Since Neupro is a transdermal system, overdosing is not likely to occur in clinical practice unless patients forget to remove the previous day's transdermal system; patients should be advised regarding this possibility.

Overdose Symptoms

The most likely symptoms of overdose 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 excessive dopaminergic stimulation.

Overdose Management

There is no known antidote for overdosage of dopamine agonists. In case of suspected overdose, the excess transdermal system(s) should immediately be removed from the patient. Concentrations of rotigotine decrease after patch removal. The terminal half-life of rotigotine is 5 to 7 hours. The pharmacokinetic profile showed a biphasic elimination with an initial half- life of 3 hours. If it is necessary to discontinue use of rotigotine after overdose, it should be discontinued gradually to prevent neuroleptic malignant syndrome [see WARNINGS AND PRECAUTIONS]. The daily dose should be reduced by 2 mg/24 hours for Parkinson's disease patients and 1 mg/24 hours for RLS patients with a dose reduction preferably every other day, until complete withdrawal of rotigotine is achieved. Before completely stopping use of Neupro in the event of an overdose [see DOSAGE AND ADMINISTRATION].

The patient should be monitored closely, including heart rate, heart rhythm, and blood pressure. As shown in a study of renally impaired patients, dialysis is not expected to be beneficial. Treatment of overdose may require general supportive measures to maintain vital signs.

Neupro is contraindicated in patients who have demonstrated hypersensitivity to rotigotine or the components of the transdermal system.

Last reviewed on RxList: 4/13/2012
This monograph has been modified to include the generic and brand name in many instances.