NEUPRO Safety & Side Effects
NEUPRO® (rotigotine transdermal system) can cause serious side effects, including:
- Severe allergic reactions. NEUPRO contains a sulfite called sodium metabisulfite. Sulfites can cause severe allergic reactions that are life threatening to some people who are sensitive to sulfites. An allergy to sulfites is not the same as an allergy to sulfa. People with asthma are more likely to be allergic to sulfites. Remove your NEUPRO Patch right away and call your doctor if you have swelling of the lips or tongue, chest pain, or trouble breathing or swallowing.
- Falling asleep during normal activities. You may fall asleep while doing normal activities such as driving a car, doing physical tasks, or using hazardous machinery while taking NEUPRO. You may suddenly fall asleep without being drowsy or without warning. This may result in having accidents. Your chances of falling asleep while doing normal activities while using NEUPRO are greater if you take other medicines that cause drowsiness. Tell your doctor right away if this happens. Before starting NEUPRO, be sure to tell your doctor if you take any medicines that make you drowsy.
- Hallucinations and other psychosis. NEUPRO can cause or worsen psychotic symptoms, including hallucinations (seeing or hearing things that are not real), confusion, excessive suspicion, aggressive behavior, agitation, delusional beliefs (believing things that are not real), and disorganized thinking. The chances of having hallucinations or these other psychotic-like changes are higher in people with Parkinson's disease who are elderly, taking NEUPRO, or taking higher doses of NEUPRO. If you have hallucinations or any of these other psychotic-like changes, talk with your doctor.
- Changes in blood pressure. NEUPRO can decrease or increase your blood pressure. Lowering of your blood pressure is of special concern. If you faint or feel dizzy, nauseated, or sweaty when you stand up from sitting or lying down, this may mean that your blood pressure is decreased. If you notice this, you should contact your doctor. Also, when changing position from lying down or sitting to standing up, you should do it carefully and slowly. Lowering of your blood pressure can happen, especially when you start taking NEUPRO or when your dose is increased.
- Fainting. Fainting can occur, and sometimes your heart rate may be decreased. This can happen especially when you start using NEUPRO or your dose is increased. Tell your doctor if you faint or feel dizzy.
- Unusual urges. Some patients using NEUPRO get urges to behave in a way that is unusual for them. Examples of this are unusual urges to gamble, strong urges to spend money, binge eating, or increased sexual urges and behaviors. Some patients may want to use more NEUPRO than prescribed for their symptoms (dopamine dysregulation syndrome). If you notice or your family notices that you are developing any unusual behaviors, talk to your doctor.
- Changes in heart rate. NEUPRO can increase your heart rate.
- Increased weight and fluid retention can occur in patients using NEUPRO. NEUPRO can cause your body to keep extra fluid, which leads to swelling and weight gain. Tell your doctor if you have swelling or fluid retention, especially in the ankles or legs, or have an unusually fast increase in weight.
- Uncontrolled, sudden movements. NEUPRO may cause uncontrolled, sudden movements or make such movements you already have worse or more frequent. Tell your doctor if this happens. The dose of your anti-Parkinson's medicine may need to be changed.
- Skin site reactions. Skin reactions may occur at the site where you apply NEUPRO. Tell your doctor if you get a rash, redness, swelling, or itching that will not go away at the skin site where you have applied NEUPRO.
- Withdrawal symptoms. NEUPRO is a dopamine agonist medicine. Dopamine agonist medicines, including NEUPRO, can cause withdrawal symptoms as your dose is slowly lowered (tapered) or when treatment with NEUPRO is stopped. Tell your doctor right away if you get any of the following withdrawal symptoms: • fever • confusion • severe muscle stiffness • feeling like you do not care about the things you usually care about (apathy) • anxiety • depression • fatigue • insomnia • sweating • pain
Common side effects
The most common side effects of NEUPRO for Parkinson's disease are:
- Application site reactions
- Loss of appetite
- Difficulty falling asleep and staying asleep
- Increased sweating
- Vision problems
- Leg swelling
- Uncontrolled, sudden movements of arms or legs
In some cases, patients using the NEUPRO Patch experienced localized redness, swelling, or itching where the patch was applied. Rotating the application site daily can reduce the chance of skin reactions. For more details, see Applying the NEUPRO Patch.
Patients should report application site reactions that do not go away after a few days, that get worse, or that spread outside the patch site. If there is a skin rash or irritation from the patch, direct sunlight on the area should be avoided until the skin heals. Exposure could lead to changes in skin color.
These are not all the possible side effects of NEUPRO. For more information, ask your doctor or pharmacist. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. You may also report side effects to UCB, Inc. at ucbCARES® (1-844-599-2273).
Important information to tell your doctor
Before you start using NEUPRO, tell your doctor if you:
- Have breathing problems, including asthma
- Have daytime sleepiness from a sleep disorder or have unexpected or unpredictable sleepiness or periods of sleep
- Have mental problems such as schizophrenia, bipolar disorder, or psychosis
- Feel dizzy, nauseated, sweaty, or faint when you stand up from sitting or lying down
- Drink alcoholic beverages. This may increase your chances of becoming drowsy or sleepy while using NEUPRO
- Have high or low blood pressure
- Have or have had heart problems
- Are pregnant or plan to become pregnant. It is not known if NEUPRO will harm your unborn baby
- Are breastfeeding or plan to breastfeed. It is not known if NEUPRO passes into your breast milk. You and your doctor should decide if you will use NEUPRO or breastfeed. You should not do both
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
NEUPRO and other medicines may affect each other, causing side effects. NEUPRO may affect the way other medicines work, and other medicines may affect how NEUPRO works.
Especially tell your doctor if you take other medicines that can make you sleepy, such as sleep medicines, antidepressants, or antipsychotics.
Know the medicines you take. Keep a list of them to show your doctor and pharmacist when you get a new medicine.