[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Dopamine agonists](https://durgical.com/en/pharmacology/classes/dopamine-agonists/) › Rotigotine

# 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](https://durgical.com/en/pharmacology/classes/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.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## 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](https://www.rcsb.org/structure/8IRS) · Drag to rotate · pinch to zoom

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 →](https://durgical.com/en/conditions/parkinson-disease/)
- Restless legs syndrome [Restless legs syndrome →](https://durgical.com/en/conditions/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

### Serious (rare, important)

- Falling asleep suddenly during daily activities
- Hallucinations, paranoia, confusion and agitation
- Impulse-control disorders: gambling, hypersexuality, shopping, binge eating
- Rise in blood pressure
- Skin burns under the patch during MRI or cardioversion
- Fever, confusion and rigidity, or withdrawal symptoms, if it is stopped abruptly

## 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.

## Memory aid

ROTIgotine ROTates sites: one patch a day, no heat, no MRI with it on, and never stop it suddenly.

## 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.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/pharmacology/rotigotine/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Ropinirole](https://durgical.com/en/pharmacology/ropinirole/)
- [Pramipexole](https://durgical.com/en/pharmacology/pramipexole/)
- [Apomorphine](https://durgical.com/en/pharmacology/apomorphine/)

## Related conditions 2

- [Parkinson disease](https://durgical.com/en/conditions/parkinson-disease/)
- [Restless legs syndrome](https://durgical.com/en/conditions/restless-legs-syndrome/)

[← Back to the class: Dopamine agonists](https://durgical.com/en/pharmacology/classes/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](https://medlineplus.gov/druginfo/meds/a607059.html) (MedlinePlus (U.S. National Library of Medicine), 2022); [RCSB PDB - 8IRS: Dopamine Receptor D2R-Gi-Rotigotine complex](https://www.rcsb.org/structure/8IRS) (RCSB Protein Data Bank, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N04BC09) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/rotigotine/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/rotigotine/