Requip vs. Sinemet for Parkinson's Disease: Important Differences and Potential Risks.

Key takeaways

Ropinirole (generic name) and Sinemet (carbidopa/levodopa) are both used to treat Parkinson's disease (PD), but they work differently. Ropinirole is a dopamine agonist that mimics dopamine in the brain, while Sinemet combines carbidopa and levodopa to increase dopamine levels. Ropinirole is also used for restless legs syndrome (RLS), whereas Sinemet is not. Ropinirole is available as immediate-release and extended-release tablets, while Sinemet comes in immediate-release, extended-release, and orally disintegrating tablets. Ropinirole can cause side effects like impulsive behavior and hallucinations, while Sinemet can cause dark-colored saliva, sweat, and urine. Both medications can make you very sleepy and should not be stopped suddenly without consulting your provider. Generic versions of both medications are available, making them more affordable.

Ropinirole

Get free coupons

Carbidopa / levodopa

(Sinemet)

Get free coupons

Summary for Requip

Prescription only

Ropinirole is a dopamine agonist that's used to treat Parkinson's disease (PD) and restless legs syndrome (RLS) in adults. For Parkinson's disease, the immediate-release tablets are taken by mouth three times per day, and the extended-release tablets are taken once per day. Ropinirole side effects include nausea, sleepiness, and dizziness.

Indications for Requip

Parkinson's disease (PD)
Moderate-to-severe restless legs syndrome (RLS) - immediate-release tablets only

Pros and Cons for Requip

Pros

Works well to control movement problems
Can take with or without food
Available as a lower-cost generic

Cons

Only available as a tablet that's swallowed whole
Can have a lot of side effects, like impulsive behavior and hallucinations (seeing things that aren't real)
Can't suddenly stop taking ropinirole because of risk of withdrawal symptoms

Common Side Effects for Requip

Parkinson's disease:

Nausea (60%)
Dizziness (40%)
Sleepiness (40%)
Weakness (16%)
Feeling faint (12%)
Vomiting (12%)
Viral infection (11%)
Indigestion (10%)

Restless legs syndrome:

Nausea (40%)
Sleepiness (12%)
Vomiting (11%)
Dizziness (11%)

Warnings for Requip

Extreme sleepiness
Changes in blood pressure and higher risk of falls
Intense urges
Hallucinations and behavior changes
Difficulty controlling body movements
Worsening symptoms of RLS (immediate-release tablets only)

Summary for Sinemet

Prescription only

Carbidopa / levodopa (Sinemet) is a first-choice option for Parkinson's disease (PD) in adults. It's also used to treat adults with conditions that cause PD symptoms, like shakiness and slowed movement. This medication helps raise and keep dopamine levels high in the brain to help with movement. But it's usually taken multiple times per day to relieve PD symptoms. Immediate-release tablets are available as brand name Sinemet and generic. Extended-release tablets and orally disintegrating tablets are generic only. Side effects can include movement problems, nausea, and possible hallucinations.

Indications for Sinemet

Parkinson's disease (PD)
Parkinsonism (conditions that cause people to have PD symptoms, like slowness, stiffness, and tremors)

Pros and Cons for Sinemet

Pros

First-choice option for treating PD symptoms
Available in many forms: immediate-release (IR) tablets, extended-release (ER) tablets, and orally disintegrating tablets (ODTs)
Might work within 1 hour

Cons

Usually need to take many times per day to control PD symptoms
Can make you very sleepy and possibly fall asleep suddenly
Can darken the color of your saliva, sweat, and urine

Common Side Effects for Sinemet

Involuntary movements (dyskinesia or dystonia)
Nausea

Warnings for Sinemet

Sleepiness or falling asleep during activities
High fevers and confusion when lowering the dose or stopping too suddenly
Hallucinations and changes in behavior and thoughts
Difficulty controlling impulsive behavior
Risk of depression and thoughts of suicide
Low vitamin B6 levels and seizures
Caution use in people with a history of heart attack and arrhythmia
Caution use in people with a history of stomach ulcers
Higher eye pressure in people with glaucoma
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only