From the Guidelines
Ropinirole should not be used as a standard treatment for Restless Legs Syndrome (RLS) due to its potential for adverse effects with long-term use, particularly augmentation, although it may be considered in patients who place a higher value on short-term symptom reduction and a lower value on long-term adverse effects 1.
Key Points
- Ropinirole is a dopamine agonist that can be used to treat Parkinson's disease and RLS.
- For RLS, the American Academy of Sleep Medicine suggests against the standard use of ropinirole due to moderate certainty of evidence 1.
- Ropinirole may still be used in patients who prioritize short-term symptom relief over potential long-term adverse effects.
- Common side effects of ropinirole include nausea, dizziness, and drowsiness.
- The medication should be tapered gradually under medical supervision if discontinued to avoid withdrawal symptoms.
Clinical Considerations
- Patients with RLS should be evaluated for iron deficiency and considered for treatment with ferrous sulfate if iron parameters are appropriate 1.
- Other treatment options for RLS, such as dipyridamole, extended-release oxycodone, and bilateral high-frequency peroneal nerve stimulation, may be considered based on individual patient needs and preferences 1.
- Ropinirole's potential for adverse effects, including unusual behaviors like compulsive gambling or hypersexuality, should be carefully weighed against its potential benefits in treating RLS.
From the FDA Drug Label
1.1 Parkinson's Disease Ropinirole tablets are indicated for the treatment of Parkinson’s disease. 1.2 Restless Legs Syndrome Ropinirole tablets are indicated for the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS). Ropinirole tablets are a prescription medicine containing ropinirole used to treat moderate-to-severe primary RLS. It is also used to treat Parkinson’s disease
The use of Ropinirole is for the treatment of:
- Parkinson's Disease
- Restless Legs Syndrome (RLS), specifically moderate-to-severe primary RLS 2
From the Research
Uses of Ropinirole
- Ropinirole is a dopamine agonist used in the treatment of Parkinson's disease and restless legs syndrome 3, 4, 5, 6, 7
- In Parkinson's disease, ropinirole is used as monotherapy in early stages and as adjunctive therapy with levodopa in more advanced cases 4, 6, 7
- Ropinirole has been shown to improve symptoms of Parkinson's disease, such as bradykinesia, rigor, and tremor, and to facilitate daily life and improve depressive moods in patients 5
- In restless legs syndrome, ropinirole is used to treat unpleasant sensory and motor symptoms in the lower limbs, which occur at rest and are relieved by moving the limb 3
Efficacy and Safety
- Ropinirole has been shown to be effective in reducing symptoms of Parkinson's disease and restless legs syndrome, with a significant improvement in Unified Parkinson's Disease Rating Scale (UPDRS) motor scores and Clinical Global Impression/Clinical Global Evaluation Scales 7
- Ropinirole is generally well tolerated, with common adverse events including nausea, dizziness, and somnolence 7
- Ropinirole has a lower risk of dyskinesia compared to levodopa, and may provide a means of treating early Parkinson's disease while minimizing the risk of dyskinesia and delaying the need for supplemental levodopa 7
Clinical Trials
- Several clinical trials have demonstrated the efficacy and safety of ropinirole in the treatment of Parkinson's disease and restless legs syndrome 3, 4, 5, 6, 7
- A 12-week double-blind randomized controlled trial showed that ropinirole led to an improvement of about 3 points on a 40-point scale compared with placebo in patients with restless legs syndrome 3
- A 3-year comparative study with bromocriptine showed that ropinirole recipients had a significant improvement in UPDRS-activities of daily living (ADL) scores, although motor scores were similar between the two groups 7