From the Guidelines
Ropinirole should not be considered a first-line treatment for Restless Legs Syndrome (RLS) due to the risk of augmentation, as recommended by the American Academy of Sleep Medicine clinical practice guideline 1. When considering treatment options for RLS, it's essential to weigh the potential benefits against the risks, particularly the risk of augmentation, which is a major issue with dopamine agonists like ropinirole 1. Some key points to consider when treating RLS include:
- Iron treatment is an important addition to the treatment of RLS, particularly for patients with brain iron deficiency 1
- Alpha-2-delta ligands, opioids, and iron are recommended treatments for RLS, and trials are needed to assess an algorithmic approach to their use 1
- Determining predictors of augmentation, including genetic markers, iron status, or other at-risk clinical phenotypes, could potentially allow dopamine agonists to be reestablished as recommended treatments for some patients 1
- Ropinirole, as a dopamine agonist, may still be considered in certain cases, but its use should be carefully evaluated and monitored due to the potential for augmentation 1.
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). The primary use of Ropinirole is for the treatment of:
- Parkinson's Disease
- Restless Legs Syndrome (RLS) 2
From the Research
Ropinirole Overview
- Ropinirole is a dopaminergic agonist used in the treatment of Parkinson's disease and restless legs syndrome 3, 4, 5, 6, 7.
- It has selective affinity for dopamine D2-like receptors and little or no affinity for non-dopaminergic brain receptors 4.
Efficacy in Parkinson's Disease
- Ropinirole is effective as monotherapy in patients with early Parkinson's disease, improving symptoms and delaying the need for supplemental levodopa 4, 5, 6.
- It is also effective as an adjunct to levodopa in patients with advanced Parkinson's disease, reducing off time and allowing a reduction of levodopa dose 4, 6.
- Ropinirole has been shown to have a lower incidence of dyskinesias compared to levodopa alone 4, 5, 6.
Efficacy in Restless Legs Syndrome
- Ropinirole is effective in reducing the motor symptoms of restless legs syndrome and improving overall sleep quality 3, 7.
- The dosage of ropinirole needed to treat restless legs syndrome is smaller than that needed for Parkinson's disease therapy 7.
- Ropinirole has been shown to have a negative risk-benefit balance in restless legs syndrome, which is a minor health disorder 3.