Rotigotine | Side Effects, Dosage, Uses & More
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Generic Name:

rotigotine, Transdermal patch

All Brands

  • Neupro
SECTION 1 of 5

Highlights for rotigotine

Transdermal patch
1

Rotigotine is used to treat Parkinson’s disease and restless legs syndrome.

2

Rotigotine is available as the brand-name drug Neupro. It isn’t available as a generic drug.

3

This drug comes in the form of a patch that you apply to your skin.

4

The more common side effects of this drug include nausea, sleepiness, sleep problems, and skin reactions where you applied the patch.

5

In some cases, rotigotine can cause serious side effects. These include hallucinations (seeing or hearing something that isn’t real) and other psychiatric problems. They also include worsening muscle movements, low or high blood pressure, increased heart rate, and increased urges to gamble or act on other impulsive behaviors.

IMPORTANT INFORMATION

Stopping the drug suddenly

Don’t stop taking this drug without talking to your doctor. Stopping it suddenly can cause a high fever and confusion. If you need to stop taking this drug, your doctor will slowly decrease your dosage over time.

Falling asleep

This drug may cause you to fall asleep while you’re doing daily activities such as driving or using machinery. Falling asleep during these activities could cause accidents. You may fall asleep without any warning signs such as drowsiness. You may even feel alert right before you fall asleep. You shouldn’t drive or do other tasks that require alertness until you know this drug doesn’t have this effect on you.

Compulsive behavior

This drug can cause intense urges to gamble, spend money, or binge eat. It can also cause increased sexual urges and other intense urges. You may not be able to control them. Tell your doctor right away if you have any of these urges.

Drug features

This drug is a prescription drug. It comes as a transdermal (skin) patch.

This drug is available as the brand-name drug Neupro. It isn’t available as a generic drug.

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

This drug is used to treat Parkinson’s disease and restless legs syndrome.

How it works

This drug belongs to a class of drugs called dopamine agonists.

See Details

How it works

This drug belongs to a class of drugs called dopamine agonists. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

This drug has the same effect in your central nervous system as dopamine does. Dopamine is a natural chemical in your body. It helps control the movement of your body.

With Parkinson’s disease, the cells that make dopamine die. This drug works by replacing the missing dopamine.

It isn’t known how this drug works to treat restless legs syndrome.

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SECTION 2 of 5

rotigotine Side Effects

Transdermal patch

More common side effects

Some of the more common side effects of rotigotine include:

  • nausea

  • vomiting

  • sleepiness

  • headache

  • skin redness where you applied the patch

  • sleep problems, such as:

    • waking up early in the morning
    • trouble falling asleep
    • trouble staying asleep
    • nightmares
    • strange dreams
  • increased sweating

  • blurry or double vision

  • problems with muscle movements

  • leg swelling

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Severe allergic reaction. Symptoms can include:

    • swelling of your lips or tongue
    • chest pain
    • trouble breathing
    • trouble swallowing
  • Excessive sleepiness. Symptoms can include:

    • getting sleepy during the day
    • falling asleep without warning while doing daily activities such as talking, eating, or driving a car
  • Psychiatric problems. Symptoms can include:

    • hallucinations (seeing or hearing things that aren’t real)
    • delusions (believing things that aren’t real)
    • confusion
    • paranoia (excessive suspicion)
    • aggressive behavior
    • agitation
  • A sudden drop in blood pressure when you stand up. This may be more likely to happen after dosage increases.

  • High blood pressure

  • Faster heart rate

  • Unusual urges or increased desires. Examples include:

    • new or increased urges to gamble
    • increased sexual urges
    • impulsive shopping sprees
    • binge eating
  • Skin cancer or skin that has an abnormal growth or appearance. Symptoms can include:

    • blue or blue-black lesions (sores)
    • lesions or spots with more than one color or flecks of a different color
    • a mole or spot that changes in color or size over time
    • lesions with irregular borders
  • Fast weight gain or swelling

  • Problems with muscle movements

  • Worse or more frequent symptoms of restless legs syndrome. These can include:

    • leg twitching
    • abnormal itching or a crawling feeling in your legs
    • moving your legs to provide relief
Pharmacist's Advice
Healthline Pharmacist Editorial Board

This drug may cause drowsiness. You shouldn’t drive or do other tasks that require alertness until you know you can function normally.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

rotigotine May Interact with Other Medications

Transdermal patch

Rotigotine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

Drinking alcohol raises your risk of falling asleep or feeling drowsy during the day from rotigotine. If you drink alcohol, talk to your doctor to see if this drug is safe for you.

Medications that might interact with this drug

Interactions that can make rotigotine less effective
  • When rotigotine is used with certain drugs, it may not work as well to treat your condition. This is because the amount of rotigotine in your body may be decreased. Examples of these drugs include:
    • Metoclopramide.
    • Antipsychotic drugs such as:
      • haloperidol
      • chlorpromazine
      • risperidone
      • olanzapine

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with a sulfites allergy

You shouldn’t take this drug. You could develop a severe allergic reaction to this drug.

People with asthma

You’re more likely to be allergic or sensitive to sulfites. This drug contains sulfites. It can cause a severe allergic reaction in people who are sensitive to them.

People with excessive daytime sleepiness

This drug may make your condition worse. This drug can cause you to feel more tired throughout the day or fall asleep without warning.

People with mental health problems

This drug can cause your psychiatric disorder to become more severe. You may have increased hallucinations (seeing or hearing things that aren’t real), delusions (believing things that aren’t real), paranoia (excessive suspicion), aggressive behavior, or agitation.

People with blood pressure problems

This drug can increase or decrease your blood pressure. It also puts you at risk for orthostatic hypotension (low blood pressure when you stand up). Your doctor will monitor you closely while you take this drug.

