Precautions and Warnings for Ropinirole
It is important to understand all precautions and warnings for ropinirole before beginning treatment. Certain existing medical conditions, such as kidney disease or alcoholism, need to be reported to your healthcare provider before you start ropinirole. Other precautions and warnings for ropinirole include being aware that the drug can cause narcolepsy, extremely low blood pressure, and fainting episodes known as syncope.
If you have any of the following conditions, you should discuss this with your healthcare provider prior to taking ropinirole (Requip®):
- Heart or blood vessel disease
- Liver failure
- Kidney disease
- Daytime sleepiness from a sleep disorder, such as sleep apnea, insomnia, or narcolepsy
Also, be sure to tell your healthcare provider:
- If you are pregnant, plan to become pregnant, or are breastfeeding
- If you smoke
- About all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements
- If you feel dizzy, nauseated, sweaty, or faint when you stand up from sitting or lying down (this is known as orthostatic hypotension)
- If you drink alcoholic beverages.
Precautions and warnings for ropinirole that you should be aware of include:
- Ropinirole has been reported to cause people to fall asleep without warning during daily activities. Some of these events have happened as late as one year after treatment with ropinirole began. If this does occur, you should discuss your options with your healthcare provider.
- Ropinirole may cause fainting, known as syncope. These episodes occurred in people with Parkinson's disease and in people with restless legs syndrome (RLS). Make sure you discuss this with your healthcare provider before starting ropinirole. This is especially true for people with blood vessel or heart disease (cardiovascular disease).
- Ropinirole may cause extreme low blood pressure. Symptoms of low blood pressure can include dizziness, nausea, sweating, or fainting. If you have Parkinson's, are being treated with a dopaminergic agonist, and are taking ropinirole, you may be at higher risk of developing extremely low blood pressure (especially during ropinirole dosage adjustments). Your healthcare provider may choose to monitor your progress more cautiously. Also, make sure to discuss these risks with your healthcare provider before beginning to take ropinirole.
- Ropinirole has been reported to cause people to experience hallucinations, although this happens mostly in people with Parkinson's who are taking ropinirole.
- For people with Parkinson's, ropinirole may worsen some side effects of levodopa (Larodopa®, Sinemet®, Atamet®). For example, ropinirole may cause uncontrolled, sudden movements or make such movements that you already have worse or more frequent. Decreasing the dose of L-dopa may improve this side effect.
- If you have liver disease or liver failure, your body may not metabolize ropinirole as quickly as it should. Therefore, your healthcare provider may choose to monitor your dosage adjustments cautiously.
- Ropinirole is a pregnancy Category C medicine, meaning that it could potentially cause harm to your unborn child. If you are pregnant, you should only take ropinirole if the benefit outweighs the possible risk to your unborn child. If you become pregnant while taking ropinirole, contact your healthcare provider immediately.
- If you are nursing, ropinirole could potentially block milk production. It is not known whether ropinirole passes through your milk. Therefore, if you are taking ropinirole, you should stop nursing.
- Studies have shown that people with Parkinson's disease are at a higher risk of developing melanoma, which is a form of skin cancer. It is not known whether this is because of Parkinson's or the medications. Therefore, people being treated with ropinirole should have regular skin exams by a healthcare provider and learn how to perform self skin exams.
- A small number of people taking Parkinson's medicines, including ropinirole, have developed a problem with gambling or other impulsive behaviors (such as risky sexual activity). It is not known if this is because of the medicine or something else. If you or your family notice that you have any unusual urges, make sure to talk with your healthcare provider.