Fertility may be restored by treatment with NORPROLAC. Women of child- bearing age who do not wish to conceive should therefore be advised to practice a reliable method of contraception. Since orthostatic hypotension may result in syncope, it is recommended to check blood pressure both lying and standing during the first days of therapy and following dosage increases.
In a few cases, including patients with no previous history of mental illness, treatment with NORPROLAC has been associated with the occurrence of acute psychosis, usually reversible upon discontinuation. Particular caution is required in patients who have had psychotic episodes in their previous history.
3 Contraindications). NORPROLAC has been associated with somnolence. Other dopamine agonists can be associated with sudden sleep onset episodes, particularly in patients with Parkinson’s disease. Patients must be informed of this and advised to exercise caution whilst driving or operating machines during treatment with NORPROLAC.
Patients who have experienced somnolence must not drive or operate machines. 7 Effects on the ability to drive and use machines). Impulse control disorders Patients should be regularly monitored for the development of impulse control disorders.
Patients and carers should be made aware that behavioural symptoms of impulse control disorders including pathological gambling, increased libido, hypersexuality, compulsive spending or buying, binge eating and compulsive eating can occur in patients treated with dopamine agonists including NORPROLAC.
Dose reduction/tapered discontinuation should be considered if such symptoms develop. Dopamine agonist withdrawal syndrome (DAWS) has been reported following discontinuation of dopamine agonists. Non-motor adverse effects may occur when discontinuing dopamine agonists.
Symptoms which have been reported with other dopamine agonists include apathy, anxiety, depression, fatigue, sweating and pain which may be severe. When treatment with quinagolide is stopped there is a possible risk that DAWS may occur in some patients.
Patients could therefore benefit from tapering of the quinagolide dose. NORPROLAC should be kept out of the reach and sight of children.