Neupro Dosage/Direction for Use

Patients should always use this medicine exactly as told by their doctor or pharmacist. Patients should check with their doctor or pharmacist if they are unsure.
Which strength patches to use: The dose of Neupro will depend on the illness (see as follows).
Neupro is available in different strength patches which release the medicine over 24 hours. The strengths are 2 mg/24 h, 4 mg/24 h, 6 mg/24 h and 8 mg/24 h for the treatment of Parkinson's disease.
More than one patch may have to be used to reach the dose, as prescribed by the doctor. For prescribed doses higher than 8 mg/24 h, multiple patches must be applied to achieve the final dose. For example, a daily dose of 10 mg/24 h may be reached by applying one patch of 6 mg/24 h and one patch of 4 mg/24 h.
The patches should not be cut into pieces.
Treatment of Parkinson's disease: Patients not taking levodopa - early stage of Parkinson's disease: The starting daily dose will be one 2 mg/24 h patch each day. From the second week, the daily dose may be increased by 2 mg each week until the right maintenance dose is achieved. For most patients, the right dose is between 6 mg and 8 mg each day. This is normally reached within 3 to 4 weeks. The maximum dose is 8 mg each day.
Patients taking levodopa - advanced stage of Parkinson's disease: The starting daily dose will be one 4 mg/24 h patch each day. From the second week, the daily dose will be increased by 2 mg each week until the right maintenance dose is achieved. For most patients, the right dose is between 8 mg and 16 mg each day. This is normally reached within 3 to 7 weeks. The maximum dose is 16 mg each day.
If this medicine has to be stopped, see If the patient stops using Neupro as follows.
Where to stick the patch: Put the sticky side of the patch onto clean, dry, healthy skin on the following areas: Shoulder or upper arm; Belly; Flank; Thigh or hip. Make sure to take the old patch off before putting on a new one. Stick the new patch on a different area of the skin each day. Leave the patch on the skin for 24 hours, then take it off and put on a new one. Change the patches at about the same time every day.
To avoid skin irritation: Stick the patch onto a different area of skin each day. For example, put it on the right side of the body one day, then on the left side of the body the next day; or on the upper body one day, then on the lower body the day after that.
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.
In case of problems with the skin because of the patch, see Skin problems caused by the patch under Side Effects for more information.
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 where the patch will be applied. Also do not use them on or near a patch already on the skin.
If the patch needs to be applied to a hairy area of skin, the area must be shaven at least 3 days before sticking the patch there.
If the edges of the patch lift, the patch may be taped down with adhesive medical tape.
If the patch falls off, put on a new patch for the rest of the day, then replace the patch at the usual time.
Do not let the area of the patch get hot (for example too much sunlight, saunas, hot baths, heating pads or hot-water bottles). This is because the medicine may be released faster. Patients should seek medical advice if they think that too much heat has been applied.
Always check that the patch has not fallen off after activities such as bathing, showering or exercising.
If the patch has irritated the skin, keep that area protected from direct sunlight. This is because it may change the colour of the skin.
How to use the patch: Each patch is packed in a separate sachet. Before opening the sachet, decide where to stick this new patch and check that any old patch has been removed. Stick the Neupro patch onto the skin as soon as the sachet has been opened and the release liner has been removed.
1. To open the sachet, hold the sachet in both hands.
2. Peel apart the foil.
3. Open the sachet.
4. Take the patch out of the sachet.
5. The sticky side of the patch is covered by a transparent release liner. Patients should hold the patch in both hands with the release liner facing them.
6. Bend the patch in half. This makes the S-shaped break in the liner open up.
7. Peel off one side of the release liner. Do not touch the sticky side of the patch with the fingers.
8. Hold the other half of the rigid release liner. Then put the sticky half of the patch onto the skin. Press the sticky side of the patch firmly into place.
9. Fold back the other half of the patch and remove the other side of the release liner.
10. Press the patch down firmly with the palm of the hand. Keep it pressed for about 30 seconds. This makes sure the patch is touching the skin and the edges stick down well.
11. Wash hands with soap and water straight after handling the patch.
How to take off a used patch: Slowly and carefully peel off the used patch.
Gently wash the area with warm water and mild soap. This will remove any stickiness that stays on the skin. A little baby oil can also be used to remove any stickiness that will not wash off.
Do not use alcohol or other dissolving liquids such as nail polish remover. These may irritate the skin.
If the patient forgets to change the patch at the usual time: If the patient has forgotten to change the patch at the usual time, it has to be changed as soon as the patient remembers. The old patch should be taken off and a new one should be used.
If the patient has forgotten to stick on a new patch after removing the old one, a new patch should be used as soon as the patient remembers.
In both cases, use a new patch at the usual time on the following day. Do not use a double dose to make up for a forgotten dose.
If the patient stops using Neupro: Do not stop using Neupro without talking to the doctor. A sudden stop could lead to neuroleptic malignant syndrome which could be life-threatening. The signs include: akinesia, rigid muscles, fever, unstable blood pressure, tachycardia, confusion, low level of consciousness (such as a coma).
If the doctor advises to stop Neupro, the daily dose should be lowered gradually (lowered by 2 mg every other day).
In case of any further questions on the use of this medicine, patients should seek medical advice.