Generic
Ropinirole
7 brands available in the market
At a glance
Ropinirole is a non-ergot dopamine agonist used for Parkinson's disease and moderate-to-severe primary Restless Legs Syndrome (RLS). It stimulates dopamine receptors in the brain to improve motor control and reduce leg discomfort.
Description
Ropinirole is a non-ergoline dopamine agonist with high affinity for D2-subfamily receptors, especially D3 receptors. In Parkinson's disease, it stimulates dopamine receptors in the caudate-putamen system to improve motor symptoms. In RLS, it reduces leg discomfort through dopamine receptor stimulation, though the exact mechanism is unknown.
Indications
- Idiopathic Parkinson's disease (monotherapy or with levodopa)
- Moderate-to-severe primary Restless Legs Syndrome (RLS)
Therapeutic class
Antiparkinson Drugs
Pharmacological class
Non-Ergot Dopamine Agonist
Pharmacology
Ropinirole stimulates dopamine D2 receptors (particularly D3) in the striatum, improving motor control in Parkinson's by compensating for dopamine deficiency. In RLS, it reduces leg discomfort and urge to move by stimulating dopamine receptors, though the exact mechanism is unknown.
Mechanism of action
Stimulates dopamine D2 receptors in the brain to improve motor control.
Dosage
Adult Dose (Oral):
Parkinson's Disease:
- Initial: 0.25 mg three times daily
- Weekly titration: Week 1: 0.25 mg x3; Week 2: 0.5 mg x3; Week 3: 0.75 mg x3; Week 4: 1 mg x3; then increase by 1.5 mg/week up to 9 mg/day; then 3 mg/week up to 24 mg/day
- Maintenance: 3-9 mg/day (max 24 mg/day)
Restless Legs Syndrome (RLS):
- Initial: 0.25 mg/day (1-3 hours before bedtime) for 2 days
- Titration: 0.5 mg/day (next 2 days); then 0.5 mg/week up to 3 mg/day; max 4 mg/day
Administration
- Take with or without food; taking with food may reduce nausea
- Swallow tablet whole; do not chew, crush, or break
- For RLS, take 1-3 hours before bedtime
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as you remember; if almost time for the next dose, skip it; do not double the dose.
Side effects
Common Side Effects:
- Headache, dizziness, and somnolence
- Nausea and vomiting
- Syncope and orthostatic hypotension
- Hallucinations and confusion
- Abnormal involuntary movements (dyskinesia)
- Leg edema and weakness
Precautions & warnings
- May cause sudden sleep onset during daily activities; avoid driving
- Orthostatic hypotension: change positions slowly
- Report compulsive behaviors (gambling, excessive spending, hypersexuality) – impulse control disorders
- Do not stop abruptly (withdrawal syndrome)
- Caution in pregnancy and lactation
Contraindications
- Hypersensitivity to ropinirole or any component
- Lactation (suppresses prolactin)
Drug interactions
- CYP1A2 inhibitors (cimetidine, ciprofloxacin, erythromycin, fluvoxamine, isoniazid, ritonavir): Increase ropinirole levels
- Estrogens and tobacco smoking: Alter clearance
- Dopamine antagonists (phenothiazines, metoclopramide): Decrease efficacy
Food interactions
Caution is advised when consuming alcohol with Ropinirole (may increase drowsiness and dizziness); consult your doctor.
Use in pregnancy
Use in Pregnancy: May be unsafe; animal studies show harmful effects; use only if clearly needed; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe; may suppress prolactin and interfere with breastfeeding; consult your doctor.
Pediatric use
Safety and efficacy not established in pediatric patients.
Geriatric use
Caution required in elderly patients; dose adjustment may be needed.
Renal / hepatic impairment
Renal Impairment: Caution in severe kidney disease; dose adjustment may be needed; consult your doctor.
Hepatic Impairment: Caution in mild-moderate liver disease; dose adjustment may be needed; avoid in severe liver disease; consult your doctor.
Overdose effects
Overdose may increase dopamine agonist side effects; consult your doctor; no specific antidote.
Storage conditions
Store below 25°C, protected from light and moisture; keep out of reach of children.
Chemical structure
Ropinirole