Ropinirole
Pronunciation: roh-PIN-ih-role.
- Generic name
- ropinirole
- Drug class
- Non-ergoline dopamine (D2/D3) receptor agonist
- Form
- Immediate-release tablet (0.25 mg to 5 mg); extended/prolonged-release tablet in some markets (Requip XL / Requip Depot / Requip-Modutab)
- Route
- Oral
- Legal status
- Prescription-only
Availability and supply rules vary by country
Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand
Australia: Repreve (restless legs syndrome) (5), ROPINIROLE ARW / APPESE (Parkinson's disease, generic) (5) · Full directory
What ropinirole is and how it works
Ropinirole is a prescription-only tablet that stimulates dopamine receptors in the brain. It is used to treat Parkinson's disease, and in some countries also moderate-to-severe restless legs syndrome (RLS), often under a different brand name. (1)
You take ropinirole by mouth, usually starting at a very low dose that is gradually increased over several weeks. It can cause sudden sleepiness or urges to gamble, spend, or eat that feel hard to control in some people -- tell your prescriber promptly if either happens. Never stop or change your dose abruptly without medical advice.
Mechanism of action: how ropinirole works
Ropinirole is a non-ergoline dopamine agonist with high relative in-vitro specificity for the D2 and D3 dopamine receptor subtypes; it binds with higher affinity to D3 than D2 or D4 receptor subtypes. Its precise mechanism of action in Parkinson's disease and restless legs syndrome is not fully established, but is thought to relate to stimulation of striatal postsynaptic dopamine receptors. (1) (7)
What ropinirole is used for
Parkinson's disease
Used alone (as initial treatment, to delay the need for levodopa) or together with levodopa, to treat the symptoms of Parkinson's disease, including when levodopa's effect wears off or fluctuates ('end of dose' or 'on-off' effects). Approved for this use in all 6 markets reviewed. (1) (2) (7)
Restless legs syndrome (RLS) -- availability varies by country
Used for moderate-to-severe primary restless legs syndrome in the US (as Requip) and Australia (as Repreve). In the UK, this use is provided by a separate brand, Adartrel, not by Requip. The current New Zealand data sheet (ROPIN) does not include restless legs syndrome as an approved use. (1) (3) (5) (7)
Before taking ropinirole
Do not take / not appropriate for
- Do not take ropinirole if you have had an allergic reaction to it or to any of its ingredients. (all countries) (1) (2)
- Do not take ropinirole if you have severe kidney impairment and are not on regular dialysis. (all countries) (1) (2) (7)
- In the UK and New Zealand, ropinirole is also contraindicated outright in people with hepatic (liver) impairment. In the US label, it is not an outright contraindication, but caution is advised because it has not been specifically studied in liver impairment. (United Kingdom and New Zealand (contraindicated); United States (caution only)) (2) (7) (1)
Tell your clinician about
- Any history of major psychiatric illness or psychotic disorders.
- Any history of gambling problems, compulsive behaviours, or difficulty controlling urges.
- Any liver or kidney problems.
- Any heart or blood vessel disease, or history of fainting or low blood pressure.
- All other medicines you take, especially other medicines for Parkinson's disease, antipsychotics, or ciprofloxacin/other CYP1A2-affecting medicines.
- Pregnancy, plans for pregnancy, or breastfeeding -- ropinirole can reduce breast milk production.
- Whether you drive or operate machinery -- sudden sleepiness can occur without warning.
How to take ropinirole
- Take ropinirole by mouth, preferably with food to reduce nausea.
- Your prescriber will start you on a low dose and increase it gradually over several weeks according to a specific schedule -- do not speed up or change this on your own.
- Do not stop taking ropinirole suddenly -- it must be tapered down gradually by your prescriber to avoid withdrawal symptoms or a rare but serious reaction resembling neuroleptic malignant syndrome.
- If you miss a dose or a dose is interrupted for a day or more, contact your prescriber, since treatment may need to restart at a lower dose and be re-titrated.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (6) (5) (7)
Missed dose
If you miss a dose, contact your prescriber for advice rather than doubling up -- if treatment has been interrupted for a day or more, your prescriber may need to restart your dose titration from a lower level.
Overdose
Seek urgent medical attention if too much ropinirole may have been taken, especially if you develop severe nausea, vomiting, low blood pressure, fainting, hallucinations, or severe drowsiness. (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms.
Nausea -- very common, especially early in Parkinson's disease treatment (up to 60%) and in restless legs syndrome (up to 40%).
