Ropinirole Ciprofloxacin

ROPINIROLE CIPROFLOXACIN t ropinirole levels Inhibition of CYP1 A2-mediated metabolism Watch for early features of toxicity (nausea, drowsiness)... 

During co-administration of ciprofloxacin with ropinirole in 12 patients there was an increase in the plasma ropinirole concentration, which is metabolized by CYP1A2 (82). 

Ciprofloxacin, an inhibitor of CYP1A2, the major enzyme whereby ropinirole is metabolized, increased the risk of ropinirole-induced adverse effects (nausea, somnolence, dizziness) (8). 

Ciprofloxacin increased the AUC of ropinirole by 84%, and other CYP1A2 inhibitors are predicted to interact similarly. Ropinirole dose adjustment may be required if potent CYP1A2 inhibitors are started or stopped. 

Ciprofloxacin 500 mg twice daily increased the AUC of ropinirole 2 mg three times daily by 84% and increased the maximum plasma level by 60% in a study in 12 patients. ... 

Ropinirole is principally metabolised by the cytochrome P450 isoenzyme CYP1A2, of which ciprofloxacin is a known inhibitor. 

Although the clinical relevance of this pharmacokinetic interaction has not been assessed, it would seem possible that the effects of ropinirole may be increased. The manufacturers suggest that if therapy with a known potent inhibitor of CYP1A2 is stopped or started during therapy with ropinirole, adjustment ofthe ropinirole dose may be required. The UK manufacturer specifically mentions cimetidine and fluvoxamine in addition to ciprofloxacin. For a full list of CYP1A2 inhibitors, see Table 1.2 , (p.4). 

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