Common questions about ropinirole - Brand names: Requip, Ipinnia, Repinex

Ropinirole belongs to a group of medicines called dopamine agonists. Dopamine is an important chemical that sends nerve messages from your brain to your muscles.

With Parkinson's disease, you have less dopamine, so it's harder for your brain to send these messages. This can make you shake, as well as making your muscles stiff and your movements slow.

Ropinirole works by copying natural dopamine in the brain. This helps improve movement symptoms related to low dopamine levels in the body, such as in Parkinson's disease and restless legs syndrome.

Because your dose will gradually be increased, you may not notice an improvement straight away. It may take several weeks to find the right dose for you and for ropinirole to work fully.

Many people take ropinirole safely for many months or years.

Ropinirole may be an effective treatment for Parkinson's disease for several years. It can be taken long-term either on its own or with other Parkinson's medicines such as co-careldopa or co-beneldopa.

However, it may not work for everyone. Speak to your doctor or specialist nurse if you feel your symptoms are getting worse. You may need to have your dose changed.

If you stop taking ropinirole, your symptoms will return unless you're taking other medicines for Parkinson's disease or restless legs syndrome.

Do not stop taking ropinirole suddenly. This can lead to serious withdrawal symptoms, such as changes in mood, tiredness, sweating and pain.

Stopping ropinirole suddenly can also cause a rare but serious condition called neuroleptic malignant syndrome. Symptoms of this can include stiff muscles, a high temperature, confusion or loss of consciousness.

If you need to stop taking this medicine, your doctor or specialist nurse will reduce the dose gradually. This will help prevent withdrawal symptoms.

Ropinirole belongs to a group of medicines called dopamine receptor agonists.

There are 2 types of dopamine receptor agonists:

• ergot-derived dopamine agonists such as bromocriptine, cabergoline and pergolide – originally made from a type of fungus called ergot
• non ergot-derived dopamine receptor agonists such as ropinirole, pramipexole and rotigotine

Non ergot-derived dopamine receptor agonists are usually preferred, as they have fewer side effects on the heart.

There are also several other medicines that work differently to ropinirole that can be used to treat Parkinson's disease or restless legs syndrome.

If ropinirole does not work for you, or you're bothered by side effects, speak to your doctor or specialist nurse. They may be able to discuss other options.

There's currently no cure, but there are treatments for Parkinson's disease to help relieve the symptoms and maintain your quality of life.

These treatments include:

• supportive therapies, such as physiotherapy or speech therapy
• medicines
• a type of surgery called deep brain stimulation

You may not need any treatment during the early stages of Parkinson's disease, as symptoms are usually mild. But you may need regular appointments with your specialist so your condition can be monitored.

A care plan will usually be agreed with your healthcare team and you and your family or carers. This will outline the treatments and help you need now and what you're likely to need in the future. This will need to be reviewed regularly.

Regular exercise is particularly important because it helps relieve muscle stiffness, improves mood and relieves stress.

Find out more about living with Parkinson's disease, including advice on staying active.

The symptoms of restless legs syndrome will usually improve by treating the underlying cause, such as iron deficiency anaemia.

But if the cause is unknown, the symptoms can get worse with time and severely affect your life. In this case there are other treatments for restless legs syndrome that can help.

These include:

• relaxation exercises, leg massage, or taking a hot bath in the evening
• lifestyle changes such as stopping smoking, getting more sleep, and exercise

If you want to give up smoking, talk to your doctor about the different ways to stop.

Ropinirole does not stop contraception working, including the combined pill, progestogen-only pill and emergency contraception.

However, the oestrogen (ethinylestradiol) in some contraceptives may increase the amount of ropinirole in your body, so your dose of ropinirole may need to be reduced.

Speak to your doctor or pharmacist before taking ropinirole if you are taking a contraceptive that contains oestrogen. This includes the combined pill, contraceptive patch and vaginal ring.

If ropinirole makes you vomit, your contraceptive pills may not protect you from pregnancy. Look at the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Some people find ropinirole can make them feel dizzy or sleepy, or makes them fall asleep suddenly. This is more likely to happen when your dose is being increased. If this happens to you, do not drive, cycle or use tools or machinery.

Talk to your doctor or specialist nurse if you're unsure whether it's safe for you to drive while taking ropinirole. GOV.UK has more information on the law on drugs and driving.

If you've been diagnosed with Parkinson's disease, you must tell the Driver and Vehicle Licensing Agency (DVLA) and your car insurance company straight away.

Drinking alcohol while taking ropinirole may make you feel sleepy or tired.

When you first start taking ropinirole it's best to stop drinking alcohol, until you see how the medicine affects you.

Smoking can affect the way ropinirole works.

If you stop or start smoking, or take it up again, while you're on ropinirole, your dose may need to be adjusted. Let your doctor know if you're thinking of stopping or starting smoking.

Apart from being careful about alcohol, you can usually eat and drink normally while taking ropinirole.

If you're taking standard tablets, it's best to take ropinirole with food if you can. This will make you less likely to feel or be sick.

Taking ropinirole with a high fat meal can sometimes affect how well your body absorbs the medicine. Speak to your specialist nurse or doctor if you think food is causing problems when you take your medicine.