Ropinirole, Oral Tablet

Medically reviewed by University of Illinois-Chicago, Drug Information Group on June 15, 2017Written by University of Illinois-Chicago, Drug Information Group on November 27, 2017

Highlights for ropinirole

  1. Ropinirole oral tablet is available as brand-name drugs and as generic drugs. Brand names: Requip and Requip XL.
  2. Ropinirole oral tablet comes in two forms: immediate-release and extended-release.
  3. Ropinirole is used to treat certain movement disorders. These include Parkinson’s disease and restless legs syndrome.

Important warnings

  • Falling asleep warning: Ropinirole may cause you to fall asleep during daily activities, such as driving or using machinery. This may happen without any warning signs, such as drowsiness. You may feel alert right before falling asleep. Until you know how this drug affects you, avoid activities that could be dangerous if you fall asleep.
  • Low blood pressure warning: Ropinirole can cause sudden low blood pressure, especially when you stand after sitting or lying down. This is called orthostatic hypotension. This occurs more often when your dosage is being increased. Your doctor may monitor your blood pressure while you take ropinirole.
  • Hallucinations warning: Ropinirole can cause hallucinations (seeing or hearing things that are not real). Seniors are at higher risk for this side effect. Tell your doctor right away if you have hallucinations.
  • Compulsive behavior warning: Ropinirole can cause intense urges to gamble, spend money, or binge-eat. It can also cause increased sexual urges or other intense urges. You may not be able to control these urges. Tell your doctor right away if you have any of these urges.

What is ropinirole?

Ropinirole is a prescription drug. It comes in the form of immediate-release and extended-release tablets you take by mouth. Extended-release drugs are released into the bloodstream slowly over time. Immediate-release drugs take effect more quickly.

Ropinirole is available as the brand-name drugs Requip and Requip XL. It’s also available as generic drugs. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name 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

Ropinirole is used to treat certain movement disorders. These include Parkinson’s disease. They also include restless legs syndrome that’s moderate to severe.

How it works

Ropinirole 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.

Ropinirole has the same effect in your central nervous system as the natural chemical dopamine. Dopamine is needed by the body to help control movement. With conditions such as Parkinson’s, the cells that produce dopamine die. Ropinirole works by acting in place of the missing dopamine.

Ropinirole side effects

Ropinirole oral tablet can cause drowsiness for several hours after you take it. It can make you fall asleep suddenly during normal daily activities. Until you know how this drug affects you, avoid activities that could be dangerous if you fall asleep. These include driving or using machinery.

Ropinirole can also cause other side effects.

More common side effects

The more common side effects that can occur with use of ropinirole include:

  • dizziness and fainting
  • seeing or hearing things that are not real (hallucinations)
  • headache
  • flushing (warm, red skin)
  • dry mouth
  • sweating
  • chest pain
  • edema (swelling)
  • high blood pressure
  • low blood pressure, which can cause dizziness, sweating, or fainting
  • dyskinesia (abnormal movement)
  • heartburn
  • nausea and vomiting
  • gas
  • heart palpitations
  • temporary memory loss
  • confusion
  • trouble concentrating
  • tiredness and yawning
  • increased infections (with symptoms such as fever or aches)
  • vision problems (such as blurry vision or double vision)

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 911 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:

  • Loss of consciousness (fainting)
  • Heart rate changes
  • Low blood pressure
  • Psychiatric effects. Symptoms can include:
    • hallucinations (seeing or hearing things that are not real)
    • paranoia (increased suspicion and distrust of people)
    • confusion
    • aggressive behavior
    • agitation
  • High fever
  • Muscle tightness
  • Excessive sleepiness. Symptoms include:
    • getting sleepy during the day
    • falling asleep without warning while doing daily activities such as talking, eating, or driving a car
  • Intense urges. Examples include:
    • new or increased urges to gamble
    • increased sexual urges
    • impulsive shopping sprees
    • binge-eating
  • Changes in size, shape, and color of moles on your skin (signs of skin cancer)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we can not 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.

