Ropinirole

Key facts

• Ropinirole is a dopamine agonist that mimics dopamine in the brain to improve movement control in Parkinson's disease and to ease the urge to move the legs in restless legs syndrome.
• It is started at a low dose and increased gradually over weeks, since higher starting doses cause more nausea and dizziness.
• Ropinirole can cause sudden episodes of falling asleep without warning, including while driving, and can trigger impulse control problems such as compulsive gambling, shopping, eating, or sexual behavior.
• Seek urgent care for fainting, distressing hallucinations, or if you or your family notice new compulsive behaviors.

What Ropinirole treats

Ropinirole treats the motor symptoms of Parkinson's disease, such as tremor, stiffness, and slow movement, and it treats moderate to severe restless legs syndrome. It does not slow or reverse the underlying nerve damage in Parkinson's disease; it manages symptoms.

How Ropinirole works

Parkinson's disease and restless legs syndrome both involve reduced dopamine signalling in parts of the brain that control movement. Ropinirole binds directly to dopamine receptors and activates them in place of the body's own dopamine, restoring more normal signalling and easing tremor, stiffness, and the urge to move the legs.

Before you take it

• Tell your prescriber about any history of compulsive behavior, impulse control problems, or psychosis, since ropinirole can trigger or worsen these.
• Ropinirole can cause sudden sleep episodes with no warning beforehand; use caution or avoid driving until you know how it affects you.
• Tell your prescriber about low blood pressure, fainting, kidney disease, or a history of heart problems.
• CYP1A2 inhibitors, such as some antibiotics, and oestrogen-containing medicines can raise ropinirole levels; smoking can lower them.

Side effects

Common effects include nausea, dizziness, drowsiness, and swelling of the legs or ankles.

Seek urgent care for:

• Falling asleep suddenly with no warning, especially while driving.
• New compulsive gambling, shopping, eating, or sexual behavior.
• Fainting, hallucinations, or severe confusion.

Safety essentials

• Ropinirole can cause sudden sleep attacks without warning signs, and impulse control disorders such as compulsive gambling, hypersexuality, or compulsive shopping; tell your prescriber immediately if these occur, since dose reduction or stopping the drug may be needed.
• Doses are increased gradually; do not raise your dose faster than instructed, since this increases side effects.
• Do not stop ropinirole abruptly if you have Parkinson's disease. Talk to your prescriber about tapering, since sudden withdrawal can cause severe symptoms.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.