Skip to main content

Rotigotine Side Effects

Medically reviewed by Philip Thornton, DipPharm. Last updated on Jul 18, 2023.

Applies to rotigotine: transdermal patch extended release.

Serious side effects of Rotigotine

Along with its needed effects, rotigotine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking rotigotine:

More common

Less common

Incidence not known

Get emergency help immediately if any of the following symptoms of overdose occur while taking rotigotine:

Symptoms of overdose

Other side effects of Rotigotine

Some side effects of rotigotine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Less common

For Healthcare Professionals

Applies to rotigotine: transdermal film extended release.


The incidence of significant decreases in blood pressure or orthostatic hypotension increased during periods of dose escalation and titration. In patients taking maximum recommended doses, orthostatic hypotension occurred (compared to placebo) at 29% (vs 11%), 27% (vs 23%), and 8% (vs 7%), in those with early stage Parkinson's disease (PD), advanced-stage PD, and restless legs syndrome, respectively.

The incidence of peripheral edema was 3% and 2% for patients with early-stage PD compared with 9% and 1% for patients with advanced-stage PD receiving drug and placebo, respectively.[Ref]

Very common (10% or more): Peripheral edema (up to 14%), orthostatic hypotension (up to 32%)

Common (1% to 10%): Abnormal ECG T wave, first degree AV block, hypertension, palpitations

Uncommon (0.1% to 1%): Atrial fibrillation

Rare (less than 0.1%): Supraventricular tachycardia[Ref]


Very common (10% or more): Nausea (up to 41%), vomiting (up to 20%),

Common (1% to 10%): Dyspepsia, constipation, diarrhea, dry mouth,

Uncommon (0.1% to 1%): Abdominal pain[Ref]

Nausea and vomiting may occur at the beginning of therapy but these are usually mild or moderate in intensity and transient even if treatment is continued.[Ref]

Nervous system

Very common (10% or more): Somnolence (up to 32%), dizziness (up to 23%), dyskinesia (up to 14%), headache (up to 21%)

Common (1% to 10%): Balance disorder, paresthesia, tremor, hypoesthesia, sleep attacks

Rare (less than 0.1%): Convulsion

Postmarketing reports: Dropped head syndrome[Ref]

In clinical trials, 2% of patients receiving maximum doses of this drug for restless legs syndrome reported sleep attacks compared with 0% of patients receiving placebo.[Ref]


Very common (10% or more): Arthralgia (up to 11%)

Common (1% to 10%): Muscle spasms

Frequency not reported: Elevated creatine phosphokinase[Ref]


Common (1% to 10%): Sinus congestion, nasal congestion, cough, nasopharyngitis, hiccups[Ref]


Common (1% to 10%): Visual disturbances

Uncommon (0.1% to 1%): Blurred vision, visual impairment, photopsia[Ref]


Common (1% to 10%): WBC in urine

Uncommon (0.1% to 1%): Erectile dysfunction[Ref]


Common (1% to 10%): Hypersensitivity including tongue edema and lip edema[Ref]


Uncommon (0.1% to 1%): Hepatic enzyme increases (ALT, AST, GGT)[Ref]


Common (1% to 10%): Anorexia, increased weight, decreased weight

Frequency not reported: Decreased serum glucose[Ref]


Frequency not reported: Elevated BUN[Ref]


Common (1% to 10%): Decreased serum ferritin

Frequency not reported: Decreased hemoglobin/hematocrit[Ref]


Very common (10% or more): Application site reactions (up to 46%), hyperhidrosis (up to 11%)

Common (1% to 10%): Erythema, pruritus,

Uncommon (0.1% to 1%): Contact dermatitis

Rare (less than 0.1%): Generalized rash[Ref]

Application site reactions (ASRs) exhibited a dose-dependent relationship for all doses in patients with both Parkinson's disease and restless legs syndrome. Reactions included localized erythema, edema, or pruritus, generally limited to the patch area; although generalized skin reactions such as allergic rash, including erythematous, macular-papular rash, or pruritus were reported at a lower incidence. Rotation of application sites has been shown to reduce the incidence of ASRs.

When applied as instructed, 34.2% (n=748) of patients experienced ASR; the majority were mild or moderate in intensity. Discontinuation occurred in 7.2% of patients[Ref]


Very common (10% or more): Disturbances in initiating and maintaining sleep (up to 14%), hallucinations (up to 13%)

Common (1% to 10%): Abnormal dreams, nightmare, irritability, sleep disorder, depression, impulse-control disorders

Uncommon (0.1% to 1%): Obsessive-compulsive disorder, disorientation, agitation

Rare (less than 0.1%): Aggressive behavior, binge eating, delusion, delirium[Ref]


Very common (10% or more): Fatigue (up to 18%), asthenic conditions (up to 14%)

Common (1% to 10%): Tinnitus, vertigo[Ref]

Asthenic conditions included asthenia, malaise, and fatigue.[Ref]


Common (1% to 10%): Menstrual disorder, sexual desire disorder[Ref]


The most common adverse reactions experienced among patients with Parkinson's disease included nausea, vomiting, somnolence, application site reactions, dizziness, anorexia, disturbances in initiating and maintaining sleep, hyperhidrosis, visual disturbances, peripheral edema, and dyskinesia. For patients with Restless Legs Syndrome, the most common adverse reactions included application site reactions, nausea, disturbances in initiating and maintaining sleep, somnolence, and headache.[Ref]


Common (1% to 10%): Basal cell carcinoma[Ref]


1. Cerner Multum, Inc. UK Summary of Product Characteristics.

2. Product Information. Neupro (rotigotine). Schwarz Pharma. 2007.

3. Cerner Multum, Inc. Australian Product Information.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.