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Dopamine Agonist — Parkinson's Disease

Ropinirole

Brand names: Requip, Requip XL

Ropinirole is a dopamine agonist used in Parkinson's disease and for moderate-to-severe restless legs syndrome.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

· Ropinirole tablets can be taken with or without food. (2.1) · Retitration of ropinirole tablets may be warranted if therapy is interrupted. (2.1) Parkinson’s Disease: · The recommended starting dose is 0.25 mg taken three times daily; titrate to a maximum daily dose of 24 mg. (2.2) · Renal Impairment: The maximum recommended dose is 18 mg/day in patients with end-stage renal disease on hemodialysis. (2.2) Restless Legs Syndrome: · The recommended starting dose is 0.25 mg once daily, 1 to 3 hours before bedtime, titrate to a maximum recommended dose of 4 mg daily. (2.3) · Renal Impairment: The maximum recommended dose is 3 mg/day in patients with end-stage renal disease on hemodialysis. …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-10-07. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It is a non-ergot dopamine (D2/D3) receptor agonist that stimulates dopamine receptors in the brain.

Prescribing in practice

  • Impulse-control disorders (pathological gambling, hypersexuality, compulsive shopping or eating) and sudden onset of sleep can occur — counsel patients and families and ask about them.
  • Nausea, hypotension and hallucinations occur; titrate slowly and do not stop abruptly.
  • In restless legs syndrome, long-term use can cause augmentation (symptoms becoming worse or earlier).

Monitoring

Ask specifically about impulse-control behaviours and daytime sleepiness; review motor or restless-legs benefit.

Counselling the patient

  • Tell us about any new urges to gamble, shop or other compulsive behaviour — they can be caused by this drug.
  • It can cause sudden sleepiness — be cautious driving.
  • Do not stop it suddenly.

Evidence & guidelines

Used in Parkinson's disease and restless legs syndrome (NICE NG71), with important counselling on impulse-control disorders.

Reference: NICE NG71 (Parkinson's Disease); MHRA ICD Warning; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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