Reactions 1318 - 11 Sep 2010

SRopinirole

Atrial fibrillation: 2 case reportsTwo men with Parkinson’s disease (PD) developed atrial

fibrillation (AF) after inadvertent administration ofstandard-formulation ropinirole [Requip] instead of anextended-release formulation [Requip XR; routes,frequencies and times to onset not stated].

Following a switch from pramipexole to extended-release ropinirole, which was titrated from 2mg to 8mg, a52-year-old man developed parossistic AF. He washospitalised and the ropinirole dose was reduced to 2mg.However, he was erroneously administered 2mg ofstandard-formulation ropinirole causing syncope due toasystole. He was treated with atropine and chestcompressions, with rapid restoration to sinus rhythm.

A 65-year-old man was switched from pramipexole toextended-release ropinirole 2mg for PD. Following anerroneous intake of 2mg of standard-formulationropinirole, he exhibited dizziness, sweating and fatigue.Following hospitalisation, AF was detected and treated withamiodarone.

Neither patient had a history of cardiac symptoms; ECGand echocardiogram were normal before startingantiparkinsonian therapy. Tests performed 72 hours afterropinirole withdrawal were normal, and both patients wereswitched to levodopa without any reported adverse effectsafter 6 months.

Author comment: "The close temporal relationshipbetween the [standard formulation] ropinirole administrationand the onset of arrhythmias suggest a possible triggeringeffect likely due to a fast drug titration."Di Giacopo R, et al. Rare and serious cardiac side effects during ropiniroletitration. Movement Disorders 25: 1509-1510, No. 10, 30 Jul 2010. Availablefrom: URL: http://dx.doi.org/10.1002/mds.23115 - Italy 803037424

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Reactions 11 Sep 2010 No. 13180114-9954/10/1318-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved