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Ropinirole involved in a fatal case: blood and urinary concentrations

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Abstract

Purpose

Ropinirole is an antiparkinsonian  drug and has recently been suggested to be effective in amyotrophic lateral sclerosis. It is expected that ropinirole prescriptions will increase in the near future. However, the fatal concentration in blood is unclear at this time. Therefore, we report a fatal case involving ropinirole intoxication and discuss the fatal concentrations with reference to several autopsy cases involving ropinirole.

Methods

Ropinirole was quantified in femoral vein blood, cardiac blood, and urine from five autopsy cases in which ropinirole was detected by drug screening in our laboratory. One is a ropinirole intoxication case (this report) and the others  were non-intoxication cases. Their ropinirole concentrations were compared and discussed.

Results

The ropinirole concentration in this case was 100 ng/mL in femoral blood, 160 ng/mL in cardiac blood, and 1840 ng/mL in urine. The ropinirole concentrations in the four non-ropinirole poisoning cases were 7–35 ng/mL (mean: 24 ng/mL) in femoral blood, 13–100 ng/mL (mean: 60 ng/mL) in cardiac blood, and 140–1090 ng/mL (mean: 640 ng/mL) in urine. Cardiac/peripheral ratios were in the range of 1.6–2.1 (mean 1.8).

Conclusions

There were no obvious signs of overdose, and the high cardiac/peripheral blood ratio suggested that postmortem redistribution may have occurred, but the  peripheral blood ropinirole concentration (100 ng/mL) was obviously higher than that reported in the previous fatal case of ropinirole poisoning (64 ng/mL). Based on these results, the cause of death in this case was considered to be shock and fatal arrhythmia due to ropinirole poisoning. This case provides important data on postmortem blood and urinary levels of ropinirole poisoning.

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Acknowledgements

We thank Vikas Narang, chief operating officer from  Editage for editing a draft of this manuscript.

Author information

Author notes

  1. Sayaka Nagasawa and Rutsuko Yamaguchi contributed equally.

Authors and Affiliations

  1. Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba, 260-8670, Japan

    Sayaka Nagasawa, Rutsuko Yamaguchi, Suguru Torimitsu, Fumiko Chiba, Daisuke Yajima, Go Inokuchi, Ayumi Motomura, Kei Kira, Yoshikazu Yamagishi & Hirotaro Iwase

  2. Laboratory of Forensic Toxicology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba, 260-8670, Japan

    Sayaka Nagasawa & Yasumitsu Ogra

  3. Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Rutsuko Yamaguchi, Kanju Saka, Suguru Torimitsu, Fumiko Chiba, Kei Kira & Hirotaro Iwase

  4. Department of Forensic Medicine, Graduate School of Medicine, International University of Health and Welfare, Kozunomori 4-3, Narita, 286-8686, Japan

    Daisuke Yajima & Ayumi Motomura

  5. Laboratory of Toxicology and Environmental Health, Graduate School of Pharmaceutical Sciences, Chiba University, Chuo-ku, Chiba, 260-8675, Japan

    Yoshikazu Yamagishi & Yasumitsu Ogra

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  1. Sayaka Nagasawa
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Correspondence to Sayaka Nagasawa.

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All the procedures performed in this study were in accordance with the ethical standards set by our institutional review board, and the 1964 Helsinki declaration and its later amendments.

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Nagasawa, S., Yamaguchi, R., Saka, K. et al. Ropinirole involved in a fatal case: blood and urinary concentrations. Forensic Toxicol 40, 173–179 (2022). https://doi.org/10.1007/s11419-021-00593-8

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  • DOI: https://doi.org/10.1007/s11419-021-00593-8

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