Ropinirole

Ropinirole is a prescription medication used to treat Restless Legs Syndrome and Parkinson's disease. Ropinirole belongs to a group of drugs called dopamine agonists, which help the brain to control body movement.

This medication comes in tablet form and is taken with or without food. For restless legs syndrome, one tablet is taken once a day before bedtime. For Parkinson's disease, ropinirole is taken three times a day.

This medication also comes in an exteneded release tablet. For Parkinson's disease, it is taken once a day , with or without food. Swallow extended release tablets whole. Do not chew, crush, or divide extended release tablets.

Common side effects of ropinirole include nausea, dizziness, and drowsiness.  Do not drive or operate machinery until you know how ropinirole affects you.

Ropinirole immediate release tablets is a prescription medicine to treat Restless Legs Syndrome and Parkinson's disease.

Ropinirole extended release tablets is a prescription medicine used to treat the signs and symptoms of Parkinson's disease.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Ropinirole may be found in some form under the following brand names:

• Requip

• Requip XL

Restless Legs Syndrome

• Most people who take ropinirole tolerate it well. The most commonly reported side effects in people taking ropinirole for RLS are nausea, vomiting, dizziness, and drowsiness or sleepiness. You should be careful until you know if ropinirole affects your ability to remain alert while doing normal daily activities, and you should watch for the development of significant daytime sleepiness or episodes of falling asleep. It is possible that you could fall asleep while doing normal activities such as driving a car, doing physical tasks, or using hazardous machinery while taking ropinirole. Your chances of falling asleep while doing normal activities while taking ropinirole are greater if you are taking other medicines that cause drowsiness.
• When you start taking ropinirole or when you increase your dose, you may feel dizzy, nauseated, sweaty or faint, when first standing up from sitting or lying down. Therefore, do not stand up quickly after sitting or lying down, particularly if you have been sitting or lying down for a long period of time. Take a minute sitting on the edge of the bed or chair before you get up.
• Hallucinations (unreal sounds, visions, or sensations) have been reported in patients taking ropinirole. These were uncommon in patients taking ropinirole for RLS. The risk is greater in patients with Parkinson's disease who are elderly, taking ropinirole with L-dopa, or taking higher doses of ropinirole than recommended for RLS.

Parkinson's Disease

• Most people who take ropinirole tolerate it well. The most commonly reported side effects in people taking ropinirole are nausea, headache, dizziness, drowsiness or sleepiness.
• You should be careful until you know if ropinirole affects your ability to remain alert while doing normal daily activities, and you should watch for the development of significant daytime sleepiness or episodes of falling asleep. It is possible that you could fall asleep while doing normal activities such as driving a car, doing physical tasks, or using hazardous machinery while taking ropinirole. Your chances of falling asleep while doing normal activities while taking ropinirole are greater if you are taking other medicines that cause drowsiness.
• When you start taking ropinirole or when you increase your dose, you may feel dizzy, nauseated, sweaty or faint, when first standing up from sitting or lying down. Therefore, do not stand up quickly after sitting or lying down, particularly if you have been sitting or lying down for a long period of time. Take a minute sitting on the edge of the bed or chair before you get up.
• Hallucinations (unreal visions, sounds, or sensations) have been reported in patients taking ropinirole. The risk is greater in patients with Parkinson's disease who are elderly, taking ropinirole with L-dopa, or taking higher amounts of ropinirole.
• If you are taking L-dopa for Parkinson's disease, ropinirole may make some of the side effects of L-dopa worse. Ropinirole may cause uncontrolled sudden movements or make such movements you already have worse or more frequent.

Some patients taking ropinirole get urges to behave in a way unusual for them. Examples of this are an unusual urge to gamble or increased sexual urges and behaviors. If you notice or your family notices that you are developing any unusual behaviors, talk to your healthcare provider.

This is not a complete list of side effects and should not take the place of discussions with your healthcare providers. Your doctor or pharmacist can give you a more complete list of possible side effects.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• other dopamine antagonists (such as phenothiazines, butyrophenones, thioxanthenes and metoclopramide)
• estrogens
• ciprofloxacin

This is not a complete list of ropinirole drug interactions. Ask your doctor or pharmacist for more information.

Restless Legs Syndrome

• Patients with RLS should take ropinirole differently than patients with Parkinson's disease. A lower dose of ropinirole is generally needed for patients with RLS.
• There are known side effects of ropinirole. If you fall asleep or feel very sleepy while doing normal activities such as driving, faint, feel dizzy, nauseated, or sweaty when you stand up from sitting or lying down, you should talk with your doctor.
• Before starting ropinirole, be sure to tell your doctor if you are taking any medicines that make you drowsy.

You should not take ropinirole if you are allergic to the active ingredient ropinirole or to any of the inactive ingredients.

