Ipinnia XL (ropinirole hydrochloride) FDG

For UK healthcare professionals only.

This formulary decision guide was commissioned by Ethypharm and developed from content provided by Ethypharm in a format developed by Guidelines in Practice.

View prescribing and adverse event reporting information

Key points

  • Ipinnia XL is bioequivalent to ReQuip® XL1
  • Prescribing branded Ipinnia XL saves the NHS 55% compared to ReQuip XL2,3
  • Ipinnia XL offers flexibility in dose-titration options and may help to reduce the pill burden for patients.4

Download a PDF of this formulary decision guide

Product name

Ipinnia® XL prolonged-release tablets

Indication

Ipinnia XL is indicated in the treatment of Parkinson’s disease under the following conditions:4

  • initial treatment as monotherapy, in order to delay the introduction of levodopa 
  • in combination with levodopa, over the course of the disease, when the effect of levodopa wears off or becomes inconsistent and fluctuations in the therapeutic effect occur (“end of dose” or “on-off” type fluctuations).

Dosage and administration

Individual dose titration against efficacy and tolerability is recommended4

  • Starting dose: 2 mg once daily for the first week, increasing to 4 mg once daily from the second week4
  • Patients should be maintained on the lowest dose that achieves symptomatic control4
  • If sufficient symptomatic control is not achieved or maintained at 4 mg once daily, the daily dose may be increased by 2 mg at weekly or longer intervals up to 8 mg once daily4
  • If sufficient symptomatic control is still not achieved or maintained, daily dose may be increased by 2–4 mg at two-weekly or longer intervals; maximum daily dose 24 mg4
  • Elderly: no dose adjustment required but dose should be individually titrated, with careful monitoring of tolerability, to the optimal clinical response4
  • Children and adolescents (<18 years): not recommended
  • Renal impairment: no dose adjustment necessary for patients with mild to moderate renal impairment (creatinine clearance 30–50 ml/min); dose adjustment required in patients with end stage renal disease (patients on haemodialysis); lack of data in severe renal impairment (creatinine clearance <30 ml/min) without haemodialysis4
  • Hepatic impairment: not recommended4
  • For further information on dosage and administration, please refer to the summary of product characteristics.4

Bioequivalence

  • Bioequivalence of ropinirole prolonged-release tablets to ReQuip® XL prolonged-release tablets was proven in a steady-state, randomised, open-label, three-way replicate, comparative bioequivalence study of 8 mg doses under fasting conditions; healthy male and female volunteers; n=28.1

Available strengths 

  • Ipinnia XL prolonged-release tablets are available in a wide range of dose strengths, including two unique strengths—3 mg and 6 mg;3,4
  • This range offers flexibility in dose-titration regimens

Ipinnia prolonged-release tablets

Tablets shown are not to scale.

  • More prescribing options may help to reduce the pill burden for patients.

Ipinnia prolonged-release tablets 2

Tablets shown are not to scale.

Budgetary implications

  • When prescribed by brand, Ipinnia XL can give significant cost savings of 55% compared to a generic prescription for 2, 4, and 8 mg doses2,3
  • If Ipinnia XL were to be prescribed instead of generic ropinirole prolonged-release tablets or ReQuip XL across all strengths, then the NHS could potentially save £2.86 million per annum.5

Pack size: 28 

2 mg

3 mg 

4 mg

6 mg

8 mg

Ipinnia XL (Ethypharm)3

£5.64

£8.46

£11.29

£15.32

£18.95

Ralnea XL (Consilient Health)3

£10.65

£21.32

£35.79

Raponer XL (Accord Healthcare)3

£12.54

£25.09

£42.11

ReQuip XL (GlaxoSmithKline)3

£12.54

£25.09

£42.11

Repinex XL (Aspire Pharma)3

£6.20

£12.50

£21.00

Ropinirole modified release tablets (Mylan)3

£10.66

£21.33

£35.79

Ropiqual XL (Milpharm)3

£12.54

— 

£25.09

£42.11

Spiroco XL (Teva UK)3

£18.94

Warnings and precautions

  • Due to the risk of hypotension, blood pressure monitoring is recommended, particularly at the start of treatment, in patients with severe cardiovascular disease
  • Patients should be regularly monitored for the development of impulse control disorders
  • Dopamine agonist withdrawal syndrome has been reported with dopamine agonists, including ropinirole
  • For a full list of warnings and precautions, please refer to the summary of product characteristics.4

Undesirable effects

  • In monotherapy:4
    • Very common (≥1/10): somnolence, nausea 
    • Common (≥1/100 to <1/10): hallucinations, dizziness (including vertigo), sudden onset of sleep, constipation, peripheral oedema
  • In adjunct therapy (to levodopa):4
    • Very common (≥1/10): dyskinesia—in patients with advanced Parkinson’s disease, dyskinesias can occur during the initial titration of ropinrole; in clinical trials, it was shown that a reduction of the levodopa dose may ameliorate dyskinesia 
    • Common (≥1/100 to <1/10): hallucinations, somnolence, dizziness (including vertigo), sudden onset of sleep, postural hypotension, hypotension, nausea, constipation, peripheral oedema
  • For a full list of undesirable effects, please refer to the summary of product characteristics.4

Contraindications

  • Hypersensitivity to the active substance or to any excipients; severe renal impairment (creatinine clearance <30 ml/min) without regular haemodialysis; hepatic impairment.4

References

  1. Ethypharm data on file; Ropinirole bioequivalence data.
  2. NHS Business Services Authority, Drug Tariff part VIIIA. September 2021.
  3. British National Formulary: ropinirole. Available at: www.bnf.nice.org.uk/medicinal-forms/ropinirole.html (last accessed September 2021).
  4. Martindale Pharma. Ipinnia XL prolonged-release tablets—summary of product characteristics. Available at: www.medicines.org.uk/emc
  5. Ethypharm data on file; Ipinnia NHS savings potential May-21.

UK-IPN-12

Date of preparation: September 2021