There are several brands of ropinirole available and your treatment could be affected by switching between brands. Each time you collect a new supply of tablets from your pharmacy, please check to see if the tablets are the same as before. If they are different, discuss this with your pharmacist who will advise you.
Ropinirole could make you feel dizzy especially during the first few days of treatment. Get up more slowly until you know how you react.Occasionally, people taking ropinirole (particularly when taken for Parkinson's disease) have fallen asleep suddenly during the day with little warning of being tired. If you experience this, please do not drive, and make an appointment to see your doctor as soon as possible. Ropinirole can also cause impulsive types of behaviour in some people.
|Type of medicine||A dopamine-receptor agonist|
|Used for||Parkinson's disease; restless legs syndrome|
|Also called||For Parkinson's disease: Ippinia® XL; Ralnea® XL; Raponer® XL; Repinex® XL; Requip®; Requip® XL; Ropiqual® XL;|
For restless legs syndrome: Adartrel®
|Available as||Tablets and prolonged-release tablets|
Most brands of ropinirole tablets are prescribed to treat Parkinson's disease. Parkinson's disease affects the way your brain co-ordinates the movements of your muscles. A number of cells in a small part of your brain called the substantia nigra become damaged and die. These brain cells pass messages down nerves in the spinal cord by producing a chemical called dopamine, and it is these messages which control the muscles of the body. As the cells in the brain are damaged, the amount of dopamine that is produced is reduced. A combination of the reduction of cells and a low level of dopamine in the cells in this part of the brain, causes nerve messages to the muscles to become slowed and abnormal. This produces the main symptoms of Parkinson's disease, which are stiffness, shaking (tremor), and slowness of movement.
Ropinirole is a dopamine-receptor agonist which means that it acts on the same receptors in your brain as dopamine. In effect, it acts like a substitute for dopamine and this helps to ease your symptoms. It may be used alone, or in combination with other medicines to treat Parkinson's disease.
A brand of ropinirole called Adartrel® is used to treat restless legs syndrome (RLS). This is an uncomfortable feeling in your legs, which gives you the urge to move your legs to get relief. Ropinirole can help when these symptoms are severe enough to cause distress.
Before taking ropinirole
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking ropinirole it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you have a heart condition or a blood vessel disorder.
- If you have any problems with the way your liver works, or any problems with the way your kidneys work.
- If you have ever had a mental health problem such as psychosis.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take ropinirole
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack and any additional information your doctor has given to you. These will give you more information about ropinirole, and will also provide you with a full list of side-effects which you could experience from taking it.
- The dose you are prescribed will be tailored to suit you. Your doctor will tell you how many tablets to take, and how often to take them. This information will also be printed on the label of the pack of tablets to remind you about what the doctor said to you. Read the directions from your doctor carefully so that you know what dose is right for you each day, and take the tablets exactly as you have been told.
- If you are taking ropinirole for the first time, your doctor will give you a small dose to begin with, and then gradually increase this over the first few weeks. Slowly increasing your dose like this will help to reduce side-effects such as dizziness and low blood pressure, which can occur when you first start treatment.
- It is best to take ropinirole tablets after a meal or a snack. This will help to prevent feelings of sickness which can sometimes occur.
- If you have been given a prolonged-release tablet of ropinirole for Parkinson's disease (these have 'XL' after the brand name), you should swallow the tablet whole. You can take it with a drink of water to help you swallow, but do not crush or break the tablet before you swallow it. This is because the tablets have been specially made to release the medicine they contain slowly over the day.
- If you are taking Adartrel® for restless legs syndrome, please take your doses just before you go to bed each evening.
- Try to get into a habit of taking your doses at the same times of day each day, as this will help you to remember to take them regularly. If you forget to take a dose, take it as soon as you remember. Try to take the correct number of doses each day, but do not take two doses at the same time to make up for a missed dose.
- There are several different strengths and brands of ropinirole tablet. Each time you collect a prescription, please check the box to make sure that you have been given the type of tablets you are expecting. Ask your pharmacist to check for you if you are unsure about anything.
Getting the most from your treatment
- Try to keep all your regular appointments with your doctor. This is so your doctor can check on your progress. Ropinirole could cause your blood pressure to fall (particularly in the early days of your treatment) and your doctor will want to check for this.
- Keep taking the tablets until your doctor tells you otherwise. Stopping suddenly can cause problems and your doctor will want you to reduce your dose gradually if you need to stop treatment. Also, if for any reason you do not take your tablets for more than a day or so, you should let your doctor know about this, as your dose may need adjusting.
- Sometimes people taking medicines like ropinirole can fall asleep suddenly during the day with little or no warning of being tired beforehand. Until you know how you react, take extra care if you drive or operate machinery. If you do find yourself falling asleep suddenly, you should see your doctor as soon as possible for advice, and avoid driving, or using tools and machines, in the meantime.
- Treatment with medicines like ropinirole can sometimes cause problems with impulsive types of behaviour. If you notice any changes in your behaviour, such as an increased desire to gamble, binge eat, or spend excessively, or an increased sex drive, you must let your doctor know as soon as possible.
- People with Parkinson's disease are likely to be advised to stay as active as possible and to exercise regularly as much as they are able. You may walk more slowly than before, but a daily walk is good exercise and may help to loosen up stiff muscles.
- If you are a driver you should tell the DVLA and your insurance company if you have Parkinson's disease. Depending on the severity of symptoms and the medicines that you are taking, you may still be allowed to drive following a medical assessment.
- Smoking can interfere with the way ropinirole works. If you either start smoking or give up smoking while you are taking ropinirole, your dose may need to be adjusted, so you should let your doctor know about this.
Can ropinirole cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the common ones associated with ropinirole. You will find a full list in the manufacturer's information leaflet supplied with the tablets. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common ropinirole side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting)||Stick to simple or bland meals (avoid rich and spicy foods). Take your doses after food|
|Common ropinirole side-effects (these affect fewer than 1 in 10 people)||What can I do if I experience this?|
|Feeling drowsy or sleepy, falling asleep suddenly during the day||If this happens, do not drive and do not use tools or machines. Speak with your doctor as soon as possible if you start falling asleep suddenly during the day|
|Feeling dizzy or faint, especially when you stand or sit up||Getting up and moving around more slowly may help. If you begin to feel dizzy, lie down so that you do not faint, then sit for a few moments before standing. This usually passes as your body gets used to the tablets, but in the meantime do not drive and do not use tools or machines|
|Swollen legs and ankles, feeling nervous or confused, indigestion, tummy (abdominal) pain, uncontrollable muscle movements, hearing or seeing things that aren't real (hallucinations)||If any of these become troublesome, speak with your doctor|
|Other ropinirole side-effects||What can I do if I experience this?|
|Impulsive types of behaviour (such as an increased desire to gamble, binge eat, or an increased sex drive)||Let your doctor know about this as soon as possible|
If you experience any other symptoms which you think may be due to the tablets, please speak with your doctor or pharmacist for further advice.
How to store ropinirole
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you are due to have any treatment like an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
If you buy any medicines, always check with a pharmacist that they are safe to take with your other medicines.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine, please ask your pharmacist for advice.
Further reading and references
Manufacturer's PIL, ReQuip® XL prolonged-release tablets; GlaxoSmithKline UK, The electronic Medicines Compendium. Dated February 2020.
Manufacturer's PIL, Adartrel® 0.25 mg, 0.5 mg, and 2 mg film-coated Tablets; GlaxoSmithKline UK, The electronic Medicines Compendium. Dated April 2020.
Medicines Complete BNF 84th Edition; British Medical Association and Royal Pharmaceutical Society of Great Britain, London