What to notice: Nausea -- very common, especially early in Parkinson's disease treatment (up to 60%) and in restless legs syndrome (up to 40%).
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Somnolence (sleepiness) -- very common across all uses.
What to notice: Somnolence (sleepiness) -- very common across all uses.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Dizziness.
What to notice: Dizziness.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Vomiting.
What to notice: Vomiting.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
In advanced Parkinson's disease combined with levodopa: dyskinesia (involuntary movements) -- common.
What to notice: In advanced Parkinson's disease combined with levodopa: dyskinesia (involuntary movements) -- common.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Serious warnings
Sudden onset of sleep or excessive daytime sleepiness — high caution
Symptoms: Falling asleep suddenly during activities such as driving, sometimes without any warning signs, even if you don't otherwise feel drowsy.
Action: Do not drive or operate machinery if you have ever had this happen. Tell your prescriber -- your dose may need to be reduced or the medicine stopped. This can occur at any point during treatment, even after a year or more. (1) (2)
Impulse control or compulsive behaviours — high caution
Symptoms: New or increased urges to gamble, unusual sexual urges, uncontrolled spending, or binge/compulsive eating that feel hard to resist.
Action: Tell your prescriber promptly if you or people close to you notice this. Your dose may need to be reduced, or the medicine tapered off, under medical supervision. (1) (2) (7)
Hallucinations or new/worsening mental or behavioural changes — high caution
Symptoms: Seeing or hearing things that are not there, confusion, or unusual behaviour.
Action: Tell your prescriber -- this may require a dose adjustment. Use particular caution if you have a history of major psychiatric or psychotic illness. (1) (7)
Fainting or symptoms of low blood pressure — high caution
Symptoms: Dizziness or light-headedness on standing, or fainting, especially when starting treatment or increasing the dose.
Action: Sit or lie down if you feel faint, and tell your prescriber, particularly if you have heart or blood vessel disease. (1) (7)
Symptoms of dopamine agonist withdrawal or a neuroleptic-malignant-syndrome-like reaction after stopping abruptly — high caution
Symptoms: Apathy, anxiety, depression, fatigue, sweating, pain, high fever, muscle rigidity, or confusion after stopping or rapidly reducing ropinirole.
Action: Never stop ropinirole abruptly on your own. Your prescriber will taper the dose gradually. Seek urgent medical attention if severe symptoms occur after stopping. (2) (7)
Worsening restless legs symptoms (augmentation) -- for people using it for RLS — moderate caution
Symptoms: Symptoms starting earlier in the day, becoming more intense, or spreading to other body parts.
Action: Tell your prescriber -- your treatment may need to be reviewed or adjusted. (3) (1)
Signs suggestive of rare fibrotic (scarring) reactions — moderate caution
Symptoms: New shortness of breath, chest pain, or persistent cough.
Action: Tell your prescriber promptly -- rare cases of fibrotic reactions affecting the lungs or heart valves have been reported in the US label reviewed for this medicine. (1)
Interactions
- Ciprofloxacin and other CYP1A2 inhibitors (such as fluvoxamine, enoxacin) can raise ropinirole levels significantly -- your dose may need adjusting if you start or stop one of these. (2) (7)
- Antipsychotics and other centrally-acting dopamine-blocking medicines (such as sulpiride or metoclopramide) can reduce ropinirole's effectiveness -- these combinations are generally avoided. (7)
- Starting or stopping hormone replacement therapy (oestrogens) may require your ropinirole dose to be adjusted. (1) (2)
- There is no significant interaction between ropinirole and levodopa or domperidone requiring a dose change. (7)
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Ropinirole may cause fetal harm based on animal studies (teratogenicity and pregnancy loss at high doses); it should be avoided in pregnancy unless the potential benefit justifies the risk to the fetus. Discuss with your prescriber. (1) (2) (3) (4) (6) (5) (7)
Breastfeeding
Ropinirole is not recommended while breastfeeding -- it reduces prolactin, which can reduce breast milk production, and it is not known whether it passes into breast milk. (1) (2) (3) (4) (6) (5) (7)
Children
Not recommended in children and adolescents under 18 years due to a lack of safety and effectiveness data. (1) (2) (3) (4) (6) (5) (7)
Elderly
Ropinirole clearance is reduced by about 15% in people 65 and older. No fixed dose reduction is required, but doses should be individually titrated with careful monitoring. (1) (2) (3) (4) (6) (5) (7)
Hepatic_impairment
Contraindicated outright in the UK and New Zealand. The US label has not specifically studied hepatic impairment and advises caution due to extensive liver metabolism, without an outright contraindication -- a genuine difference between regulators. (1) (2) (3) (4) (6) (5) (7)
Renal_impairment
No dose adjustment needed for mild-to-moderate impairment. Reduced maximum doses apply for people on regular haemodialysis (see dosing section). Severe impairment without dialysis has not been studied and is contraindicated without haemodialysis. (1) (2) (3) (4) (6) (5) (7)
Source_ids
US-DAILYMED-ROPINIROLE-2026,UK-EMC-REQUIP-2026,NZ-MEDSAFE-ROPIN-2026 (1) (2) (3) (4) (6) (5) (7)
Monitoring
Before starting
- Assessment of liver and kidney function
- Screening for history of psychiatric/psychotic illness, impulse control problems, or compulsive behaviours
- Blood pressure and cardiovascular history review
- Review of all other medicines, especially CYP1A2 inhibitors and other dopamine-active medicines
During treatment
- Regular monitoring for excessive sleepiness or sudden sleep episodes.
