Rotigotine

Dopamine agonists
Dopamine agonists

Non-ergot dopamine agonist delivered by a daily skin patch for Parkinson disease and restless legs syndrome.

Updated Nov 1, 2026

Quick facts

Group: Dopamine agonists
Target: Dopamine D2-like receptors (also D1)
Used for: Parkinson disease · Restless legs syndrome
Key effects: Application-site rash · Nausea · Drowsiness
Monitor: Blood pressure · Daytime sleepiness and sudden sleep
ATC: N04BC09

No doses: the clinician sets them by the current guideline.

Mechanism of action

Dopamine D2-like receptors (also D1)Rotigotine

The figure shows rotigotine bound to the human dopamine D2 receptor coupled to its Gi protein.

Target in 3D: Dopamine D2-like receptors (also D1). PDB structure 8IRS (RCSB PDB, public domain). View the structure at RCSB PDB

Rotigotine is a non-ergot dopamine agonist that acts mainly on D2-family receptors and also has activity at D1 receptors. Released steadily from a transdermal patch, it stimulates striatal receptors continuously in place of the lost dopamine, which relieves the motor signs of Parkinson disease and the urge to move in restless legs syndrome.

Released steadily from a skin patch into the blood
Stimulates D2-family (and D1) dopamine receptors
Continuous stimulation replaces lost dopamine
Fewer motor symptoms in Parkinson disease; less leg restlessness

Indications

Parkinson disease: tremor, stiffness, slowness and balance problems Parkinson disease →
Restless legs syndrome Restless legs syndrome →

Adverse effects

Common

Application-site rash, redness, swelling or itching
Nausea, vomiting and loss of appetite
Drowsiness, insomnia and abnormal dreams
Dizziness, headache and orthostatic hypotension
Peripheral oedema and weight gain

Contraindications

Hypersensitivity to rotigotine or to any component of the patch

Key interactions

Alcohol: Adds to the drowsiness and the risk of sudden sleep.

What is monitored

Blood pressure, including standing
Daytime sleepiness and sudden sleep
Hallucinations and impulse-control behaviours
Skin at the application sites

Administration and safety

Apply once a day to clean, dry, intact skin of the abdomen, thigh, hip, flank, shoulder or upper arm; not on folds or under tight clothing.
Rotate sites and do not reuse the same site within two weeks.
Keep heat sources (heating pads, electric blankets, saunas, hot baths, strong sun) away from the patch; do not cut it.
Tell the team before MRI or cardioversion, because the patch can burn the skin.
It is not stopped suddenly; the dose is reduced gradually.

Pregnancy and breastfeeding

Data are limited; pregnancy or breastfeeding is reported to the treating doctor.

Nursing care

Inspect old and new application sites and record the site used each day.
Check blood pressure lying and standing, especially during dose increases.
Warn about sudden sleep; no driving until the effect is known.
Ask patient and family about compulsive behaviours and hallucinations.

Pharmacokinetics

Absorption: Transdermal, from a patch applied once a day.
Onset and duration: The full benefit may take several weeks as the dose is titrated.

Test yourself

Think of the answer, then tap the question to see it.

How is rotigotine given?

As a transdermal patch applied once a day, with site rotation.

Which two conditions does rotigotine treat?

Parkinson disease and restless legs syndrome.

Why must the team know about a rotigotine patch before an MRI?

The patch can cause skin burns during MRI or cardioversion.

What can happen if rotigotine is stopped suddenly?

Fever, confusion and muscle rigidity, and withdrawal symptoms such as apathy, anxiety, depression and pain.

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Connections

← 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: Rotigotine Transdermal Patch: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2022); RCSB PDB - 8IRS: Dopamine Receptor D2R-Gi-Rotigotine complex (RCSB Protein Data Bank, 2023); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.