Ropinirole

Ropinirole works similarly to a chemical called dopamine, which is naturally found in your body. Low dopamine levels in the brain are linked to Parkinson's disease.

Ropinirole is used to treat symptoms of Parkinson's disease, including stiffness, tremors, muscle spasms, and poor muscle control. Ropinirole is also used to treat restless legs syndrome (RLS).

Only immediate-release ropinirole (Requip) is approved to treat either Parkinson's symptoms or RLS. Extended-release ropinirole (Requip XL) is approved only for treating Parkinson's symptoms.

Parkinson's and RLS are two different disorders. Having one of these conditions will not lead to having the other.

Ropinirole may also be used for other purposes that are not listed in this medication guide.

Follow all instructions on your prescription label. Your doctor may occasionally adjust your dose. Do not take this medicine in larger or smaller amounts or for longer than what is recommended.

If you are taking immediate-release ropinirole (Requip), you should not take extended-release ropinirole (Requip XL) at the same time.

The dose and timing of ropinirole for treating Parkinson's disease is different from the dose and timing for treating RLS. Follow the directions on your prescription label. Ask your pharmacist if you have questions about the type of ropinirole you receive at the pharmacy.

Ropinirole can be taken with or without food. Take the medicine at the same time every day.

Do not crush, chew, or break an extended-release tablet (Requip XL). Swallow it whole.

Call your doctor if you see part of the ropinirole tablet in your stool. This means your body may not have absorbed all of the medicine.

If you are taking this medicine for RLS, tell your doctor if your symptoms worsen, if they happen in the morning or earlier than usual in the evening, or if you feel restless symptoms in your hands or arms.

It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not get better.

Do not stop using ropinirole suddenly, or you could experience unpleasant withdrawal symptoms. Follow your doctor's instructions about gradually reducing your dose.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Follow all instructions on your medicine label and package. Inform each of your healthcare providers about all your medical conditions, allergies, and all medicines you are taking.

You should not use ropinirole if you are allergic to it.

To make sure ropinirole is safe for you, tell your doctor if you have:

• high or low blood pressure;
• kidney disease (or if you are on dialysis);
• heart disease, heart rhythm problems;
• a sleep disorder such as narcolepsy, or other conditions that may cause daytime sleepiness; or
• if you smoke.

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Talk to your doctor about this risk and what skin symptoms to watch for.

It is not known whether ropinirole will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether ropinirole passes into breast milk or if it could affect the nursing baby. Ropinirole may slow breast milk production. Tell your doctor if you are breast-feeding.

Ropinirole is not approved for use by anyone younger than 18 years old.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Some people taking ropinirole have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking ropinirole. Talk with your doctor if this occurs.

Ropinirole may cause serious side effects. Call your doctor at once if you have:

• extreme drowsiness, falling asleep suddenly (even after feeling alert);
• worsening or no improvement in your symptoms;
• a light-headed feeling, like you might pass out;
• unusual changes in mood or behavior;
• tremors, twitching uncontrollable muscle movements; or
• hallucinations (seeing or hearing things that are not real).

Side effects such as confusion or hallucinations may be more likely in older adults.

Common side effects of ropinirole may include:

• drowsiness, dizziness, weakness;
• headache, confusion, hallucinations;
• increased blood pressure (severe headache, pounding in your neck or ears, nosebleed, irregular heartbeats);
• nausea, vomiting, upset stomach, constipation;
• flu symptoms (fever, chills, body aches);
• sudden muscle movements;
• increased sweating; or
• swelling in your legs or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Take the missed dose as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose. Do not take extra medicine to compensate for the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Avoid standing up quickly from a sitting or lying position, as this may cause dizziness. Get up slowly and steady yourself to prevent falling. Dizziness may affect your thinking or reactions. Avoid driving or using machinery until you understand how ropinirole will affect you.

Drinking alcohol can make some side effects of ropinirole worse.

Taking ropinirole with other medications that cause drowsiness can increase this effect. Speak to your doctor before using a sleeping pill, narcotic medication, muscle relaxant, or medication for anxiety, depression, or seizures.

Other medications may interact with ropinirole, including prescription and over-the-counter drugs, vitamins, and herbal products. Inform all of your health care providers about all medicines you are currently taking and any medicines you begin or stop taking.