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Generic Name: ropinirole (oral) (roe PIN i role)
Brand Name: Requip, Requip XL

What is ropinirole?

Ropinirole has some of the same effects as a chemical called dopamine, which occurs naturally in your body. Low levels of dopamine in the brain are associated with Parkinson's disease.

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

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

What is the most important information I should know about ropinirole?

Ropinirole may cause you to fall asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Tell your doctor if you have any problems with daytime sleepiness or drowsiness. If you are unsure of how this medicine will affect you, be careful if you drive or do anything that requires you to be awake and alert.

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

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Do not share this medication with another person, even if they have the same symptoms you do.

Avoid drinking alcohol, which can increase some of the side effects of ropinirole.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by ropinirole. Tell your doctor if you regularly use any of these other medicines.

Ropinirole may cause hallucinations (the sensation of hearing or seeing something that is not there), most commonly among elderly people. Call your doctor if you experience hallucinations.

Do not stop using ropinirole or change your dose without first talking to your doctor. You may have side effects such as fever, muscle stiffness, and confusion if you stop the medication suddenly or if you change doses.

Some people taking medicines for Parkinson's disease have developed skin cancer (melanoma). However, people with Parkinson's disease may have a higher risk than most people for developing melanoma. Talk to your doctor about your specific risk and what skin symptoms to watch for. You may need to have regular skin exams.

What should I discuss with my healthcare provider before taking ropinirole?

Ropinirole may cause you to fall asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Tell your doctor if you have any problems with daytime sleepiness or drowsiness. If you are unsure of how this medicine will affect you, be careful if you drive or do anything that requires you to be awake and alert.

You should not use this medication if you are allergic to ropinirole.

If you have certain conditions, you may need a dose adjustment or special tests to safely take this medication. Before you take this medication, tell your doctor if you are allergic to any drugs, or if you have:

  • heart disease;

  • high or low blood pressure;

  • mental illness or compulsive behaviors;

  • kidney disease;

  • liver disease; or

  • if you smoke.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking ropinirole. It is not known whether the medicine actually causes this effect. Talk with your doctor if you believe you have any intense or unusual urges while taking ropinirole.

FDA pregnancy category C. It is not known whether ropinirole is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether ropinirole passes into breast milk or if it could harm a nursing baby. Ropinirole may reduce breast milk production. Do not take ropinirole without telling your doctor if you are breast-feeding a baby.

Ropinirole may cause hallucinations (the sensation of hearing or seeing something that is not there), most commonly among elderly people. Call your doctor if you experience hallucinations.

Some people taking medicines for Parkinson's disease have developed skin cancer (melanoma). However, people with Parkinson's disease may have a higher risk than most people for developing melanoma. Talk to your doctor about your specific risk and what skin symptoms to watch for. You may need to have regular skin exams.

How should I take ropinirole?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

The dose and timing of ropinirole in treating Parkinson's disease is different from the dose and timing in treating RLS.

You may receive ropinirole in a starting kit that has each pill marked with the day you should take it. Do not mix these pills up because they each contain different amounts of ropinirole. The pills must be taken in order so that you gradually receive higher doses of the medication.

You may have a brief increase in side effects whenever your dose is changed.

Ropinirole can be taken with or without food. Taking the medicine with food may help prevent nausea, which is a common side effect of ropinirole.

It may take several weeks or months of using this medicine before your symptoms improve. For best results, keep using the medication as directed.

Do not stop taking ropinirole suddenly or change your doses, or you could have unpleasant withdrawal symptoms such as fever, muscle stiffness, and confusion. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Do not share this medication with another person, even if they have the same symptoms you do.

Store ropinirole at room temperature away from moisture and heat.

What happens if I miss a dose?

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

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include nausea, vomiting, weakness, fainting, agitation, confusion, hallucinations, muscle twitching, tingly feeling, and chest pain.

What should I avoid while taking ropinirole?

Ropinirole can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid smoking, which can make ropinirole less effective.

Avoid drinking alcohol. It can increase some of the side effects of ropinirole.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Ropinirole side effects

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

Call your doctor at once if you have any of these serious side effects:

  • feeling like you might pass out;

  • fever, stiff muscles, confusion, sweating, fast or uneven heartbeats (especially if you stop taking ropinirole or use a lower dose);

  • hallucinations;

  • tremors (uncontrolled shaking); or

  • tight feeling in your chest, trouble breathing.

Call your doctor promptly if you fall asleep during a daily activity, if you faint, or if you have hallucinations (hearing or seeing something that is not there). Your doctor may want you to stop taking ropinirole, or take a lower dose.

Less serious side effects may occur, such as:

  • mild nausea, vomiting, stomach pain, or loss of appetite;

  • worsened RLS symptoms early in the morning;

  • diarrhea or constipation;

  • dry mouth, sweating;

  • headache;

  • dizziness, drowsiness;

  • sleep problems (insomnia); or

  • agitation or anxiety.

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.

See also: Side effects (in more detail)

What other drugs will affect ropinirole?

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by ropinirole. Tell your doctor if you regularly use any of these other medicines, or any other Parkinson's medications..

Before taking ropinirole, tell your doctor if you are using any of the following drugs:

  • levodopa;

  • ciprofloxacin (Cipro);

  • fluvoxamine (Luvox);

  • metoclopramide (Reglan);

  • omeprazole (Prilosec);

  • a medication used to treat nausea and vomiting or mental illness, such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), thioridazine (Mellaril), promazine (Sparine), trifluoperazine (Stelazine), thiothixene (Navane), or haloperidol (Haldol); or

  • an estrogen such as Premarin, Prempro, Estratest, Ogen, Estraderm, Climara, Vivelle, estradiol, and others.

This list is not complete and there may be other drugs that can interact with ropinirole. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about ropinirole.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 12.02. Revision Date: 2010-12-15, 5:01:39 PM.

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