Dosing & Uses
Dosage Forms & Strengths
tablet
- 0.25mg
- 0.5mg
- 1mg
- 2mg
- 3mg
- 4mg
- 5mg
tablet, extended release
- 2mg
- 4mg
- 6mg
- 8mg
- 12mg
Parkinson Disease
Immediate release
- 0.25 mg PO q8hr for 1 week initially, then increased weekly by 0.25 mg q8hr; if necessary, after week 4, may be increased weekly by 1.5 mg/day up to 9 mg/day, then increased weekly by 3 mg/day up to 24 mg/day
- See Administration for discontinuation instructions
Extended release
- 2 mg/day PO initially for 1-2 weeks; increased by 2 mg/day at intervals >1 week; not to exceed 24 mg/day
- See Administration for discontinuation instructions
Maximum dose
- Although the maximum recommended is 24 mg/day, patients with advanced Parkinson disease should generally be maintained at lower doses
- In fixed-dose studies designed to characterize dose-response, no additional therapeutic benefit was shown in advanced stage Parkinson disease with doses >8 mg/day or with early stage Parkinson disease with doses >12 mg/day
- Early Parkinson disease: ≤12 mg/day
- Advanced Parkinson disease: ≤8 mg/day
Restless Leg Syndrome (Moderate-Severe)
Immediate release: 0.25 mg/day PO 1-3 hr before bedtime; after day 2, may be increased to 0.5 mg/day PO; at end of week 1, increased to 1 mg/day, then increased weekly by 0.5 mg/day up to 4 mg/day
See Administration for discontinuation instructions
Dosage Modifications
Renal impairment
- CrCl 30-50 mL/min: Dose adjustment not necessary
- CrCl <30 mL/min: Safety and efficacy not established; use with caution; use of ropinirole XL not studied
- End-stage renal disease on hemodialysis: Maximum recommended dose is 18 mg/day in Parkinson disease and 3 mg/day in restless legs syndrome
Hepatic impairment
- Safety and efficacy not established; use with caution
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- fezolinetant
ropinirole will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitors
Serious - Use Alternative (28)
- amisulpride
amisulpride, ropinirole. Either decreases effects of the other by pharmacodynamic antagonism. Contraindicated. Avoid use of amisulpride, a dopamine receptor antagonist, with dopamine agonists.
- aripiprazole
aripiprazole decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- chlorpromazine
chlorpromazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- clozapine
clozapine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- droperidol
droperidol decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- fluphenazine
fluphenazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- fluvoxamine
fluvoxamine will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.
- givosiran
givosiran will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.
- haloperidol
haloperidol decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- iloperidone
iloperidone decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- leniolisib
leniolisib will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. If unable to avoid coadministration, decrease ropinirole dose
- loxapine
loxapine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- loxapine inhaled
loxapine inhaled decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- metoclopramide
metoclopramide decreases levels of ropinirole by pharmacodynamic antagonism. Contraindicated.
- metoclopramide intranasal
ropinirole, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
metoclopramide intranasal, ropinirole. dopaminergic effects. Avoid or Use Alternate Drug. Opposing effects of metoclopramide and the interacting drug on dopamine. Potential exacerbation of symptoms (eg, parkinsonian symptoms) or decreased therapeutic effects of metoclopramide. - olanzapine
olanzapine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- olopatadine intranasal
ropinirole and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- paliperidone
paliperidone decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- perphenazine
perphenazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- pimozide
pimozide decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- prochlorperazine
prochlorperazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- promethazine
promethazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- quetiapine
quetiapine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- risperidone
risperidone decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- thioridazine
thioridazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- thiothixene
thiothixene decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- trifluoperazine
trifluoperazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- ziprasidone
ziprasidone decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
Monitor Closely (50)
- apomorphine
apomorphine and ropinirole both increase dopaminergic effects. Use Caution/Monitor.
- bromocriptine
bromocriptine and ropinirole both increase dopaminergic effects. Use Caution/Monitor. Combining drugs may be therapeutic in patients with Parkinsonism.
- cabergoline
cabergoline and ropinirole both increase dopaminergic effects. Use Caution/Monitor.
- cannabidiol
cannabidiol, ropinirole. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.
- captopril
ropinirole, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.
- carbamazepine
carbamazepine will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- cenobamate
cenobamate, ropinirole. Either increases effects of the other by sedation. Use Caution/Monitor.