Parkinson's Disease

• Patients with Parkinson's disease should take ropinirole differently than patients with Restless Legs Syndrome. For Parkinson's disease, a higher dose of ropinirole is generally needed.
• There are known side effects of ropinirole.
• If you fall asleep or feel very sleepy while doing normal activities such as driving, faint, feel dizzy, nauseated, or sweaty when you stand up from sitting or lying down, you should talk with your doctor.
• Hallucinations (unreal visions, sounds, or sensations) have been reported in patients taking ropinirole. The risk is greater in patients with Parkinson's disease who are elderly, taking ropinirole with L-dopa or taking higher doses of ropinirole. If these occur, you should discuss them with your doctor.
• Ropinirole may make some of the side effects of L-dopa worse. Ropinirole may cause uncontrolled sudden movements or make such movements you already have worse or more frequent. You should notify your doctor in such a case as dosage adjustments to your anti-Parkinson’s medications may be necessary.
• Before starting ropinirole, be sure to tell your doctor if you are taking any medicines that make you drowsy.
• Studies of people with Parkinson’s disease show that they may be at an increased risk of developing melanoma, a form of skin cancer, when compared to people without Parkinson’s disease. It is not known if this problem is associated with Parkinson’s disease or the medicines used to treat Parkinson’s disease. Ropinirole is one of the medicines used to treat Parkinson’s disease, therefore, patients being treated with ropinirole should have periodic skin examinations.

Unusual urges: Some patients taking ropinirole get urges to behave in a way unusual for them. Examples of this are an unusual urge to gamble or increased sexual urges and behaviors. If you notice or your family notices that you are developing any unusual behaviors, talk to your healthcare provider.

You should not take ropinirole if you are allergic to ropinirole or to any of the inactive ingredients.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of ropinirole there are no specific foods that you must exclude from your diet when receiving ropinirole.

Be sure to tell your doctor if:

• you are pregnant or plan to become pregnant.
• you are breastfeeding.
• you have daytime sleepiness from a sleep disorder other than RLS or have unexpected sleepiness or periods of sleep while taking ropinirole.
• you are taking any other prescription or over-the-counter medicines. Some of these medicines may increase your chances of getting side effects while taking ropinirole.
• you start or stop taking other medicines while you are taking ropinirole. This may increase your chances of getting side effects.
• you start or stop smoking while you are taking ropinirole. Smoking may decrease the treatment effect of ropinirole.
• you feel dizzy, nauseated, sweaty, or faint when you stand up from sitting or lying down.
• you drink alcoholic beverages. This may increase your chances of becoming drowsy or sleepy while taking ropinirole.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if ropinirole is excreted in human breast milk or if it will harm your nursing baby.

Take ropinirole exactly as prescribed.

Restless Legs Syndrome

• Be sure to take ropinirole exactly as directed by your doctor or healthcare provider.
• The usual way to take ropinirole is once in the evening, 1 to 3 hours before bedtime.
• Your doctor will start you on a low dose of ropinirole. Your doctor may change the dose until you are taking the amount of medicine that is right for you to control your symptoms.
• If you miss your dose, do not double your next dose. Take only your usual dose 1 to 3 hours before your next bedtime.
• Contact your doctor, if you stop taking ropinirole for any reason. Do not restart without consulting your doctor.
• You can take ropinirole with or without food. Taking ropinirole with food may decrease the chances of feeling nauseated.

Parkinson's Disease

• Be sure to take your ropinirole exactly as directed by your doctor or healthcare provider.
• Your doctor will start you on a low dose of ropinirole. Your doctor will change the dose until you are taking the right amount of medicine to control your symptoms. It may take several weeks before you reach a dose that controls your symptoms.
• If you miss a dose, do not double your next dose.
• Contact your doctor, if you stop taking ropinirole for any reason. Do not restart without consulting your doctor.
• Your doctor may prescribe ropinirole alone or add ropinirole to medicine that you are already taking for Parkinson's disease.
• You can take ropinirole with or without food. Taking ropinirole with food may decrease the chances of feeling nauseated.
• If you are taking ropinirole extended-release tablets for Parkinson's, do not chew, crush, or divide tablets.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

Ropinorole immediate release tablets:

 

Parkinson’s Disease:

The recommended starting dose is 0.25 mg taken three times daily. The maximum daily dose is 24 mg.

Kidney Impairment: The maximum recommended dose is 18 mg/day in patients with end-stage renal disease on hemodialysis.

 

Restless Legs Syndrome:

The recommended starting dose is 0.25 mg once daily, 1 to 3 hours before bedtime. The maximum daily dose is 4 mg.

Kidney Impairment: The maximum recommended dose is 3 mg/day in patients with end-stage renal disease on hemodialysis.

 

Ropinorole extended release tablets:

Parkinson’s Disease:

The recommended starting dose is 2 mg taken once daily for 1 to 2 weeks. The dose should be increased by 2 mg/day at 1 week or longer intervals. 

The maximum daily dose is 24 mg/day. 

Kidney Impairment: The maximum recommended dose is 18 mg/day in patients with end-stage renal disease on hemodialysis.

If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Do not share ropinirole with other people, even if they have the same symptoms you have.
• Keep ropinirole out of the reach of children.
• Store ropinirole at room temperature out of direct sunlight.
• Keep ropinirole in a tightly closed container.