- Regular monitoring for new or worsening impulse control or compulsive behaviours, ideally also involving family/carers.
- Blood pressure monitoring, especially at treatment start and dose increases.
- Monitoring for hallucinations or behavioural changes.
- For restless legs syndrome: periodic review for augmentation and reassessment of ongoing need after 12 weeks.
Storage
Store at room temperature, away from moisture and light, in the original packaging, out of reach of children.
Study the drug class: Antiparkinsonian agents
Professional information
Clinician-facing context only, sourced from the current US FDA prescribing information and UK/NZ regulator sources; verify against the current full label in the relevant jurisdiction before prescribing.
United States
Indication: Parkinson's disease and moderate-to-severe primary restless legs syndrome
Dose summary: PD: 0.25 mg TID titrated to max 24 mg/day (18 mg/day on haemodialysis). RLS: 0.25 mg once daily 1-3h before bedtime, titrated to max 4 mg/day (3 mg/day on haemodialysis).
Renal context: No adjustment for CrCl 30-50 mL/min; reduced maximum doses for haemodialysis patients as above; not studied in severe impairment without dialysis. (1)
United Kingdom
Indication: Parkinson's disease (Requip brand) and restless legs syndrome (separate Adartrel brand)
Dose summary: Requip (PD): 0.25 mg TID titrated weekly to therapeutic range 3-9 mg/day, max 24 mg/day, 18 mg/day on haemodialysis. Adartrel (RLS): individually titrated, doses above 4 mg/day not studied, mean effective dose ~2 mg/day, review continued need after 12 weeks.
Renal context: Hepatic impairment is an outright contraindication for both brands (severe only, for Adartrel; unqualified for Requip). (2) (3)
New Zealand
Indication: Parkinson's disease only (no restless legs syndrome indication in the current data sheet)
Dose summary: 0.25 mg TID initial, titrated per a defined weekly schedule to 3 mg/day by week 4, then further titrated to a therapeutic range of 3-9 mg/day, max 24 mg/day; haemodialysis max 18 mg/day.
Renal context: No adjustment for CrCl 30-50 mL/min. Hepatic impairment is an outright, unqualified contraindication (matching the UK Requip PD product). (7)
Hepatic guidance
Not specifically studied in hepatic impairment in the US label (caution advised); contraindicated outright in the UK and New Zealand labels reviewed.
Overdose note
Manage supportively; monitor for hypotension, hallucinations, and severe nausea/vomiting. (1) (7)
Frequently asked questions
Is ropinirole available in the US, UK, Europe, Canada, Australia, and New Zealand?
Yes, ropinirole is approved and available in all of these regions for Parkinson's disease. Its availability and branding for restless legs syndrome vary: it is available for RLS in the US (as Requip) and Australia (as Repreve) and in the UK under a separate brand, Adartrel -- but the current New Zealand data sheet (ROPIN) does not include restless legs syndrome as an approved use. (1) (2) (3) (4) (6) (5) (7)
Does ropinirole have a boxed warning?
No. Ropinirole does not carry an FDA boxed warning. It does carry substantial warnings for sudden sleep onset, impulse control/compulsive behaviours, hallucinations, and low blood pressure, which are described in detail on this page. (1)
Can I take ropinirole if I have liver problems?