- cigarette smoking
cigarette smoking will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- cimetidine
cimetidine will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- ciprofloxacin
ciprofloxacin will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Ciprofloxacin may decrease the metabolism of ropinirole; monitor for increased effects of ropinirole.
- clobazam
ropinirole, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).
- clonidine
clonidine, ropinirole. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.
- daridorexant
ropinirole and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- deferasirox
deferasirox increases levels of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and ropinirole both decrease serum potassium. Use Caution/Monitor.
- difelikefalin
difelikefalin and ropinirole both increase sedation. Use Caution/Monitor.
- elranatamab
elranatamab will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Elranatamab causes cytokine release syndrome (CRS) that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. This is more likely to occur from initiation of elranatamab step-up dosing up to 14 days after the first treatment dose and during and after CRS.
- epcoritamab
epcoritamab, ropinirole. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Epcoritamab causes release of cytokines that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. For certain CYP substrates, minimal changes in their concentration may lead to serious adverse reactions. If needed, modify therapy as recommended in the substrate's prescribing information. .
- erythromycin base
erythromycin base will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- erythromycin lactobionate
erythromycin lactobionate will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- erythromycin stearate
erythromycin stearate will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- ethinylestradiol
ethinylestradiol will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
ethinylestradiol increases levels of ropinirole by unspecified interaction mechanism. Use Caution/Monitor. - fexinidazole
fexinidazole will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- glofitamab
glofitamab, ropinirole. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Glofitamab causes release of cytokines that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. For certain CYP substrates, minimal changes in their concentration may lead to serious adverse reactions. If needed, modify therapy as recommended in the substrate's prescribing information. .
- isoniazid
isoniazid will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- levodopa
levodopa and ropinirole both increase dopaminergic effects. Use Caution/Monitor.
- lonapegsomatropin
lonapegsomatropin will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates
- lurasidone
lurasidone decreases effects of ropinirole by Other (see comment). Use Caution/Monitor. Comment: Antipsychotics may diminish the therapeutic effect of anti-parkinson's agents.
- methyldopa
methyldopa and ropinirole both increase dopaminergic effects. Use Caution/Monitor.
- methylphenidate
ropinirole, methylphenidate. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive CNS stimulation.
- mexiletine
mexiletine will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, ropinirole. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- peginterferon alfa 2a
peginterferon alfa 2a will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- phenobarbital
phenobarbital will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- pramipexole
pramipexole and ropinirole both increase dopaminergic effects. Use Caution/Monitor.
- primidone
primidone will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- rifampin
rifampin will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- ritlecitinib
ritlecitinib will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Ritlecitinib inhibits CYP1A2 substrates; coadministration increases AUC and peak plasma concentration sensitive substrates, which may increase risk of adverse reactions. Additional monitoring and dosage adjustment may be needed in accordance with product labeling of CYP1A2 substrates.
- rucaparib
rucaparib will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.
- smoking
smoking will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- solriamfetol
ropinirole and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- somapacitan
somapacitan will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates
- somatrogon
somatrogon will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates
- somatropin
somatropin will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Limited published data indicate that growth hormone treatment increases cytochrome P450 (CYP450)-mediated antipyrine clearance. Caution with sensitive CYP substrates
- stiripentol
stiripentol, ropinirole. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP1A2 inhibitor and inducer. Monitor CYP1A2 substrates coadministered with stiripentol for increased or decreased effects. CYP1A2 substrates may require dosage adjustment.
stiripentol, ropinirole. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence. - talquetamab
talquetamab will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Talquetamab causes cytokine release syndrome (CRS) that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. This is more likely to occur from initiation of talquetamab step-up dosing up to 14 days after the first treatment dose and during and after CRS.
- teriflunomide
teriflunomide decreases levels of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- tobacco use
tobacco use will decrease the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
- zileuton
zileuton will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.
Minor (8)
- bazedoxifene/conjugated estrogens
bazedoxifene/conjugated estrogens increases levels of ropinirole by unspecified interaction mechanism. Minor/Significance Unknown.
- benazepril
ropinirole, benazepril. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May increase risk of hypotension.
- conjugated estrogens
conjugated estrogens increases levels of ropinirole by unspecified interaction mechanism. Minor/Significance Unknown.
