prolonged sunlight while using it. Heat can cause an increase in drug release into the body. 

Inform your physician if you experience daytime sleepiness or drowsiness while using Neupro, as some individuals have reported falling asleep during regular activities like working, talking, eating, or driving. 

Neupro should only be used during pregnancy if necessary. Consult with your doctor regarding the potential risks and benefits of this medication prior to use. 

The excretion of rotigotine in breast milk is unknown, but it can potentially reduce prolactin secretion and interfere with lactation. Consult your doctor before breastfeeding while using this medication.