People with heart failure

This drug may cause you to gain weight or retain more fluid. This could make your heart failure worse. You may have more shortness of breath, swelling in your legs, and a faster heartbeat. These symptoms could lead to dizziness or lightheadedness.

Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

This drug may pass into breast milk and may cause side effects in a child who is breastfed. This drug could also decrease the amount of milk your body makes.

Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For children

This medication hasn’t been studied in children. It should not be used in people younger than 18 years of age.

Contact with drug

Your used patch might still contain some drug that could be transferred to pets or children if they touch it. When you remove the patch, fold the sticky sides together before throwing it away.

When to call the doctor

Tell your doctor if you plan to have a medical procedure, such as an MRI scan or cardioversion. You’ll need to remove your patch before these procedures to avoid burns.

Allergies

This drug patch can cause a severe allergic reaction. Symptoms can include:

  • swelling of your lips or tongue
  • chest pain
  • trouble breathing and swallowing
  • hives
  • rash

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it or sulfites. Taking it again could be fatal (cause death).

SECTION 4 of 5

How to Take rotigotine (Dosage)

Transdermal patch

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Parkinson’s disease

Brand: Neupro

Form: skin patch
Strengths:
  • 1 mg/24 hours
  • 2 mg/24 hours
  • 3 mg/24 hours
  • 4 mg/24 hours
  • 6 mg/24 hours
  • 8 mg/24 hours
Adult dosage (ages 18 and older)
  • Typical starting dosages:
    • Early-stage disease: 2 mg/24 hours
    • Advanced-stage disease: 4 mg/24 hours
  • Dosage increases: Your doctor may increase your dosage by 2 mg/24 hours every week.
  • Maximum dosages:
    • Early-stage disease: 6 mg/24 hours
    • Advanced-stage disease: 8 mg/24 hours
Child dosage (ages 0–17 years)

This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years of age.

Warnings

Don’t stop using your patch suddenly. Doing so can cause you to develop a high fever and confusion. If you need to stop taking this drug, your doctor will slowly decrease your dosage over time.

Restless legs syndrome

Brand: Neupro

Form: skin patch
Strengths:
  • 1 mg/24 hours
  • 2 mg/24 hours
  • 3 mg/24 hours
  • 4 mg/24 hours
  • 6 mg/24 hours
  • 8 mg/24 hours
Adult dosage (ages 18 and older)
  • Typical starting dosage: 1 mg/24 hours
  • Dosage increases: Your doctor may increase your dosage by 1 mg/24 hours each week.
  • Maximum dosage: 3 mg/24 hours
Child dosage (ages 0–17 years)

This medication hasn’t been studied in children. It shouldn’t be used in people younger than 18 years of age.

Warnings

Don’t stop using your patch suddenly. Doing so can cause you to develop a high fever and confusion. If you need to stop taking this drug, your doctor will slowly decrease your dosage over time.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

Your symptoms may not get better or may get worse. Stopping this drug suddenly can also cause a high fever and confusion. Don’t stop taking this drug without talking to your doctor. If you need to stop taking this drug, your doctor will slowly decrease your dosage over time.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you apply too many patches

You could have dangerous levels of the drug in your body. Symptoms may include:

  • low blood pressure
  • movements or twitches that you can’t control
  • hallucinations (hearing or seeing things that aren’t real)
  • confusion
  • convulsions (sudden, violent movements)

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose or forget to apply a patch

Apply a new patch as soon as you remember and wear it for 24 hours. Never try to catch up by applying two patches at once. This could cause dangerous side effects.

How to tell if the drug is working

Your symptoms of Parkinson’s disease or restless legs syndrome should improve or be better controlled.

This drug is used for long-term treatment.

Apply your patch at the same time each day

Leave it on for 24 hours and then remove it before applying a new patch.

Store this drug carefully

  • Store the patches at room temperature. Keep them between 68°F and 77°F (20°C and 25°C).
  • Store this medication in the pouch it came in.
  • Do not store this drug in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

Your doctor or nurse can show you how to apply your patch.

Apply a new patch once per day at the same time each day. When choosing where to apply your patch, keep the following in mind:

  • Don’t put a patch on oily or irritated skin.
  • Don’t put a patch on skin that will be covered by tight clothing.
  • After you’ve removed a patch, don’t apply another patch to that same site for 14 days.
  • Shave any hairy skin 3 or more days before applying a patch. You should wait at least 3 days to make sure your skin isn’t irritated. Applying the patch to irritated skin may increase the speed or amount of the drug that’s absorbed. This raises your risk of side effects.
  • Don’t apply a patch to red and inflamed skin, or to any skin folds.
  • Don’t use creams or lotions on top of your patch.

Press the patch firmly for 30 seconds to make sure that it attaches to your skin. Wash your hands right after applying it. Avoid touching your eyes until after you’ve washed your hands.

To remove the patch, slowly peel it off. Fold the sticky sides together before throwing the patch away.

Clinical monitoring

You and your doctor should monitor certain health issues during your treatment. This can help make sure you stay safe while you take this drug. These issues include:

  • your blood pressure
  • weight gain and swelling
  • signs of skin cancer

Sun sensitivity

You should avoid heat while you’re taking this drug. If your skin gets hot, you can absorb too much of the drug. Avoid the sun, heating pads, heat lamps, saunas, hot tubs, and heated water pads.

Insurance

Some insurance companies might require a prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

SECTION 5 of 5

How Much Does rotigotine Cost?

Transdermal patch

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Lowest price for rotigotine

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These prices represent the lowest priced national pharmacies for rotigotine on GoodRx. They may be lower than your insurance.

Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on October 30, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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