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Drug Profile

The information on this site is intended to supplement and enhance, not replace, the advice of a physician who is familiar with your medical history. Decisions about your health should always be made ONLY after detailed conversation with your doctor.

Limited Use [what does this mean?]
Generic drug name: ropinirole (roe PIN i ROLE)
Brand name(s):
GENERIC: available FAMILIES: Drugs for Parkinson’s Disease, Dopamine Agonists, Drugs for Restless Legs Syndrome
Find the drug label by searching at DailyMed.

Pregnancy and Breast-feeding Warnings [top]

Pregnancy Warning

Ropinirole caused serious harm in studies of pregnant animals, including an increased incidence in fetal malformations of digits, nervous system and cardiovascular system, as well as impaired neurobehavioral development. Because of the potential for serious adverse events, women should talk to their doctor if they are taking or plan to take ropinirole and are pregnant or plan to become pregnant.

Breast-Feeding Warning

Ropinirole is excreted in animal milk. Although there are no data on humans, many drugs are excreted in human milk. Because ropinirole inhibits prolactin secretion in women, it is expected to inhibit milk production. Women taking ropinirole should talk to their doctor about whether to discontinue the drug if they plan to nurse.

Safety Warnings For This Drug [top]


  • Excessive drowsiness and suddenly falling asleep may occur, which may lead to motor vehicle accidents and injuries while operating heavy machinery.
  • Fainting or sudden loss of consciousness may occur.
  • Low blood pressure, especially upon standing, may occur, which can lead to dizziness and fainting.
  • High blood pressure and increases or decreases in heart rate may occur.
  • May cause hallucinations and psychotic-like behaviors.
  • May cause or worsen dyskinesia (involuntary muscle movements).
  • May cause uncontrollable urges to behave in unusual ways and can result in uncontrollable gambling, increased or unusual sexual behaviors, compulsive shopping or compulsive eating.

Facts About This Drug [top]

Ropinirole is approved by the FDA for the treatment of Parkinson’s disease,[1] a condition that produces tremor (shaking); rigid muscles; and disturbances in posture, walking, balance, speech, swallowing, muscle strength and cognitive function. It is a member of the drug family called dopamine agonists. Ropinirole also is approved for restless legs syndrome.[1] Public Citizen’s Health Research Group has designated ropinirole as Limited Use for both disorders.

Parkinson’s disease


Ropinirole is approved by the FDA for the treatment of Parkinson’s disease,[1] a condition that produces tremor (shaking); rigid muscles; and disturbances in posture, walking, balance, speech, swallowing, muscle strength and cognitive function. It is a member of the drug family called dopamine agonists. Ropinirole also is approved for restless legs syndrome.[1] Public Citizen’s Health Research Group has designated ropinirole as Limited Use for both disorders.

Parkinson’s disease

Ropinirole is prescribed as single-drug therapy for early-stage Parkinson’s disease and as add-on therapy for advanced disease that is no longer adequately controlled with the combination drug levodopa and carbidopa (SINEMET, SINEMET CR ).[2]

For many years before the availability of the newer dopamine agonists like ropinirole, the levodopa-carbidopa combination was the first choice for initial treatment for Parkinson’s disease patients with significant symptoms. But since the late 1990s, physicians have increasingly favored initial treatment with dopamine agonists, especially in patients younger than age 60, because the drugs are less likely to cause dyskinesia (involuntary muscle movements, such as sudden flailing of an arm or a leg), a well-known adverse effect of long-term treatment with levodopa and carbidopa.[2]

In 2008, researchers analyzed data from multiple randomized clinical trials that compared dopamine agonists with levodopa-carbidopa in patients with early Parkinson’s disease.[3] They found that dopamine agonists indeed were less likely to cause dyskinesia and other movement complications seen with levodopa-carbidopa. However, dopamine agonists were less effective for controlling the primary symptoms of Parkinson’s disease. More importantly, patients receiving dopamine agonists were more likely to experience a variety of nonmovement adverse effects, including swelling, drowsiness, constipation, dizziness, hallucinations and nausea. Dopamine-agonist–treated patients also were much more likely to stop treatment due to adverse events.

More recently, researchers reported similar findings from a large randomized clinical trial published in 2014.[4] In the trial — known as the PD MED study — patients with newly diagnosed Parkinson’s disease were randomly assigned to long-term treatment with either levodopa-carbidopa, a dopamine agonist like ropinirole or a type B monoamine oxidase (MOA) inhibitor (for example, selegiline [EMSAM, ZELAPAR]). After a median follow-up of three years, patient receiving levodopa-carbidopa scored better on measures of mobility-related quality of life than those assigned to other treatments. Patients assigned to either a dopamine agonist or a type B MOA inhibitor also had greater than 10-fold higher rates of stopping their assigned treatment because of adverse effects than those assigned to levodopa-carbidopa. Rates of long-term Parkinson’s disease complications, including dementia, admission to a nursing home or other institution, and death, were not different between groups. Importantly, the advantage of levodopa compared with levodopa-sparing therapy (dopamine agonists or type B MOA inhibitors) was similar in patients younger than 70 and those older than 70.