- conjugated estrogens, vaginal
conjugated estrogens, vaginal increases levels of ropinirole by unspecified interaction mechanism. Minor/Significance Unknown.
- estradiol
estradiol increases levels of ropinirole by unspecified interaction mechanism. Minor/Significance Unknown.
- estrogens conjugated synthetic
estrogens conjugated synthetic increases levels of ropinirole by unspecified interaction mechanism. Minor/Significance Unknown.
- estropipate
estropipate increases levels of ropinirole by unspecified interaction mechanism. Minor/Significance Unknown.
- mestranol
mestranol increases levels of ropinirole by unspecified interaction mechanism. Minor/Significance Unknown.
Adverse Effects
>10%
Nausea (40-60%)
Dizziness (6-40%)
Somnolence (11-40%)
Syncope (1-12%)
Vomiting (12%)
Fatigue (8-11%)
Viral infection (11%)
Dyspepsia (10%)
Falls (10%)
1-10%
Hypertension (5%)
Flushing (3%)
Orthostasis (1-6%)
Chest pain (4%)
Palpitation (3%)
Extrasystoles (2%)
Tachycardia (2%)
Hyperhidrosis (3%)
Abnormal pain (3-7%)
Anorexia (4%)
Flatulence (3%)
Malaise (3%)
Hypoesthesia (4%)
Urinary tract infection (5%)
Impotence (3%)
Alkaline phosphatase (3%)
Abnormal vision (6%)
Xerophthalmia (2%)
Increased diaphoresis (3-6%)
<1%
Agitation
Aneurysm
Aphasia
Bradycardia
Cardiac arrest
Valvulopathy
Cellulitis
Colitis
Delusion
Delirium
Diaphoresis
Dyspnea
Ulceration
Glaucoma
Psychotic-like behavior
Impulse control/compulsive behavior
Withdrawal-emergent hyperpyrexia and confusion
Melanoma
Fibrotic complications
Postmarketing Reports
Retinal pathology
Withdrawal symptoms upon tapering drug
Warnings
Contraindications
Known hypersensitivity/allergic reaction (including urticaria, angioedema, rash, pruritus) to ropinirole or to any of the excipients
Cautions
Risk of somnolence associated with use for restless legs syndrome, as well as (rare) risk of syncope, hypotension, and hallucinations
May cause psychotic-like behavior; abnormal thinking and behavior can consist of one or more of a variety of manifestations including paranoid ideation, delusions, hallucinations, confusion, disorientation, aggressive behavior, agitation, and delirium; risk may be increased in the elderly; consider dose reduction or stopping the medication if a patient develops psychiatric symptoms while taking the medication
Risk of orthostatic hypotension with extended-release formulation
Possible risk of erratic behavior associated with dopamine agonists, compulsive behavior including urge to gamble and increased sexual urges
Potential for elevation in blood pressure and changes in heart rate should be considered when treating patients with cardiovascular disease with extended release formulation
Dyskinesia seen with concurrent use of levodopa
Increased risk of melanoma development and pleural retroperitoneal fibrosis reported, but causation not established; monitoring warranted
Use caution in patients with history of hepatic/renal impairment, psychotic disorders, dyskinesias, restless leg syndrome
In patients with advanced Parkinson’s disease dyskinesia may occur
Before initiating treatment, patients should be advised of potential to develop drowsiness and specifically asked about factors that may increase risk such as concomitantly taking sedating medications or alcohol; the presence of sleep disorders (other than RLS), and concomitant medications that increase ropinirole plasma levels (e.g., ciprofloxacin); if patient develops significant daytime sleepiness or episodes of falling asleep during activities that require active participation (e.g., driving a motor vehicle, conversations, eating); therapy should be discontinued; if decision is made to continue therapy patients should be advised to not drive and avoid other potentially dangerous activities; there is insufficient information to establish whether dose reduction will eliminate episodes of falling asleep while engaged in activities of daily living
Patients with Parkinson’s disease may have impaired ability to respond normally to a fall in blood pressure after standing from lying down or seated position; patients receiving therapy should be monitored for signs and symptoms of orthostatic hypotension, especially during dose escalation, and should be informed of risk for syncope and hypotension
Withdrawal symptoms
- Abrupt withdrawal or significant dosage reduction associated with syndrome resembling neuroleptic malignant syndrome (characterized by elevated temperature, muscular rigidity, altered consciousness, and autonomic instability); see Administration section for how to gradually discontinue drug
- Symptoms including insomnia, apathy, anxiety, depression, fatigue, sweating, and pain reported during taper or after discontinuation of dopamine agonists; these symptoms generally do not respond to levodopa
- Prior to discontinuation, patients should be informed about potential withdrawal symptoms, and monitored during and after discontinuation; in case of severe withdrawal symptoms, a trial re-administration of a dopamine agonist at the lowest effective dose may be considered
Augmentation and rebound in restless leg syndrome
- Augmentation is a phenomenon in which dopaminergic medication causes a worsening of symptom severity above and beyond the level at the time the medication was started
