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Ropinirole: Difference between revisions

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{{MedTemplate
{{MedTemplate
| generic           = Ropinirole
| generic           = Ropinirole
| brand             = Requip
| brand             = Requip (IR), Requip XL (extended-release)
| structure         =  
| structure         =
| classes           = Antiparkinsonian, Dopamine agonist
| classes           = [[:Category:Dopamine agonists|Dopamine D2/D3 receptor agonist (non-ergot)]], [[:Category:Antiparkinsonians|Antiparkinsonian]]
| mechanism          = D2/D3 receptor agonist
| uses             = <vote slug="parkinson-disease-monotherapy-use">Parkinson disease, early monotherapy and advanced adjunct (FDA)</vote>, <vote slug="restless-legs-syndrome-use">Restless legs syndrome (FDA)</vote>
| uses               =  
| starting_dose     = Parkinson disease: 0.25 mg PO TID, titrate weekly. Restless legs syndrome: 0.25 mg PO 1-3 hours before bedtime, titrate to 4 mg/day if needed
| starting_dose     =  
| preparations     = IR tablets 0.25, 0.5, 1, 2, 3, 4, 5 mg; XL tablets 2, 4, 6, 8, 12 mg
| preparations       =  
| fda_max           = 24 mg/day (Parkinson disease); 4 mg/day (restless legs syndrome)
| fda_max          =  
| pill_id           =
| routes             =  
| routes           = Oral
| onset             =  
| onset             = Motor improvement over days at therapeutic dose
| duration           =  
| duration         = TID dosing (IR); once-daily (XL)
| halflife           =
| halflife          = ~6 hours<ref name="requip-label">FDA Prescribing Information, Requip (ropinirole hydrochloride), GSK, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/020658s022,021829s011lbl.pdf</ref>
| bioavailability    =
| bioavailability   = ~55% (oral)<ref name="requip-label" />
| pregnancy         =  
| pregnancy        = Limited human data.{{citation needed}}
| legal              =  
| legal             = [[USLegal:Prescription only|Rx-only]] in US
| intro              =
| mechanism        = <vote slug="ropinirole-mech-claim">Selective non-ergot D2 and D3 dopamine receptor agonist (similar pharmacology to pramipexole, with slight D3 preference). Used in Parkinson disease as monotherapy in early disease and as adjunct to levodopa in advanced disease; first-line in moderate-to-severe restless legs syndrome.</vote> Same class adverse-effect profile as pramipexole: '''impulse control disorders''' (pathological gambling, hypersexuality, compulsive shopping, binge eating), somnolence with sleep attacks (potentially while driving), hallucinations, and peripheral edema. CYP1A2 substrate: '''ciprofloxacin raises exposure approximately 5-fold'''; smoking (CYP1A2 inducer) lowers exposure, requiring dose adjustment when patients start or stop smoking<ref name="requip-label" />.
| pharmacokinetics   =  
| pharmacodynamics  =  
| indications        =  
| dosing             =  
| effects            =
| interactions      = <pharmaInteractions/>
| pregnancy_details  =
| monitoring        =
| counseling        =
| anecdotes          =
| seealso            =
| references        =  
}}
}}


== References ==
<references />


[[Category:Antiparkinsonian Medicines]]
[[Category:Dopamine agonists]]
[[Category:Antiparkinsonian]]
[[Category:Antiparkinsonians]]
[[Category:Dopamine Agonists]]

Latest revision as of 07:23, 23 May 2026

Dopamine D2/D3 receptor agonist (non-ergot), Antiparkinsonian
Ropinirole
Requip (IR), Requip XL (extended-release)

Experience

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Problems

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Titration strategies

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Summary
Classes
Dopamine D2/D3 receptor agonist (non-ergot), Antiparkinsonian
Common uses
Parkinson disease, early monotherapy and advanced adjunct (FDA)0, Restless legs syndrome (FDA)0
Pharmacy
Starting dose
Parkinson disease: 0.25 mg PO TID, titrate weekly. Restless legs syndrome: 0.25 mg PO 1-3 hours before bedtime, titrate to 4 mg/day if needed
Preparations
IR tablets 0.25, 0.5, 1, 2, 3, 4, 5 mg; XL tablets 2, 4, 6, 8, 12 mg
US FDA Max
24 mg/day (Parkinson disease); 4 mg/day (restless legs syndrome)
Pharmacology
Routes
Oral
Onset
Motor improvement over days at therapeutic dose
Duration
TID dosing (IR); once-daily (XL)
Half-life
~6 hours[1]
Bioavailability
~55% (oral)[1]
Pregnancy
Limited human data.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Selective non-ergot D2 and D3 dopamine receptor agonist (similar pharmacology to pramipexole, with slight D3 preference). Used in Parkinson disease as monotherapy in early disease and as adjunct to levodopa in advanced disease; first-line in moderate-to-severe restless legs syndrome.0 Same class adverse-effect profile as pramipexole: impulse control disorders (pathological gambling, hypersexuality, compulsive shopping, binge eating), somnolence with sleep attacks (potentially while driving), hallucinations, and peripheral edema. CYP1A2 substrate: ciprofloxacin raises exposure approximately 5-fold; smoking (CYP1A2 inducer) lowers exposure, requiring dose adjustment when patients start or stop smoking[1].

References

  1. ↑ 1.0 1.1 1.2 FDA Prescribing Information, Requip (ropinirole hydrochloride), GSK, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/020658s022,021829s011lbl.pdf
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