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NERVOUS SYSTEM › ANTI-PARKINSON DRUGS › DOPAMINERGIC AGENTS › Dopamine agonists
ropinirole
N04BC04
Forms & Strengths
- Tablets (immediate-release): 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg
- Tablets (extended-release): 2 mg, 4 mg, 6 mg, 8 mg, 12 mg
Adult Dosing
- Parkinson's disease (IR): Initial 0.25 mg TID; titrate weekly by 0.25 mg/dose up to 3 mg TID; max 24 mg/day
- Parkinson's disease (ER): Initial 2 mg once daily for 2 weeks; titrate weekly by 2 mg/day up to max 24 mg/day
- Restless Legs Syndrome (IR): Initial 0.25 mg once daily 1-3 hours before bedtime; titrate every few days up to 4 mg once daily
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Treatment of the signs and symptoms of idiopathic Parkinson's disease
- Treatment of moderate-to-severe primary Restless Legs Syndrome (RLS)
Mechanism of Action
- Non-ergoline dopamine agonist with high relative in vitro specificity and full intrinsic activity at the dopamine D2 and D3 receptor subtypes
- Exerts stimulant effect on dopamine receptors in the striatum and substantia nigra to ameliorate motor deficits in Parkinson's disease
Contraindications
- Known hypersensitivity to ropinirole or any formulation excipient
Adverse Reactions
- Nausea
- Dizziness / Somnolence (including sudden sleep onset)
- Syncope
- Orthostatic hypotension
- Hallucinations / Confusion
- Dyskinesia
- Impulse control disorders (pathological gambling, hypersexuality, compulsive buying)
Drug Interactions
- CYP1A2 inhibitors (e.g., ciprofloxacin, fluvoxamine) may increase ropinirole plasma concentrations
- CYP1A2 inducers (e.g., smoking, omeprazole) may decrease ropinirole clearance
- Dopamine antagonists (e.g., antipsychotics, metoclopramide) may diminish the effectiveness of ropinirole
- Additive CNS depressants and alcohol may potentiate somnolence and sedation
Curated Content: Needs Vetting Before Put to Clinical Use