An editorial commenting on the PD MED study stated that since the study was launched in 2000, “a large proportion of the [neurology] community have espoused the choice of dopamine agonists over levodopa as initial therapy…encouraged by aggressive pharmaceutical marketing.”[5] It further noted that the result of the PD MED study “will help to persuade physicians and reassure patients that the fears that have served as the groundwork in establishing levodopa phobia…are unfounded.”[5]

The available evidence thus indicates that the overall balance of benefits and risks generally favors levodopa-carbidopa over ropinirole and other dopamine agonists as initial treatment for Parkinson’s disease, regardless of patient age. Ropinirole should be reserved as add-on therapy for patients who are no longer responding adequately to levodopa-carbidopa alone.

Other studies have shown the beneficial role of vigorous daily exercise in improving motor fitness and gait in patients with Parkinson’s disease. Thus, physical activity or physical therapy should be encouraged in all patients with the disease.

If you have symptoms of parkinsonism, there is a chance that some symptoms are actually caused by a drug you are taking. As many as half of older adults with symptoms of parkinsonism may have developed them as adverse effects of a drug. A list of drugs that can cause symptoms of parkinsonism is available here. If you take any of the drugs on this list, discuss the possibility of drug-induced parkinsonism with your doctor and ask to have your prescription changed or stopped.

Restless legs syndrome

According to the National Institute of Neurological Disorders and Stroke (NINDS) — part of the National Institutes of Health — restless legs syndrome is a condition that “causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them.”[6] These sensations may be described as aching, throbbing, pulling, itching, crawling or creeping. The symptoms typically occur during the late afternoon or evening and are most severe at night when a person is resting or lying down in bed. Moving the legs relieves the discomfort, which leads patients to pace the floor, constantly move their legs while sitting, and toss and turn in bed.

Patients diagnosed with restless legs syndrome should be evaluated for secondary causes, which include end-stage kidney disease requiring hemodialysis; diabetes and peripheral neuropathy (nerve damage); and certain medications, including drugs to treat nausea (such as prochlorperazine [COMPRO, PROCOMP] and metoclopramide [GIMOTI, REGLAN]), antipsychotic drugs (such as haloperidol [HALDOL]), antidepressants (such as fluoxetine [PROZAC] and sertraline [ZOLOFT]) and older antihistamines (such as diphenhydramine [BENADRYL]).[6] Patients’ medications should be scrutinized carefully to determine whether the symptoms may be drug-induced. If no underlying cause of the symptoms is found, the patient probably has primary RLS.

Patients with mild or moderate RLS often can reduce or resolve their symptoms with changes to their lifestyle or daily routine. Strategies recommended by NINDS to reduce RLS symptoms include the following:

  • Decreasing alcohol and tobacco consumption
  • Improving sleep hygiene, including maintaining a regular sleep pattern
  • Exercising regularly
  • Applying leg-care measures such as massaging the legs, taking a hot bath or using a heating pad or ice pack[6]

NINDS also recommends that RLS patients with low blood iron levels be treated with a trial of iron supplementation.[6]

Drug therapy with a dopamine agonist such as ropinirole should be pursued only when RLS symptoms are moderate and persist despite lifestyle changes or are severe and incapacitating.

Adverse effects

Studies have shown that as many as one in five patients taking ropinirole or another dopamine agonist may develop certain impulse-control problems and compulsive behaviors. Patients can lose control of their behavior, leading to pathological gambling, hypersexuality, and compulsive shopping or eating. In their more severe cases, these drug-induced behaviors can have devastating, life-altering effects: Divorces, financial ruin, criminal charges and suicide attempts have been reported in patients using these drugs. In 2016, we petitioned the FDA to require the addition of a black-box warning to the labels of all dopamine agonist drugs describing these risks.[7] The FDA subsequently denied our petition.

Patients often do not recognize these behaviors as abnormal. They can begin at any time while taking ropinirole, even if you have taken it for several years. Stopping the drug can sometimes, but not always, reduce or eliminate these behaviors. Promptly talk to your prescribing health care provider if you or your family notices that you are developing any unusual behaviors.

Other adverse effects of ropinirole include dangerously low blood pressure when standing up, hallucinations (or even psychosis) and excessive and sudden daytime sleepiness, potentially resulting in dangerous driving impairment.

Never stop taking ropinirole abruptly because doing so commonly causes a withdrawal syndrome characterized by anxiety, panic attacks, depression, sweating, nausea, pain, fatigue, dizziness and drug craving.[1] These symptoms only respond to resuming the drug. Abrupt cessation of ropinirole also can rarely cause a life-threatening condition resembling neuroleptic malignant syndrome.[1] Symptoms include confusion, muscle rigidity and fever.

Before You Use This Drug [top]

Do not use this drug if you have or have had:

  • an allergic reaction to ropinirole or any of the ingredients in ropinirole tablets.

