Ropinirole Risks, Warnings, and Complications

Precautions Before Starting Ropinirole

Tell your doctor if you have ever had an allergic reaction to ropinirole, any of the active or inactive ingredients in ropinirole formulations, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, supplements, and herbal products. This can help avoid possible drug interactions.

Give your doctor a complete medical history. Ropinirole may not be safe for people with certain medical conditions such as daytime sleepiness or other sleep disorders (other than restless legs syndrome), high blood pressure, low blood pressure, the urge to gamble, psychotic disorders (mental illnesses that cause abnormal thinking), heart disease, liver disease, or kidney disease.

Tell your doctor if you are pregnant, could be pregnant, or planning a pregnancy. Also, tell your doctor if you are breast-feeding. Ropinirole can decrease breast milk production.

Precautions During Use of Ropinirole

Keep all your medical and laboratory appointments. Your doctor may adjust your dose based on your response and will monitor you for side effects. 

Ropinirole can cause drowsiness. Be cautious while driving and doing other hazardous activities until you know how it affects you. Tell your doctor if you find yourself suddenly falling asleep during daily activities like driving, eating, reading, or watching TV. 

Avoid alcoholic drinks while on ropinirole as they can make side effects like drowsiness and dizziness worse. Smoking tobacco can make ropinirole less effective. Tell your doctor if you start or stop smoking during treatment.

Taking ropinirole can cause orthostatic hypotension (postural dizziness when arising quickly from a lying or sitting position to standing). To prevent loss of balance and falls, get out of bed slowly by placing your feet on the ground for a few minutes before standing up.

Ropinirole can cause increased sexual urges and other urges such as gambling, spending money, or eating. Tell your provider if you or family members notice any strong or unusual urges.

Tell all your healthcare providers and laboratory personnel you are on ropinirole, especially before any surgery, including dental procedures.

Ropinirole Drug Interactions

Certain medicines can affect how ropinirole works. Possible interactions between ropinirole and other medicines can increase the risk of severe adverse reactions. Your healthcare provider may change the dose of your medicine, switch you to a different medication, or monitor you carefully for side effects if there are known interactions between ropinirole and your other medications. 

Ropinirole can interact with the following medications: 

• Antidepressants, including fluvoxamine (Luvox)
• Antipsychotics (medications used to treat mental illness)
• Medications for excessive stomach acid such as lansoprazole (Prevacid) and omeprazole (Prilosec, Zegerid)
• H2 blockers (acid reducers) such as cimetidine (Tagamet, Tagamet HB)
• Medications prescribed for heartburn, such as metoclopramide (Reglan) 
• Fluoroquinolone antibiotics such as ciprofloxacin (Cipro) and norfloxacin (Noroxin)
• Beta-lactam antibiotics such as nafcillin
• Hormonal contraceptives (birth control pills, rings, patches, and injections) and hormone replacement therapy 
• Insulin
• Other Parkinson’s medications, such as levodopa (in Sinemet, in Stalevo)
• Drugs prescribed for anxiety 
• Anti-seizure drugs
• Medications that cause drowsiness, for example, sedatives, sleeping pills, tranquilizers, and muscle relaxants
• Drugs for irregular heart rhythm, such as mexiletine (Mexitil)
• Medications for narcolepsy (excessive sleepiness), such as modafinil (Provigil)

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, OTC medications, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.