How does this medication work? What will it do for me?

Ropinirole belongs to the class of medications called antiparkinsonian agents. It is used to treat the signs and symptoms of Parkinson's disease. It helps to improve muscle control and movement by affecting the balance of a chemical in the brain called dopamine.

Ropinirole may be used alone or in combination with another medication called levodopa, which is also used to treat Parkinson's disease. It may take several weeks for ropinirole to take effect.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

This medication is available as 0.25 mg, 1 mg, and 5 mg tablets.

How should I use this medication?

The recommended adult starting dose of ropinirole is 0.25 mg taken 3 times daily. The dose may be increased weekly up to a maximum of 8 mg taken 3 times daily as needed in individual circumstances.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.

Ropinirole may be taken with or without food. If nausea occurs, take the tablets with food to prevent stomach upset. The tablets should be swallowed whole and not chewed.

This medication should not be stopped suddenly. If you feel it is necessary to stop taking ropinirole, discuss the best way to do so with your doctor.

It is important to take this medication exactly as prescribed by the doctor. If you miss a dose of this medication, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you are allergic to ropinirole or any ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • decrease in sexual desire or performance
  • diarrhea
  • dry eyes
  • headache
  • heartburn
  • nausea
  • sleepiness
  • tremor
  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abdominal pain
  • confusion
  • extreme sleepiness
  • falling asleep without warning
  • hallucinations (seeing, hearing, or feeling things that are not there)
  • increased falls
  • lightheadedness or fainting, especially when standing up
  • personality changes (e.g., paranoia, agitation, anxiety, nervousness)
  • signs of anemia (low red blood cells; e.g., pale skin, unusual tiredness or weakness)
  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities)
  • swelling of legs
  • trouble swallowing
  • twisting, twitching, or other unusual body movements
  • unusual tiredness or weakness
  • vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Behaviour changes: Ropinirole can cause behaviour changes that may include being unable to control certain behaviours such as gambling. Personality changes may also occur, including paranoia, anxiety or nervousness, or a sense of not being oneself.

If you experience changes in behaviour or are aware of these changes happening in someone who is taking ropinirole, contact the doctor as soon as possible.

Breathing problems: Ropinirole has been known to cause scarring or thickening of the tissues in the abdomen, including the lungs and heart. If you experience any difficulty breathing or chest pain, contact your doctor as soon as possible.

Dizziness: Ropinirole may cause dizziness when getting up from a lying or sitting position to a standing position. This usually happens at the start of treatment or when the dose is being increased.

Hallucinations: Ropinirole causes hallucinations for about 5% of people who take it and for about 10% of people who take it at the same time as levodopa. The incidence of hallucinations increases as the dose increases. If you experience hallucinations or are aware of a person who is taking ropinirole experiencing hallucinations, contact the doctor as soon as possible.

Heart disease: This medication has not been studied for use by people with significant heart disease. If you have heart disease and are taking ropinirole, discuss with your doctor how this medication may affect your medical condition, and how your medical condition may affect the dosing and effectiveness of this medication. Your doctor will want to monitor your heart condition closely while you are taking ropinirole.

Kidney function: If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed

Liver function: The safety and effectiveness of ropinirole when used by people with reduced liver function has not been studied. Ropinirole is not recommended for people with reduced liver function.

Melanoma: People with Parkinson's disease may be at increased risk of developing melanoma (a type of skin cancer). It is not known if this increased risk is due to Parkinson's disease or to the medications used to treat Parkinson's disease. Your doctor will monitor you for skin cancer while you are taking this medication. Talk to your doctor if you have any concerns.

Neuroleptic malignant syndrome (NMS): As with other medications that have an effect on movement disorders, ropinirole can trigger a potentially fatal set of symptoms known as neuroleptic malignant syndrome (NMS). If you experience symptoms of NMS, such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, rapid or irregular heartbeat seek immediate medical attention.

This is more likely to occur if ropinirole is stopped suddenly or the dose is decreased rapidly. If you are considering stopping this medication, discuss the appropriate way to reduce ropinirole with your doctor.

Sudden onset of sleep: Ropinirole can cause the sudden, unpredictable onset of sleep. This can happen while participating in the daily activities of living, including driving or operating machinery. This effect may occur at any point while taking the medication.

Because there is no warning when or if this will occur, it is suggested that if you are taking ropinirole, you do not drive or operate dangerous machinery.

Pregnancy: The use of ropinirole during pregnancy is not recommended. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: Ropinirole reduces the production of breast milk, and therefore, should not be taken by women who wish to breast-feed.

Children: The safety and effectiveness of this medication have not been established for use by children.

What other drugs could interact with this medication?

There may be an interaction between ropinirole and any of the following:

  • abiraterone
  • alcohol
  • amlodipine
  • antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  • anti-psychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzepine, quetiapine, risperidone)
  • aripiprazole
  • baclofen
  • barbiturates (e.g., butalbital, pentobarbital phenobarbital)
  • benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
  • buspirone
  • carbamazepine
  • chloral hydrate
  • cyproterone
  • deferasirox
  • digoxin
  • estrogens (e.g., conjugated estrogen, estradiol, ethinyl estradiol)
  • efavirenz
  • fluvoxamine
  • fluoxetine
  • gabapentin
  • gemfibrozil
  • ketoconazole
  • lamotrigine
  • levetiracetam
  • levodopa
  • methylphenidate
  • metoclopramide
  • mexiletine
  • mirtazapine
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
  • muscle relaxants (e.g., cyclobenzaprine, methocarbamol, orphenadrine)
  • narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
  • olopatadine
  • phenobarbital
  • phenytoin
  • pimozide
  • primaquine
  • primidone
  • rifampin
  • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
  • scopolamine
  • tapentadol
  • topiramate
  • tramadol
  • tranylcypromine
  • vemurafenib
  • warfarin
  • zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.