ROTIGOTINE PATCH TREATMENT FOR PARKINSONS DISEASE

10 December, 2016

ROTIGOTINE PATCH TREATMENT FOR PARKINSONS DISEASE

By SAMUEL D. MOORE

Rotigotine is a dopamine agonist.  It is used as a dopamine supplement in the treatment of Parkinson’s Disease symptoms.  Unlike levodopa, it is used as a substitute for the deficiency of dopamine which is believed to be a factor in the PD symptoms.  Levodopa is a precursor to dopamine that is converted to dopamine as it penetrates the brain cell barrier.

The delivery system for the Rotigotine is a derma patch (Neupro patch) which supplies a more consistent flow of medication than the system used for other medications.  This method is used to minimize the wide fluctuations in the delivery of the medication.  For instance levodopa is delivered in instant release or controlled release tablets.  The result is a profile of blood concentration with peaks and valleys that are thought to exaggerate dyskinesia.  The goal is to provide a smooth flow of fuel for firing the synapses.  

The rate of delivery of Rotigotine is determined by the total medication in the patch and the surface area of the patch in contact with the skin.  The 4 mg. Neupro patch, I am using, supplies 4 mg. of medication in 24 hours.  To achieve this, the patch starts off with 8.89 mg. of medication. At the end of 24 hours, the patch still contains 4.49 mgs. of Rotigotine.

I have seen on the internet that some patients, in an attempt to save money, change the patch every 48 hours instead of the prescribed 24 hours.  On the surface, this looks like a good way to save on resources.  However, because of the short elimination half life of the Rotigotine, very little of the 4.49 mgs. is effective. Instead, it passes through the system without adding a significant amount to the medication’s blood concentration.  

The blood concentration averages about 25% of the 4 mg. level. The peak concentration after stabilization occurs shortly after the patch is changed, then it tapers off during the 24 hours.

I started Rotigotine with doctor’s samples.  For several months, I received a months supply, for $10.00., using a coupon, not realizing that the cost was driving me into the “donut hole”.  When I found out the cost of a month’s supply, I realized I could not afford it, so I dropped it.  Since then, I have received a free supply of the medication from the UCB Patient Assistance Program.

Tomorrow, 11 December, 2016,  is the first anniversary of this blog.  It has received 500 hits, 0 Likes, 0 Dislikes, 0 Criticisms.   It has been a disappointment, but I have learned a lot, mostly about what I had forgotten and what I thought I knew.   I also started with a lot of misconceptions.  I wish I had started this journey earlier.