Ropinirole may interact with other medications

Ropinirole oral tablet 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.

Examples of drugs that can cause interactions with ropinirole are listed below.

Antibiotic

Ciprofloxacin is used to treat infections caused by bacteria. Using this drug with ropinirole can increase the amount of ropinirole in your body. This raises your risk of side effects from ropinirole.

Asthma drug

Zileuton is used to treat asthma. Using this drug with ropinirole can increase the amount of ropinirole in your body. This raises your risk of side effects from ropinirole.

Gastrointestinal drugs

Cimetidine is used to treat GI conditions such as ulcers or GERD (gastroesophageal reflux disease). Using this drug with ropinirole can increase the amount of ropinirole in your body. This raises your risk of side effects from ropinirole.

Metoclopramide is used to treat GI conditions such as heartburn or nausea. Using this drug with ropinirole can make ropinirole less effective. This means it won’t work as well to treat your condition.

Heart drug

Mexiletine is used to treat arrhythmias (irregular heart rhythms). Using this drug with ropinirole can increase the amount of ropinirole in your body. This raises your risk of side effects from ropinirole.

Oral birth control drugs and estrogens

When used with ropinirole, certain oral birth control drugs and estrogens can increase the amount of ropinirole in your body. This raises your risk of side effects from ropinirole. Examples of these drugs include:

  • ethinyl estradiol
  • estrogens

Psychiatric drugs

Fluvoxamine is used to treat certain psychiatric conditions. Using this drug is used with ropinirole can increase the amount of ropinirole in your body. This raises your risk of side effects from ropinirole.

Using certain other psychiatric drugs with ropinirole can make ropinirole less effective. This means it won’t work as well to treat your condition. Examples of these drugs include:

  • thioridazine
  • fluphenazine
  • perphenazine
  • trifluoperazine
  • haloperidol
  • thiothixene
  • chlorpromazine

Seizure drugs

Taking certain drugs used to treat seizures with ropinirole can decrease the amount of ropinirole in your body. This means ropinirole may not work as well to treat your condition. Examples of these drugs include:

  • primidone
  • phenobarbital

Tuberculosis drugs

When used with ropinirole, certain antibiotics used to treat tuberculosis can decrease the amount of ropinirole in your body. This means ropinirole may not work as well to treat your condition. Examples of these drugs include:

  • rifampin
  • rifabutin
  • rifapentine

Other drugs

Carbamazepine is used to treat several types of conditions. These include seizures, nerve pain, and bipolar disorder. When used with ropinirole, carbamazepine can decrease the amount of ropinirole in your body. This means ropinirole may not work as well to treat your condition.

Prochlorperazine is used to treat conditions such as schizophrenia, nausea, and vomiting. When used with ropinirole, prochlorperazine can make ropinirole less effective. This means it may not work as well to treat your condition.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we can not 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.

Ropinirole warnings

This drug comes with several warnings.

Allergy warning

Ropinirole can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • trouble swallowing
  • swelling of your tongue, lips, face, or throat
  • rash
  • hives

If you develop these symptoms, call 911 or go to the nearest emergency room.

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

Smoking interaction warning

The use of cigarettes can decrease the amount of ropinirole in your body. This may decrease the effectiveness of ropinirole.

Warnings for people with certain health conditions

For people with sleep disorders: Ropinirole can cause severe drowsiness. If you already have a sleep disorder or take medications for sleep problems, this drug may make these problems worse. Talk with your doctor about whether taking this drug is safe for you.

For people with low blood pressure: Ropinirole can lower your blood pressure even more, especially when you stand after sitting or lying down. Talk with your doctor about whether this drug is safe for you.

For people with psychotic disorders: Ropinirole can cause hallucinations. Therefore, people with psychotic disorders generally should not use this drug. Talk with your doctor about your condition before taking ropinirole.

For people with compulsive behaviors: Ropinirole can cause intense urges to engage in compulsive behaviors. These can include gambling, spending money, or eating. If you already have similar urges, talk with your doctor about whether this drug is safe for you.