- Augmentation symptoms may include earlier onset of symptoms in the evening (or even the afternoon), increase in symptoms, and spread of symptoms to involve other extremities
- Rebound refers to new onset of symptoms in the early morning hr
- Therapy should be reviewed and dosage adjustment or discontinuation of treatment considered with augmentation and early-morning rebound in restless syndrome; when discontinuing therapy in patients with restless leg syndrome, gradual reduction of the daily dose is recommended whenever possible
Pregnancy & Lactation
Pregnancy
There are no adequate data on developmental risk associated with use in pregnant women; in animal studies, ropinirole had adverse effects on development when administered to pregnant rats at doses similar to (neurobehavioral impairment) or greater than (teratogenicity and embryolethality at >36 times) maximum recommended human dose (MRHD) for Parkinson’s disease
Lactation
There are no data on presence of ropinirole in human milk, the effects of ropinirole on breastfed infant, or effects of ropinirole on milk production; however, inhibition of lactation is expected because ropinirole inhibits secretion of prolactin in humans; ropinirole or metabolites, or both, are present in rat milk
Developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from ropinirole or from the underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Potent nonergoline dopamine agonist specific for D2 and D3 subtypes, possibly within caudate putamen in brain
Absorption
Bioavailability: 55%
Peak plasma time: Immediate release, 1-2 hr; extended release, 6-10 hr
Distribution
Protein bound: 40%
Vd: 525 L
Metabolism
Metabolized in liver by CYP1A2
Elimination
Half-life: 6 hr (extended release)
Total body clearance: 47 L/hr
Excretion: Urine
Administration
Oral Administration
May take with or without food
If a significant interruption in therapy has occurred, retitration of the drug is warranted
Conversion from immediate-release to extended-release formulation
- Choose extended-release strength that most closely matches total daily dose of immediate-release formulation
Discontinuation
- Abrupt withdrawal or significant dosage reduction associated with syndrome resembling neuroleptic malignant syndrome (see Cautions)
- Parkinson disease: Discontinued gradually over a 7-day period; administration frequency should be reduced from TID to BID for 4 days, and then once daily for the remaining 3 days prior to completely withdrawing the drug
- Restless leg syndrome: Gradually reduce the daily dose
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| ropinirole oral - | 1 mg tablet |  | |
| ropinirole oral - | 0.25 mg tablet |  | |
| ropinirole oral - | 1 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 1 mg tablet |  | |
| ropinirole oral - | 0.25 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 0.25 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 3 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 1 mg tablet |  | |
| ropinirole oral - | 0.5 mg tablet |  | |
| ropinirole oral - | 0.25 mg tablet |  | |
| ropinirole oral - | 5 mg tablet |  | |
| ropinirole oral - | 3 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 0.5 mg tablet |  | |
| ropinirole oral - | 0.25 mg tablet |  | |
| ropinirole oral - | 12 mg tablet |  | |
| ropinirole oral - | 6 mg tablet |  | |
| ropinirole oral - | 5 mg tablet |  | |
| ropinirole oral - | 8 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 5 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 0.5 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 1 mg tablet |  | |
| ropinirole oral - | 5 mg tablet |  | |
| ropinirole oral - | 3 mg tablet |  | |
| ropinirole oral - | 8 mg tablet |  | |
| ropinirole oral - | 6 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 5 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 3 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 1 mg tablet |  | |
| ropinirole oral - | 0.5 mg tablet |  | |
| ropinirole oral - | 0.25 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 0.5 mg tablet |  | |
| ropinirole oral - | 5 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 3 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 6 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 5 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 1 mg tablet |  | |
| ropinirole oral - | 0.5 mg tablet |  | |
| ropinirole oral - | 0.25 mg tablet |  | |
| ropinirole oral - | 3 mg tablet |  | |
| ropinirole oral - | 8 mg tablet |  | |
| ropinirole oral - | 12 mg tablet |  | |
| ropinirole oral - | 1 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 0.5 mg tablet |  | |
| ropinirole oral - | 3 mg tablet |  | |
| ropinirole oral - | 2 mg tablet |  | |
| ropinirole oral - | 4 mg tablet |  | |
| ropinirole oral - | 5 mg tablet |  | |
| ropinirole oral - | 5 mg tablet | | |
| ropinirole oral - | 4 mg tablet | | |
| ropinirole oral - | 4 mg tablet | | |
| ropinirole oral - | 3 mg tablet | | |
| ropinirole oral - | 3 mg tablet | | |
| ropinirole oral - | 2 mg tablet | | |
| ropinirole oral - | 2 mg tablet | | |
| ropinirole oral - | 1 mg tablet | | |
| ropinirole oral - | 1 mg tablet | | |
| ropinirole oral - | 0.5 mg tablet | | |
| ropinirole oral - | 0.5 mg tablet | | |
| ropinirole oral - | 0.25 mg tablet | | |
| ropinirole oral - | 0.25 mg tablet | |
Copyright © 2010 First DataBank, Inc.
