Neupro (rotigotine) is a prescription drug used to relieve symptoms of Parkinson’s disease and restless legs syndrome. Neupro can cause side effects that range from mild to serious. Examples include sleepiness, nausea, and vomiting.

Specifically, Neupro is used in adults to relieve symptoms of:

Neupro comes as a patch you apply to your skin. It contains the active ingredient rotigotine. (An active ingredient is what makes a drug work.)

Keep reading to learn about the common, mild, and serious side effects that Neupro can cause. For a general overview of the drug, including details about its uses, see this article.

Below are just a few of the more common side effects reported by people using Neupro in studies. These side effects can vary depending on which condition the drug is being used to treat.

More common side effects in people using Neupro for Parkinson’s disease include:

  • dizziness
  • nausea
  • vomiting
  • patch site reactions*
  • sleepiness

More common side effects in people using Neupro for moderate to severe primary restless legs syndrome include:

  • insomnia (trouble falling or staying asleep)
  • nausea
  • sleepiness
  • patch site reactions*
  • headache

* To learn more about this side effect, see the “Side effects explained” section below.

Mild side effects have been reported with Neupro. These include:

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop using Neupro unless your doctor recommends it.

Neupro may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using Neupro, but it’s not clear whether this side effect occurred in studies.

Serious side effects have been reported with Neupro. These include:

  • withdrawal symptoms (see “FAQ about Neupro’s side effects” below for more information)
  • sulfite reaction, including anaphylaxis, especially in people with asthma
  • severe patch site reactions*
  • falling asleep during daily activities
  • abnormal thinking and behavior
  • impulse control problems and compulsive behaviors
  • blood pressure problems (too high or too low)
  • rapid heartbeat
  • fainting
  • weight gain and fluid retention*
  • involuntary movements
  • increased restless legs symptoms
  • high fever with confusion
  • risk of hardening or scarring of body tissues such as lung or heart tissue
  • severe allergic reaction*†

If you develop serious side effects while using Neupro, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using Neupro, but it’s not clear whether this side effect occurred in studies.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Neupro, visit MedWatch.

Get answers to some frequently asked questions about Neupro’s side effects.

Are withdrawal symptoms possible with Neupro?

Yes. If you and your doctor decide you should stop using Neupro, you may experience withdrawal symptoms. These can include:

  • anxiety
  • depression
  • fatigue (low energy)
  • insomnia
  • sweating
  • pain
  • apathy (not caring about things you usually care about)

Some side effects of withdrawal may be life threatening, such as:

  • fever
  • confusion
  • very stiff muscles

If you experience serious Neupro withdrawal symptoms, call your doctor right away. For life threatening side effects or a medical emergency, call 911 or your local emergency number.

If you have questions about how to stop Neupro, talk with your doctor. They can instruct you on how to wean yourself off of the medication to minimize withdrawal symptoms.

Does Neupro cause long-term side effects?

It’s possible. Long-term side effects include those that may start at any time during your treatment with a drug, even if you’ve used it for a long time. They also include side effects that may not go away, even after you stop using the drug.

Examples of long-term side effects reported in Neupro’s studies include:

  • involuntary movements
  • increased restless legs symptoms
  • rare risk of hardening or scarring of body tissues* such as:
    • heart valves
    • the lining of the abdomen
    • the lining around the lungs

This hardening causes an increase in inflammation in the tissues of the lungs and around the heart. Inflammation can lead to excess fluid in and around the lungs and swelling of the tissue around the heart.

If you’re concerned about possible long-term side effects from Neupro, talk with your doctor or pharmacist.

* There are reports of people developing hardened or scarred body tissue from taking ergotamine-related drugs. This hasn’t been reported in Neupro studies but may still be a risk, as ergotamines can affect dopamine in the same way Neupro does.

Learn more about some of the side effects Neupro may cause.