Tell your doctor if you have or have had:

  • an allergic reaction to ropinirole, any other medications, or any of the ingredients in ropinirole tablets or extended-release tablets;
  • daytime sleepiness from a sleep disorder;
  • unexpected or unpredictable sleepiness or periods of sleep;
  • dizziness, nausea, sweating or fainting when you stand up from sitting or lying down;
  • tobacco-product use;alcoholic beverages;
  • high or low blood pressure;
  • heart, liver, lung or kidney disease;
  • heart rhythm problems;
  • mental health problems
  • skin cancer;
  • an urge to gamble or engage in other behaviors that are or were difficult to control;
  • current pregnancy or plan to become pregnant; or
  • current breastfeeding or plan to breastfeed.

Tell your doctor about any other drugs you take, including aspirin, dietary supplements, herbs, vitamins and other nonprescription products.

When You Use This Drug [top]

  • Take exactly as directed by your health care provider.
  • The extended-release tablets work differently from the regular tablets. Do not switch from one form to the other unless your doctor tells you to.
  • Swallow the extended-release tablet whole. Do not crush, break or chew it.
  • Do not suddenly stop taking ropinirole tablets without talking to your health care provider because this may cause fever, confusion or severe muscle stiffness.
  • If you take ropinirole for Parkinson’s disease and miss a dose, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take extra medicine to make up for a missed dose.
  • Talk to your doctor before starting or stopping other medicines while you are taking ropinirole tablets.
  • Be aware that ropinirole may make you drowsy or cause you to suddenly fall asleep during your regular daily activities without any warning signs.
  • Do not drive a car, operate machinery, work at heights or participate in potentially dangerous activities until you know how the medication affects you.
  • If you suddenly fall asleep while watching television, talking, eating or riding in a car, or you become very drowsy especially during the daytime, call your doctor.
  • If you have an urge to gamble that is difficult to control, have other intense urges or are unable to control your behavior, call your doctor. Tell your family members about this risk so they can call the doctor even if you do not realize what is happening.
  • Ropinirole may cause dizziness when you get up too quickly from a sitting or lying position. Get out of the chair or bed slowly, resting your feet on the floor for a few minutes before standing up.
  • If you become pregnant while taking ropinirole, call your doctor.
  • Call your doctor if your symptoms do not improve or if they get worse.
  • Call your doctor if you start or stop smoking during your treatment with ropinirole because smoking may decrease the effectiveness of ropinirole.
  • Store in a closed container at room temperature away from heat, moisture and direct light.

Interactions with Other Drugs [top]

Ropinirole can have clinically important interactions with the following drugs: CIPRO, ciprofloxacin, GIMOTI, HALDOL, haloperidol, JANTOVEN, LYBALVI, metoclopramide, olanzapine, REGLAN, SYMBYAX, warfarin, ZYPREXA, ZYPREXA RELPREVV, ZYPREXA ZYDIS.

Adverse Effects [top]

Call your doctor immediately if you experience:

  • allergic reaction: itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness or trouble breathing;
  • chest pain, trouble breathing, or fast or slow heartbeat;
  • confusion, unusual changes in mood or behavior, or behaviors you cannot control;
  • extreme sleepiness or drowsiness;
  • fever, sweating or muscle stiffness;
  • lightheadedness, dizziness or fainting;
  • hallucinations (seeing things or hearing voices that do not exist);
  • skin changes or growths;
  • twitching or muscle movements you cannot control (either new or worse than usual);
  • difficulty swallowing; or
  • double vision or other changes in vision.

Call your doctor for these symptoms if they are severe or do not go away: 

  • nausea or vomiting
  • dizziness
  • drowsiness or sleepiness
  • fatigue, tiredness or weakness
  • stomach pain
  • heartburn or gas
  • diarrhea
  • nausea, vomiting, constipation or stomach upset
  • decrease in appetite
  • weight loss
  • headache
  • sweating or flushing
  • confusion
  • difficulty remembering or concentrating
  • anxiety
  • uncontrolled, sudden body movements
  • shaking of a part of your body that you cannot control
  • decreased sensitivity (response) to touch
  • frequent or urgent need to urinate
  • difficulty urinating or pain when urinating
  • in men, difficulty achieving or maintaining an erection
  • back, muscle or joint pain
  • pain, burning, numbness or tingling in the hands or feet
  • swelling of the hands, arms, feet, ankles or lower legs
  • dry mouth

Signs of an overdose:

  • nausea
  • vomiting
  • dizziness
  • fainting
  • hallucinations
  • nightmares
  • drowsiness
  • confusion
  • sweating
  • fear when in a small or closed space
  • body movements that are difficult to control
  • fast, irregular or pounding heartbeat
  • chest pain
  • weakness
  • cough
  • agitation

Periodic Tests[top]

Ask your doctor about whether these tests should be done periodically while taking this drug:

  • skin exams for melanoma

last reviewed April 30, 2022