Pharmacology · Dopamine agonists
Ropinirole !
A non-ergot dopamine agonist for Parkinson disease and restless legs. Cleared by the liver (CYP1A2); causes sleep attacks and impulse-control problems.
Updated 2026-11-01
The figure shows bromocriptine in the human D2 receptor; ropinirole, a non-ergot agonist, acts on the same dopamine binding site.
Mechanism of action
Ropinirole is a non-ergoline dopamine agonist. Its benefit in Parkinson disease is thought to come from stimulation of D2 receptors in the caudate and putamen; how it helps restless legs is not fully known.
- Ropinirole binds D2-family receptors in the striatum
- It replaces the missing dopamine signal
- Movement and leg discomfort improve
Pharmacokinetics
- Metabolism
- Extensively metabolized in the liver, mainly by CYP1A2; less than a tenth excreted unchanged
- Half-life
- About 6 hours
Indications
- Parkinson disease Parkinson disease →
- Moderate to severe primary restless legs syndrome Restless legs syndrome →
Adverse effects
Common
- Nausea, vomiting, dyspepsia
- Somnolence and dizziness
- Leg oedema
- Fatigue and weakness
Contraindications
- Hypersensitivity to ropinirole (urticaria, angioedema, rash)
Key interactions
- Ciprofloxacin and other CYP1A2 inhibitors
- Raise ropinirole levels and sleepiness
- Smoking and other CYP1A2 inducers
- Can lower ropinirole levels
- Oestrogens
- Reduce ropinirole clearance
- Antipsychotics, metoclopramide
- Reduce its effect
What is monitored
- Daytime sleepiness and sleep attacks
- Impulse-control behaviours (ask the family)
- Blood pressure and fainting
- New interacting drugs, especially ciprofloxacin
Administration and safety
- Increased gradually; tapered when stopped
- Immediate-release and extended-release tablets are different products
- Taking it with food may reduce nausea
Nursing care
- Teach about sleep attacks before driving
- Ask about gambling, shopping and sexual urges
- Check for dizziness on standing and fall risk
- Report a new antibiotic such as ciprofloxacin to the prescriber
Pregnancy and breastfeeding
There are no adequate human data; animal studies showed harm to development.
Test yourself
Think of the answer, then tap the question to see it.
Which enzyme metabolizes ropinirole, and which antibiotic raises its levels?
CYP1A2; ciprofloxacin is the classic inhibitor.
How does ropinirole differ from pramipexole in elimination?
Ropinirole is metabolized by the liver; pramipexole is excreted unchanged by the kidney.
Is ropinirole an ergot or a non-ergot agonist?
Non-ergot, so it does not carry the fibrosis and valve risk of the ergot agonists.
Related drugs
Related conditions
← Back to the class: Dopamine agonists
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - ROPINIROLE tablet, film coated (DailyMed (U.S. National Library of Medicine), 2026); Ropinirole: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2025); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 21 (McGraw Hill, 2023).
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Representative model, for educational purposes only.