Patch site reactions

Patch site reactions were a common side effect reported in studies of Neupro. These reactions may cause symptoms such as:

  • swelling
  • skin discoloration
  • itching

Factors that can increase the risk of patch site reactions when using this drug include:

  • applying the patch to the same site each day
  • wearing tight clothing (such as a waistband or bra) at the patch site
  • applying the patch to shaved, broken, or irritated skin
  • using powders, creams, ointments, or oils on the area where you’ll apply the patch
  • applying the patch on skin folds
  • wearing a patch while using heating pads, electric blankets, hot tubs, or saunas
  • wearing a patch during a cardioversion (heart procedure) or an MRI scan

What might help

Mild patch site reactions usually clear up in a few days. Apply the patch to a different site each day, and don’t use the same area of skin for at least 14 days. Wait 3 days before applying a patch to a newly shaved area.

If a skin reaction from the patch persists, worsens, or spreads, talk with your doctor. They’ll determine whether Neupro’s advantages outweigh the risks of continued use.

Weight gain and fluid retention

Weight gain and fluid retention were common side effects reported in studies of Neupro. Weight gain was linked to fluid swelling in the arms and legs.

People using the maximum dose of Neupro for early stage Parkinson’s disease had the highest risk of weight gain and fluid retention. Other factors that may increase weight gain with this drug include congestive heart failure and kidney problems.

Weight gain combined with fluid retention may cause symptoms such as:

What might help

If you’re at risk for weight gain or fluid retention during Neupro treatment, your doctor may ask you to weigh yourself daily and report specific changes. You may also want to talk with your pharmacist. They can check to see whether any other medications you take can make fluid retention worse.

If you have sudden weight gain or fluid retention during Neupro treatment, call your doctor right away. And do not stop using Neupro without their approval.

Allergic reaction

Like most drugs, Neupro can cause an allergic reaction in some people. But it’s not clear whether this side effect occurred in studies. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

In addition, Neupro contains sodium metabisulfite, a sulfite preservative. This can trigger severe allergic reactions, including life threatening responses, in people who are sensitive to it. (A sulfite allergy is not the same as a sulfa allergy.)

Allergic reactions from sulfites occur more often in people with asthma. So, if you have a sulfite allergy or asthma, it’s important to talk with your doctor before starting Neupro treatment.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an oral antihistamine, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Neupro, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, quickly remove the patch and call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Neupro, they may have you switch to a different treatment.

Keeping track of side effects

During your Neupro treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the medication you were using when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Neupro affects you. They can then use this information to adjust your treatment plan if needed.

Below is important information you should consider before starting Neupro treatment.

Warnings

Neupro can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Neupro is a good treatment option for you.

Talk with your doctor about your health history before using Neupro. Be sure to tell them if any of the following factors apply to you:

  • asthma or other breathing problems
  • heart problems
  • high or low blood pressure
  • sudden nausea or fainting when getting up from bed or a chair
  • daytime sleepiness or other sleep problems
  • mental health conditions such as:
  • alcohol use
  • use of other prescription drugs, over-the-counter drugs, vitamins, herbs, or supplements
  • previous allergic reaction to Neupro
  • pregnancy
  • breastfeeding

Alcohol and Neupro

You should not use Neupro with alcohol. Drinking alcohol while wearing a Neupro patch may increase drowsiness and the risk of falls and accidents.

If you have questions about consuming alcohol during Neupro treatment, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Neupro

There’s limited information about the safety of Neupro use during pregnancy or while breastfeeding.

Pregnancy

It’s not known whether it’s safe to use Neupro during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor before starting Neupro.

If you’re able to become pregnant, your doctor may recommend using a form of birth control before and throughout your Neupro treatment.

Breastfeeding

It isn’t known whether Neupro is safe to use while breastfeeding. Because of how it works in your body, Neupro may lower prolactin hormone levels, reducing breast milk production. But there’s not enough research data to know for certain.

If you’re breastfeeding or planning to do so, talk with your doctor before starting this medication.

Like most drugs, Neupro can cause a number of side effects that range from mild to serious. But most are temporary and go away after a few days to weeks. If you have questions about side effects Neupro can cause, talk with your doctor. Examples to help get you started include:

  • Considering my health history, what side effects, if any, am I likely to have with Neupro?
  • Will I be able to drive while using this medication?
  • Can I drink caffeine or energy drinks to counteract sleepiness from Neupro?
  • Are there over-the-counter drugs I can take to treat nausea and vomiting from Neupro?

To learn more about Neupro, see these articles:

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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 another 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.