Requip® is a prescription product approved for the treatment of restless leg syndrome (RLS) and appears to be safe to use with patients taking warfarin. While no large scale clinical trials have been conducted on warfarin patients; the package insert along with post-marketing evaluations have not suggested a significant interaction with warfarin.

GlaxoSmithKline, makers of Requip, provided only one instance where an elevated INR was associated with the initiation of Requip. An increase in INR test result to 4.6 nine days after Requip was reported in a Parkinson ’s disease patient. The patient’s INR returned to baseline upon discontinuation of Requip.

Patients with restless leg syndrome should be able to take Requip safely with warfarin. More frequent testing is always recommended when initiating a new medication to ensure warfarin compatibility.

Patients may experience marked drowsiness and dizziness making patients unsteady and at risk of falling. Patients should be instructed to take Requip immediately before bedtime. Patients should also use the bathroom before bed to reduce the need to get up in the middle of the night when falling risks increase.

Patient self-testing is a safe and proven technique to increase testing frequency. Weekly testing patients identify drug-drug interactions sooner than patients who test monthly. Patient home testing is complimentary to routine physician care.

QAS would like to thank the medical affairs department of GlaxoSmithKline for their support in providing information on Requip.