Patient Handout
ropinirole oral
ROPINIROLE EXTENDED-RELEASE - ORAL
(row-PIN-uh-roll)
COMMON BRAND NAME(S): Requip XL
USES: This medication is used alone or with other medications to treat Parkinson's disease. It can improve your ability to move and decrease shakiness (tremor), stiffness, slowed movement, and unsteadiness. It may also decrease the number of episodes of not being able to move ("on-off syndrome").Ropinirole works by helping to restore the balance of a certain natural substance (dopamine) in the brain.
HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking ropinirole and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually once daily. Taking this medication with food may decrease the risk of nausea. Swallow the tablets whole. Do not crush or chew the tablets. Doing so can release all of the drug at once, increasing the risk of side effects.The dosage is based on your medical condition and response to treatment. Your doctor may direct you to start this medication at a low dose and gradually increase your dose to reduce the risk of side effects. Follow your doctor's instructions carefully.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day. If you stop taking this medication for several days, you may need to slowly increase your dose back to your previous dosage. Talk with your doctor about how to restart this medication.Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this medication is suddenly stopped. Also, if you suddenly stop using this medication, you may have withdrawal symptoms (such as anxiety, depression, confusion, fever, muscle stiffness). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used ropinirole for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.Tell your doctor if your condition does not get better or if it gets worse.
SIDE EFFECTS: Nausea, vomiting, drowsiness, dizziness, abdominal pain/discomfort, or headache may occur. If these effects last or get worse, tell your doctor promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.You may develop a sudden drop in blood pressure, which can cause dizziness, nausea, and fainting. This is more likely when you are first starting the medication, when your dose is increased, or when you get up suddenly. To lower your risk, get up slowly from a sitting or lying position.This medication may also raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: new or worsening uncontrolled movements (dyskinesia), mental/mood changes (such as confusion, agitation, hallucinations), unusual strong urges (such as increased gambling, increased sexual urges).Some people taking ropinirole have fallen asleep suddenly during their usual daily activities (such as talking on the phone, driving). In some cases, sleep occurred without any feelings of drowsiness beforehand. This sleep effect may occur anytime during treatment with ropinirole even if you have used this medication for a long time. If you experience increased sleepiness or fall asleep during the day, do not drive or take part in other possibly dangerous activities until you have discussed this effect with your doctor. Your risk of this sleep effect is increased by using alcohol or other medications that can make you drowsy. See also Precautions section.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking ropinirole, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart disease, high or low blood pressure, sleep disorder (such as sleep apnea, narcolepsy), mental/mood disorder, liver problems.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis). See also Side Effects section.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially mental/mood changes (such as hallucinations), nausea, and vomiting.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: antipsychotic medications (such as chlorpromazine, haloperidol, thiothixene), metoclopramide.Other medications can affect the removal of ropinirole from your body, which may affect how ropinirole works. Examples include cimetidine, fluvoxamine, mexiletine, omeprazole, among others.Tell your doctor or pharmacist if you are taking other products that can cause drowsiness, including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.Cigarette smoking decreases blood levels of this medication. Tell your doctor if you smoke or if you have recently stopped smoking.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised July 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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