Always use Neupro exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
Neupro is generally used as a long term treatment. Normally, you will start your treatment with a low dose and, if necessary, increase it week by week, as told by your doctor, until reaching the right dose for you. You will then continue treatment with this dose, also called the maintenance dose.
You should change your Neupro patch once a day. For reaching the needed doses, different patches of Neupro are available, each releasing a different amount of the active substance per day: 2 mg/24h, 4 mg/24h, 6 mg/24 h and 8 mg/24 h. For higher doses, multiple patches must be applied. For example a daily dose of 10 mg may be reached by applying one patch of 6 mg/24 h and one patch of 4 mg/24 h.
Treatment of Parkinson?s diseasePatients not taking levodopa (early stage of Parkinson?s disease)
You will start by using one Neupro 2 mg/24 h patch daily. From the second week, the daily dose will be increased by 2 mg, on a weekly basis, until reaching the right (maintenance) dose for you. For most patients, the right dose is between 6 mg and 8 mg per day (reached within 3 to 4 weeks). The maximum dose is 8 mg per day.
Patients taking levodopa (advanced stage of Parkinson?s disease)
You will start by using one Neupro 4 mg/24 h patch daily. From the second week, the daily dose will be increased by 2 mg, on a weekly basis, until reaching the right (maintenance) dose for you. For most patients, the right dose is between 8 mg and 16 mg per day (reached within 3 to 7 weeks). The maximum dose is 16 mg per day.
If you have to stop taking this medicine, see Section 3, ?If you stop using Neupro?.
FOLLOW THESE INSTRUCTIONS WHEN USING NEUPRO:
You should stick a new Neupro patch onto the skin once a day. Leave the patch on your skin for 24 hours, then remove it and apply a new one. Make sure that you take the old patch off before applying a new one; place the new patch on a different area of skin.
You should change your patch at around the same time every day.
Do not cut the Neupro patches into pieces.
Where to stick the patch
Put the sticky side of the patch onto clean, dry, healthy skin on the following areas, as indicated by the grey areas in the picture shoulder upper arm belly thigh hip flank your side, between your ribs and your hip.
To help avoid skin irritation:
- Stick the patch onto a different area of skin each day, for example on the right side of your body one day, then on the left side the next day; on your upper body one day, then on your lower body.
- Do not stick Neupro on the same area of skin twice within 14 days.
- Do not stick the patch on broken or damaged skin or on skin that is red or irritated. If you still get problems with your skin because of the patch, please see in Section 4 ?Possible side effects? the details about what you should do.
To prevent the patch becoming loose or falling off
- Do not put the patch in an area where it can be rubbed by tight clothing.
- Do not use creams, oils, lotions, powders or other skin products on the area of skin you will be sticking the patch on or near a patch you are already wearing.
- If you need to stick the patch to a hairy area of skin, you must shave the area at least 3 daysbefore sticking the patch there. If the patch falls off, a new patch should be applied for the rest of the day, then replace the patch at the same time as usual.
- Bathing, showering and exercising should not affect how Neupro works. Nevertheless, check that the patch has not fallen off afterwards.
- You should avoid external heat (for example excessive sunlight, saunas, hot baths heating pads or hot-water bottles) on the area of the patch.
- If the patch has irritated your skin, you should keep that area protected from direct sunlight, as it may cause changes in the colour of the skin.
How to use the patch
Each patch is packed in a separate sachet. You should stick Neupro onto your skin as soon as you have opened the sachet and removed the protective liner.
1. To open the sachet, hold the two sides of the sachet. Peel apart the foil and open the sachet. 2. Take the patch out of the sachet.
3. The sticky side of the patch is covered by a transparent protective liner. Hold the patch in both hands with the protective liner facing you. 4. Bend the patch in half so that the S-shaped break in the liner opens. 5. Peel off one side of the protective liner. Dont touch the sticky side of the patch with your fingers. 6. Hold the other half of the rigid protective liner and put the sticky surface of the patch onto your skin. Press the sticky side of the patch firmly into place. 7. Fold back the other half of the patch and remove the other side of the protective liner. 8. Press the patch down firmly with the palm of your hand for about 20 to 30 seconds to make sure the patch is touching the skin and the edges stick well.
Wash your hands with soap and water immediately after handling the patch.
How to remove a used patch
Slowly and carefully peel off the used patch.
Gently washing the area with warm water and mild soap should remove any adhesive that stays on your skin after you remove the patch. You can also use a small amount of baby oil to remove any adhesive that won?t wash off.
Do not use alcohol or other dissolving liquids such as nail polish remover as these may irritate your skin.
Choose a new area of skin where you will apply a new patch, then follow the instructions above.
If you use more Neupro than you should
Using higher doses of Neupro than your doctor has prescribed may cause side effects such as nausea (feeling sick), vomiting, low blood pressure, hallucinations (seeing or hearing things that are not real), confusion or extreme sleepiness.
If you have used more patches than your doctor told you to, remove the extra patches and contact yourdoctor or hospital for advice immediately.
If you have forgotten to change the patch at the usual time
If you have forgotten to change the patch at your usual time, change it as soon as you remember: remove the old patch and use a new one. If you have forgotten to stick on a new patch after removing the old one, use a new patch as soon as you remember.
In both cases, on the following day you should use a new patch at the usual time. Do not use a double dose to make up for a forgotten dose.
If you stop using Neupro
Do not stop using Neupro suddenly without talking to your doctor. A sudden stop could cause you to develop a medical condition called neuroleptic malignant syndrome which may represent a major health risk. The symptoms include: akinesia (loss of muscle movement), rigid muscles, fever, unstable blood pressure, tachycardia (increased heart rate), confusion, depressed level of consciousness (e.g. coma).
Your daily dose of Neupro should be reduced gradually
- by 2 mg every other day - if you use Neupro for Parkinson?s disease
If you have any further questions on the use of this product, ask your doctor or pharmacist.