Experiences with

Ropinirole

About ropinirole

Ropinirole is a medicine used for conditions that affect the way you move. It is used to treat the symptoms of Parkinson's disease and restless legs syndrome.

If you have Parkinson's disease, ropinirole can improve symptoms like shaking (tremors), slowness and stiffness. If you have restless legs syndrome, it helps control your leg muscles.

Ropinirole is only available on prescription and comes as tablets, including slow-release tablets.

Who can and cannot take ropinirole

Most adults (aged 18 and above) can take ropinirole. However, it's not suitable for everyone.

To make sure it's OK for you, tell your doctor if you:

• have ever had an allergic reaction to ropinirole or any other medicine
• have kidney disease or liver disease
• have a serious heart condition or problems with your blood pressure
• have a serious mental health condition such as psychosis
• are pregnant, trying to get pregnant, or breastfeeding

How and when to take ropinirole

Ropinirole comes as

• standard tablets (immediate release)
• slow-release tablets (also called prolonged release) that release the medicine into your body gradually

Try to take your ropinirole at the same time, or times, every day.

You can take ropinirole with or without food. However, you're less likely to feel sick if you have it with food.

Swallow the tablets whole with a drink of water. Do not crush or chew the slow-release tablets. This is because they have a coating that lets the medicine into your body gradually.

If you have problems swallowing tablets, speak to a pharmacist or doctor.

Dosage and strength

Standard tablets come as 0.25mg, 0.5mg, 1mg, 2mg and 5mg strength tablets.

Slow-release tablets come as as 2mg, 3mg, 4mg, 6mg and 8mg strength tablets.

Doses vary from person to person. Always follow the instructions from your doctor or specialist nurse.

You will usually start on a low dose. Your doctor or specialist nurse will increase your dose gradually until your symptoms are under control. It's best to take the lowest dose to control your symptoms because this helps reduce the chance of side effects.

Dosage for restless legs syndrome

You will usually start on 0.25mg, taken once a day. It’s best to take it just before bed to help with restless legs syndrome. Your dose will be increased gradually after a few days or weeks, up to a maximum dose of 4mg a day.

Dosage for Parkinson’s disease

You will usually start on 0.25mg, taken 3 times a day. Your dose will be increased each week, up to a usual daily dose of 9mg to 16mg.

However, if you take ropinirole with co-beneldopa or co-careldopa (or any other medicine containing levodopa), the maximum dose can go up 24mg a day.

What if I miss a dose?

If you forget to take a dose of ropinirole, skip the missed dose and take your next one at the usual time.

Do not take a double dose to make up for a forgotten one.

If you take ropinirole for Parkinson's disease and miss your doses for 1 day or more, ask your doctor or specialist nurse for advice on how to start taking it again.

If you take ropinirole for restless legs syndrome and miss your doses for more than 2 days, ask your doctor for advice on how to start taking it again.

Do not stop taking ropinirole suddenly. You can have serious withdrawal symptoms, such as changes in mood, tiredness, sweating and pain. If you need to stop taking it, your doctor or specialist nurse will reduce the dose gradually.

Taking 1 extra tablet is unlikely to harm you, but talk to your doctor, specialist nurse or pharmacist if you are concerned.

If you take more than your usual dose, you may get symptoms such as:

• feeling or being sick
• headaches, sweating or feeling dizzy
• feeling confused, or seeing, feeling or hearing things that other people cannot (hallucinations)
• feeling more sleepy or physically weak
• twitching or twisting

• you take more than double your total daily dose of ropinirole
• you take more than your usual dose of ropinirole and have any of the symptoms above

Go to 111.nhs.uk or call 111

You have taken more than your usual dose of ropinirole and:

• you have chest pain
• you have fast or irregular heart beats

If you need to go to hospital, take the medicines packet and any remaining medicine with you. Do not drive yourself. Get someone else to drive you or call for an ambulance.

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the ropinirole packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Side effects

Like all medicines, ropinirole can cause side effects. However, many people have no side effects or only minor ones.

Common side effects

These common side effects of ropinirole happen in more than 1 in 100 people.

