Reduce concomittant levodopa dose, Antiarrhythmics , CNS depressants, phenothizines, butyrophenones, Drugs affecting CYP1A2 such as ciprofloxacin, Cigerrete smoking, high dose ostrogens, HRT, alcohol, Other dopamine agonists metoclopramide, fluvoxamine, enoxacin, sulpride

Parkinsons disease

GI upset, dyspepsia, pharyngitis, Constipation, pain, Sweating, headache, Somnolence, fatigue, asthenia, Nausea, dizziness, Abnormal vision, arthalgia, Aggravated symptoms of Parkinsonism, Tremors, anxiety, nervousness,

Dry mouth, leg edema, Syncope, hypotension, bradycardia, Dyskinesia, hypokinesia, Paraesthesisia, confusion,hallucinations, Compulsive gambling, Sudden onset of sleep ( warn patients ) Pathological gambling, Increased libido

Severe renal or hepatic impairment

Pregnancy,lactation Special precaution- Severe cardiovascular disease. Psychoses, neuroleptic induced akasthesia, Dyskinesia, sleep disorders Withdraw gradually.

Consider discontinuing if excessive day time sleepiness or if sudden onset of sleep during daiy activities occur.

Elderly may have higher risk of hallucinations Melonoma

Dose - Adult- Week 1 - 0.25mg three times daily Week 2 - 0.5mg three times daily Week 3 - 0.75mg three times daily Week 4 - 1mg three times daily All with meals

If necessary continue to titrate in weekly intervals of upto 3mg daily Symptom control may be seen at 3-9mg daily, Maximum 24mg daily Restless leg syndrome- Initially 0.25mg once daily at bed time for 2 days If well tolerated increase to 0.5mg once daily for remainder of week.

Increase if required by 0.5mg per week to usual dose of 2mg daily Maximum- 4mg daily Not recommended for patients below 18 years

To be taken with meals

Contraindicated for use during pregnancy and lactation.

Observe caution if use is required