Warnings for other groups

For pregnant women: There haven’t been enough studies done in pregnant women to show if ropinirole poses a risk to the fetus when the woman takes this drug. However, studies of the drug in pregnant animals have shown risk to a 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.

For women who are breastfeeding: Ropinirole may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk of side effects.

For children: It has not been confirmed that ropinirole is safe and effective for use in children younger than 18 years.

How to take ropinirole

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

Dosage for Parkinson’s disease

Generic: Ropinirole

  • Form: oral immediate-release tablet
  • Strengths: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg
  • Form: oral extended-release tablet
  • Strengths: 2 mg, 4 mg, 6 mg, 8 mg, 12 mg

Brand: Requip

  • Form: oral immediate-release tablet
  • Strengths: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg

Brand: Requip XL

  • Form: oral extended-release tablet
  • Strengths: 2 mg, 4 mg, 6 mg, 8 mg, 12 mg

Adult dosage (ages 18–64 years)

  • Immediate-release tablets (Requip):
    • Typical starting dosage: 0.25 mg 3 times per day.
    • Maximum dosage: 8 mg 3 times per day.
  • Extended-release tablets (Requip XL):
    • Typical starting dosage: 2 mg once per day.
    • Maximum dosage: 24 mg once per day.

Note: If you stop taking this drug, your doctor will slowly reduce your dosage. You should not stop taking this drug suddenly.

Child dosage (ages 0–17 years)

It has not been confirmed that ropinirole is safe and effective for use in children younger than 18 years. This drug should not be used in children in this age group.

Senior dosage (ages 65 years and older)

Older adults may not be able to eliminate ropinirole from their bodies as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This increases your risk of side effects.

Your doctor may start you on a lowered dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for moderate to severe restless legs syndrome

Generic: Ropinirole

  • Form: oral immediate-release tablet
  • Strengths: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg

Brand: Requip

  • Form: oral immediate-release tablet
  • Strengths: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg

Adult dosage (ages 18–64 years)

  • Typical starting dosage: 0.25 mg once per day, taken 1–3 hours before bedtime.
  • Maximum dosage: 4 mg once per day.

Note: If you stop taking this drug, your doctor will slowly reduce your dosage. You should not stop taking the drug suddenly.

Child dosage (ages 0–17 years)

It has not been confirmed that ropinirole is safe and effective for use in children younger than 18 years. This drug should not be used in children in this age group.

Senior dosage (ages 65 years and older)

Older adults may not be able to eliminate ropinirole from their bodies as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This increases your risk of side effects.

Your doctor may start you on a lowered dosage or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

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

Take as directed

Ropinirole oral tablet is used for long-term treatment. It comes with risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: If you don’t take ropinirole at all, your symptoms won’t be controlled. If you suddenly stop taking it, you may have certain symptoms. These can include a fever, a fast heartbeat, muscle stiffness, sweating, and confusion. It’s very important that your dosage of ropinirole be gradually reduced. You should not stop this drug suddenly. Never stop taking ropinirole or change your dosage without talking to your doctor first.

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 take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • nausea or vomiting
  • hallucinations (seeing or hearing things that aren’t there)
  • increased sweating
  • drowsiness
  • palpitations (feeling like your heart is beating faster or skipping beats)

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 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: The symptoms of your condition should be reduced.

Important considerations for taking ropinirole

Keep these considerations in mind if your doctor prescribes ropinirole for you.

General

  • You can take ropinirole with or without food. Taking it with food may help reduce upset stomach.
  • Take this drug at the time(s) recommended by your doctor.
  • You can cut or crush the immediate-release tablets. Do not cut or crush the extended-release tablets.

Storage

  • Keep ropinirole at room temperature between 68°F and 77°F (20°C and 25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.
  • Keep this medication away from light.

Refills

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 harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container 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.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Prior authorization

Many insurance companies 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.

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 here in 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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