Keep taking the medicine, but talk to your doctor or pharmacist if these side effects bother you or do not go away:

• dizziness when you get up from sitting or lying down
• feeling tired and weak
• stomach pain
• heartburn
• feeling sick or being sick
• feeling anxious or nervous
• uncontrollable twitching or twisting movements – this is more likely if you've been taking ropinirole for a long time or at a high dose.

Serious side effects

It is possible to have serious side effects with ropinirole. Some are rare and happen in less than 1 in 1,000 people, but others can be more common.

Tell your doctor or specialist nurse if:

• you start binge eating, gambling or shopping uncontrollably or having an unusually high sex drive – these are signs of impulse control disorder
• you feel unusually sleepy or suddenly fall asleep during the day
• you see, feel or hear things that are not there (hallucinations) or feel confused – this is more likely to happen in older people
• your legs, feet or hands become swollen
• your restless legs syndrome gets worse

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to ropinirole.

These are not all the side effects of ropinirole. For a full list, see the leaflet inside your medicines packet.

How to cope with the side effects of ropinirole

What to do about:

• dizziness when you get up from sitting or lying down – try getting up very slowly, or stay sitting down until you feel better. If you still feel dizzy, lie down so you do not faint, then sit up for a while until you feel OK again. Do not drive, cycle, or operate machinery if you feel dizzy. Try to avoid alcohol as it may make you feel worse.
• feeling tired and weak – make sure you rest and drink plenty of fluids and try to avoid alcohol. Do not drive, cycle or use tools or machinery if you are feeling tired or weak. Try to take ropinirole at a time when you can sit or lie down until you feel better. If you're still having problems after a week, speak to your doctor, as they may need to change your medicine.
• stomach pain – it can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to a doctor or pharmacist. 
• heartburn – it might help to eat smaller and more frequent meals, and to eat and drink slowly. Talk to your doctor if the symptoms get worse.
• feeling or being sick - taking your ropinirole after a meal or a snack can help. If you are being sick, have small, frequent sips of water to avoid dehydration. Sickness should improve with time, but if it becomes a problem your doctor may be able to prescribe an anti-sickness medicine. If you take the combined contraceptive pill or progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.
• feeling anxious or nervous – this should improve as your body gets used to the medicine. If it does not, or the symptoms get worse, speak to your doctor or specialist nurse.
• uncontrollable twitching or twisting movements – let your doctor or specialist nurse know as soon as possible. They may need to adjust your dose or medicine.

Pregnancy and breastfeeding

Ropinirole is not often used in pregnancy. This is because there is little information about how the medicine may affect your baby. However, your doctor may advise you to take it if they think the benefits of taking the medicine outweigh any risks.

If you become pregnant while taking ropinirole, speak to your doctor as soon as possible.

Breastfeeding and ropinirole

Ropinirole is not often used when breastfeeding.

The medicine can make breastfeeding more difficult as it can reduce the amount of milk your body makes.

Cautions with other medicines

There are some medicines that do not mix well with ropinirole.

Tell your doctor, specialist nurse or pharmacist if you're taking any of these medicines before starting ropinirole:

• anti-sickness medicines, such as metoclopramide or prochlorperazine
• antidepressants or antipsychotic medicines, such as fluvoxamine, amisulpride, risperidone or haloperiodol
• hormone replacement therapy (HRT) or contraceptives that contain high levels of oestrogen (ethinylestradiol)
• medicines that can lower your blood pressure – blood pressure medicines, tablets that make you pee more (diuretics), or erectile dysfunction medicines such as sildenafil (Viagra) or tadalafil (Cialis)
• ciprofloxacin, an antibiotic
• warfarin, to prevent blood clots (anticoagulant)

Taking painkillers with ropinirole

It's usually OK to take mild painkillers, such as paracetamol or ibuprofen, if you need pain relief.

Check with your doctor before taking any stronger prescription painkillers (including opioids) such as codeine, morphine or tramadol).

Mixing ropinirole with herbal remedies and supplements

There’s very little information about taking herbal remedies and supplements with ropinirole. Not enough research has been done to know whether they can affect your medicine.

Related links

Parkinson's disease — Link to Related Condition

Restless legs syndrome — Link to Related Condition

Parkinson's UK: charity — Link to Useful Resource

Restless legs syndrome: charity — Link to Useful Resource

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