What side effects can ropinirole have?
Below you will find the most important information about possible known side effects of ropinirole.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).
The side effects differ depending on the field of application in the type and frequency of their occurrence:
Common side effects:
Insomnia, sleep disorders, confusion, hallucinations, dizziness, involuntary movements, drowsiness, nausea, constipation, water retention in the legs.
Occasional side effects:
lowering of blood pressure, sudden falling asleep.
Side effects without frequency:
Dyskinesia worsening, low blood pressure.
During therapy with ropinirole as a single agent, side effects such as hypotension, fainting, drowsiness, nausea and vomiting, heartburn, water retention in the legs and liver irritation (increase in liver enzymes) may occur.
During therapy with ropinirole in combination with levodopa, side effects such as nausea, uncontrollable movements (dyskinesias), drowsiness, confusion, drop in blood pressure, irritation to the liver and extreme daytime fatigue with sudden falling asleep may occur.
Due to the mass application, additional side effects of ropirinol such as increased sexual desire (libido) and morbid gambling addiction have been shown. However, the frequency of these possible side effects has not been clearly established.
Symptoms of restless legs
Very common side effects:
Movement disorders, excessive drowsiness, nausea.
Common side effects:
Nervousness, fainting, dizziness, delusions, confusion, leg swelling, vomiting, abdominal pain, heartburn.
Uncommon side effects:
confusion, drop in blood pressure in body posture, low blood pressure, libido increase.
Side effects without frequency:
Hypersensitivity, delirium, paranoia.
Patients with serious mental disorders should only be treated with ropinirole if the doctor presents the potential benefit over the risk. The motor control disorders, including pathological gambling and oversexuality as well as increased libido, as observed in Parkinson’s patients, may also occur in the treatment of restless legs. These disorders are especially likely at high doses and obsessive-compulsive behaviors. Patients should be regularly monitored by the doctor and their relatives for behavioral problems such as pathological gambling addiction, morbid sexual desire, compulsive spending or shopping, binge eating, and eating. If such symptoms occur, treatment should be changed.
In Parkinson’s, ropinirole has been associated with excessive drowsiness and sudden falling asleep. This is very rare in restless legs syndrome. Nevertheless, patients should be careful when driving a motor vehicle or operating a machine during treatment with ropinirole. Patients experiencing excessive sleepiness and / or falling asleep must not drive or operate a machine. If necessary, the doctor must reduce the dosage or stop the treatment.
What interactions does Ropinirole show?
Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).
The concomitant use of other agents for the treatment of Parkinson’s disease, such as the dopamine agonist selegiline or amantadine, enhances their effects. It may be necessary to adjust the dose of other anti-Parkinson agents. Especially with selegiline the daily dose of a maximum of ten milligrams must not be exceeded.
In the case of anti-stomach acid remedies such as cimetidine, concomitant administration may increase the kidney-damaging effects of these drugs.
The active substances dopamine, norepinephrine or adrenaline, antidepressants such as desipramine, maprotiline, venlafaxine, cardiovascular and hypotensive agents (antihypertensives) should be used with ropinirole only with the utmost care and under observation.
If patients already have blood-thinning agents such as warfarin, the bleeding time should be carefully monitored by the doctor with additional ropinirole therapy.
Iron supplements may only be taken at least two hours apart from a dose of ropinirole. Otherwise, the Parkinson’s agent may be weakened by iron complexes.
Co-administration of estrogen (when taking the pill or hormone therapy for menopause) may increase the effect of ropinirole. If the hormone therapy has to be continued, the doctor will adjust the dose of ropinirole.
The stomach medicine domperidone relieves any nausea that may occur. On the other hand, metoclopramide (also against nausea), as well as neuroleptics and other brain-acting dopamine antagonists (eg sulpiride) should not be used during ropinirole treatment because they decrease the effectiveness of the latter.
Drugs such as the antibiotics ciprofloxacin, enoxacin or fluvoxamine hinder the breakdown of ropinirole in the body. When combining the active ingredients, the doctor must therefore adjust the dose of ropinirole. The same applies at the end of antibiotic therapy.
Smoking speeds up the breakdown of ropinirole and reduces its effects. Therefore, a dose adjustment by the physician may be required in patients who start or stop smoking during treatment with ropinirole.