ropinirole

Adjunctive therapy

Brands: Requip

Last reviewed 2025-12-30

Reviewed by PsychMed Editorial Team.

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Quick answers

What is ropinirole?
Ropinirole (brand Requip) is a non-ergoline dopamine agonist indicated for Parkinson’s disease and moderate-to-severe primary RLS (label).
What is Requip?
Requip is a brand name for ropinirole.
What is Requip (ropinirole) used for?
Label indications include: Parkinson’s disease (PD) and moderate-to-severe primary restless legs syndrome (RLS) (label).
What drug class is Requip (ropinirole)?
Non-ergoline dopamine agonist (D2/D3) indicated for Parkinson’s disease and moderate-to-severe primary restless legs syndrome; metabolized primarily by CYP1A2 with ~6 hour half-life and clinically important somnolence, impulse- control, hallucination/psychosis, and RLS augmentation considerations.
What strengths does Requip (ropinirole) come in?
Tablets: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, and 5 mg (label).

Snapshot

Class: Adjunctive therapy
Common US brands: Requip
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2025-12-30

Label indications

Parkinson’s disease (PD) and moderate-to-severe primary restless legs syndrome (RLS) (label).

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Clinical Highlights

Ropinirole (brand Requip) is a non-ergoline dopamine agonist indicated for Parkinson’s disease and moderate-to-severe primary RLS (label). In RLS, dopamine agonists can improve symptoms but require long-term risk management. A key concern is augmentation, which influences drug choice and follow-up plans (guideline/clinical).

Recent RLS guidance often favors alpha-2-delta ligands (e.g., gabapentin enacarbil, pregabalin) for chronic persistent RLS to reduce long-term augmentation risk. Dopamine agonists remain useful, but use is often paired with “lowest effective dose” strategies and explicit early augmentation monitoring (guideline/clinical).
Clinically important adverse effects include somnolence/sudden sleep onset, orthostatic hypotension, hallucinations/psychosis, and impulse-control symptoms; monitoring is especially important in serious mental illness (label/clinical).
Ropinirole is metabolized primarily by CYP1A2, so interaction review includes CYP1A2 inhibitors/inducers and smoking status (label/clinical).
The compare view, ropinirole evidence feed, and print page support side-by-side review of RLS options and monitoring topics.

Dosing & Formulations

Tablets: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, and 5 mg (label). RLS: start 0.25 mg once daily 1 to 3 hours before bedtime; titrate based on response/tolerability up to a maximum recommended dose of 4 mg once daily (label).

Parkinson’s disease uses different titration schedules and higher total daily doses than RLS; indication-specific dosing is important (label).
Abrupt discontinuation can be associated with withdrawal/emergent symptoms; tapering is often used when stopping dopaminergic therapy (label/clinical).

Monitoring & Risks

Somnolence and sudden sleep onset can occur; next-day impairment and safety-sensitive activities are core counseling and follow-up topics (label). Neuropsychiatric effects (hallucinations, confusion, impulse-control symptoms) can occur and are clinically important in serious mental illness (label/clinical).

Orthostatic hypotension can occur during titration; blood pressure and dizziness/falls risk are common monitoring targets (label/clinical).
For RLS, monitoring includes whether symptoms are shifting earlier in the day or intensifying (augmentation) and whether dose escalation is driven by worsening rather than inadequate initial control (guideline/clinical).

Drug Interactions

CYP1A2 inhibitors (e.g., ciprofloxacin, fluvoxamine) can increase exposure; monitoring for increased adverse effects is commonly considered when these are started or stopped (label). CYP1A2 induction (including cigarette smoking) can reduce exposure and may reduce efficacy; follow-up is often needed when smoking status changes (label/clinical).

Alcohol and other CNS depressants can increase sedation and impairment (label/clinical).

Practice Notes

RLS frameworks emphasize addressing contributors (iron deficiency, sleep apnea, medication triggers) and using symptom timing tracking to detect augmentation early (guideline/clinical). Updated algorithms and AASM guidance highlight balancing short-term symptom control against augmentation and neuropsychiatric adverse effects when selecting dopamine agonists (guideline).

In serious mental illness, dopaminergic activation can complicate psychosis or mood instability; monitoring for behavioral change is a key practical safeguard (label/clinical).

References

Ropinirole tablets prescribing information — DailyMed (2025)
Treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine clinical practice guideline — Journal of Clinical Sleep Medicine (2025)
The Management of Restless Legs Syndrome: An Updated Algorithm — Mayo Clinic Proceedings (2021)
Randomized, Double Blind, Placebo Controlled, Short Term Trial OF Ropinirole IN Restless Legs Syndrome — Sleep Medicine (2005)