Is Ropinirole an effective treatment for Restless Legs Syndrome and Parkinson's Disease?

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Last updated: February 16, 2025 • View editorial policy

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From the Guidelines

Ropinirole is not a first-line treatment for Restless Legs Syndrome (RLS) and its use is generally not recommended due to the risk of augmentation 1.

Key Points

  • The American Academy of Sleep Medicine suggests against the standard use of ropinirole for RLS, with a conditional recommendation and moderate certainty of evidence 1.
  • Ropinirole may be used to treat RLS in patients who place a higher value on the reduction of restless legs symptoms with short-term use and a lower value on adverse effects with long-term use, particularly augmentation 1.
  • For Parkinson's disease, ropinirole is used as a treatment, with a recommended initial dose of 0.25 mg three times a day, gradually increasing to a maximum of 24 mg daily 1.
  • The treatment with ropinirole should be individualized and adjusted according to the patient's clinical response and tolerance.

Considerations

  • The use of ropinirole for RLS should be carefully considered due to the risk of augmentation, which can lead to worsening symptoms over time 1.
  • Alternative treatments for RLS, such as iron supplementation, dopamine agonists, and opioids, may be more effective and have a lower risk of adverse effects 1.
  • The diagnosis and treatment of RLS and Parkinson's disease should be guided by clinical practice guidelines and individualized to the patient's needs and preferences 1.

From the FDA Drug Label

Ropinirole tablets are indicated for the treatment of Parkinson’s disease. Ropinirole tablets are indicated for the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS). The effectiveness of ropinirole in the treatment of RLS was demonstrated in randomized, double-blind, placebo-controlled trials in adults diagnosed with RLS using the International Restless Legs Syndrome Study Group diagnostic criteria In all 3 trials, a statistically significant difference between the treatment group receiving ropinirole and the treatment group receiving placebo was observed at Week 12 for both the mean change from baseline in the IRLS scale total score and the percentage of patients rated as responders (much improved or very much improved) on the CGI-I At the end of 6 months, the percentage of responders was greater on ropinirole than on placebo and the difference was statistically significant

Ropinirole is an effective treatment for:

  • Parkinson's Disease: as it has been shown to reduce "off" time and decrease L-dopa dosage in patients with advanced Parkinson's disease.
  • Restless Legs Syndrome (RLS): as it has been demonstrated to improve symptoms of RLS in randomized, double-blind, placebo-controlled trials, with a statistically significant difference in mean change from baseline in the IRLS scale total score and percentage of patients rated as responders on the CGI-I. 2 2

References

1
Guideline

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Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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