It depends on where you live and how severe your liver condition is. In the UK and New Zealand, liver impairment is an outright contraindication. In the US label, it isn't specifically studied but caution is advised because ropinirole is broken down mainly by the liver. Discuss your specific situation with your prescriber. (2) (7) (1)
Why might I suddenly feel an urge to gamble or spend money while taking this medicine?
Ropinirole and other dopamine agonists can cause impulse control disorders -- new or intense urges around gambling, spending, sexual behaviour, or eating that feel hard to resist. This is a recognised, genuine drug effect, not a personal failing. Tell your prescriber if this happens; reducing the dose or stopping the medicine (under medical supervision) usually resolves it. (1) (2)
What is the mechanism of action of ropinirole?
Ropinirole is a non-ergoline dopamine agonist with high relative in-vitro specificity for the D2 and D3 dopamine receptor subtypes; it binds with higher affinity to D3 than D2 or D4 receptor subtypes. Its precise mechanism of action in Parkinson's disease and restless legs syndrome is not fully established, but is thought to relate to stimulation of striatal postsynaptic dopamine receptors. (1) (7)
What is the generic name of Ropinirole?
The generic name is ropinirole. (1)
What class of drug is ropinirole?
Ropinirole is classed as: Non-ergoline dopamine (D2/D3) receptor agonist. (1)
References
- ROPINIROLE tablets, for oral use -- full prescribing information (Requip)U.S. Food and Drug Administration / DailyMed (NIH), full prescribing information · United States · accessed 2026-07-30 · source 1
- Requip 1 mg / 2 mg Film-coated Tablets -- Summary of Product Characteristics (Parkinson's disease only)electronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-30 · source 2
- Adartrel 0.25 mg / 0.5 mg / 2.0 mg Film-coated Tablets -- Summary of Product Characteristics (restless legs syndrome brand)electronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-30 · source 3
- Ropinirole -- List of nationally authorised medicinal products (EMA/280628/2017)European Medicines Agency (EMA) -- Human Medicines Evaluation Division, list of nationally authorised medicinal products (PSUSA/00002661/201607) · European Union · accessed 2026-07-30 · source 4
- Ropinirole ARTG entries (Repreve, ROPINIROLE ARW, APPESE) and REQUIP cancellation recordsTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-30 · source 5
- Ropinirole tablets -- Health Canada Drug Product Database entries and product monographsHealth Canada Drug Product Database / product monographs (Sun Pharma, Teva, and other generic sponsors) · Canada · accessed 2026-07-30 · source 6
- ROPIN (ropinirole) 0.25 mg / 0.5 mg / 1 mg / 2 mg / 5 mg tablets -- New Zealand Data SheetMedsafe (New Zealand regulator) -- Viatris New Zealand data sheet · New Zealand · accessed 2026-07-30 · source 7
Brand names by country
Single-ingredient ropinirole names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Requip / Requip XL (and generic ropinirole) (1)FDA approved currently labeled · 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 5 mg tablets (immediate release) · GlaxoSmithKline (originator); multiple generic sponsors
United Kingdom
- Requip (Parkinson's disease only) (2)MHRA licensed emc smpc confirmed · 0.25 mg, 1 mg, 2 mg, 5 mg tablets · GlaxoSmithKline UK Ltd
- Adartrel (restless legs syndrome only -- separate brand, same active ingredient) (3)MHRA licensed emc smpc confirmed · 0.25 mg, 0.5 mg, 2.0 mg tablets · GlaxoSmithKline UK Ltd
Canada
- REQUIP
Australia
- Repreve (restless legs syndrome) (5)TGA ARTG registered 2017-11-07 confirmed · 0.25 mg tablet · Arrotex Pharmaceuticals Pty Ltd
- ROPINIROLE ARW / APPESE (Parkinson's disease, generic) (5)TGA ARTG registered 2004-10-05 confirmed; original Requip brand cancelled 2015-03-18 · 0.25 mg, 0.5 mg, 1 mg tablets · Arrotex Pharmaceuticals Pty Ltd
New Zealand
- ROPIN (Parkinson's disease only -- no restless legs syndrome indication in the current data sheet) (7)Medsafe approved confirmed via current NZ data sheet · 0.25 mg, 0.5 mg, 1 mg, 2 mg, 5 mg tablets · Viatris (New Zealand)
View brands in additional countries.
European Union
Requip Depot / Requip-Modutab / Requip XL / Requip LP / Requip-Prolib (prolonged-release, national brand names vary by member state) (4)