Ropinirole Dosages: Your GoodRx Guide

If you have restless legs syndrome (RLS) or Parkinson’s disease, you may have been prescribed ropinirole. Ropinirole works by turning on dopamine receptors in the body. This makes dopamine more active, which is thought to help improve movement problems that occur in Parkinson’s disease and RLS. 

Here, we’ll cover what you need to know about ropinirole dosages for Parkinson’s and RLS. But keep in mind that your healthcare provider may prescribe dosages that are different from what’s discussed here. It’s important to follow your provider’s instructions when taking ropinirole.

What’s the typical ropinirole dosage for adults?

The usual ropinirole dosage for adults depends on what you’re treating and what formulation you’re taking. Ropinirole comes as an immediate-release (IR) and extended-release (ER) tablet. The IR tablet is approved to treat Parkinson’s disease and RLS. The ER tablet is only approved for Parkinson’s.

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Regardless of what formulation you take, you’ll start at a lower dose that can be gradually increased if needed. Starting at a lower dose helps minimize possible side effects like drowsiness and low blood pressure. 

Both forms of ropinirole can be taken with or without food. But the ER tablets shouldn’t be chewed, divided, or crushed. They should be swallowed whole.

Parkinson’s Disease

The usual starting dosage for IR ropinirole tablets is 0.25 mg three times daily. If this dose isn’t working well enough, your healthcare provider may increase your dose up to 1 mg three times daily over the course of 4 weeks or longer. The maximum daily dose is 8 mg three times daily (24 mg/day).

The usual ropinirole ER starting dosage is 2 mg once daily for 1 to 2 weeks. If a higher dose is needed, your provider may increase the dose over several weeks. The maximum dose of ropinirole ER is 24 mg per day. But lower doses are usually used, since a dose this high hasn’t been found to be more effective.

Restless Legs Syndrome

The starting ropinirole dosage for RLS is one 0.25 mg tablet daily. It should be taken 1 to 3 hours before bedtime. If this dose isn’t enough, your provider may increase it to 0.5 mg daily after 2 days. If this still isn’t enough, your dose can be increased on a weekly basis. The maximum dose is 4 mg per day, and it can take several weeks to reach this dose.

How do you stop ropinirole?

If your healthcare provider thinks you should stop ropinirole, your dose will be gradually reduced over several days. There are a few reasons for this:

• Lower the risk of withdrawal symptoms. Withdrawal symptoms may occur after stopping dopamine agonists, like ropinirole, abruptly. Symptoms may include anxiety, agitation, and nausea and vomiting.

• Lower the risk of neuroleptic malignant syndrome (NMS). NMS is a medical condition that happens when dopamine levels in the brain drop too quickly. It’s characterized by a high fever, rigid muscles, and confusion. NMS is rare, but it’s a medical emergency.

• Prevent worsening symptoms of Parkinson’s disease and RLS. Stopping ropinirole abruptly may cause the return of symptoms of Parkinson’s disease and RLS.

Don’t stop taking ropinirole without talking to your healthcare provider. If you decide together that stopping ropinirole is a good idea, make sure you understand the plan for lowering your dose and follow it closely.

How do you switch from IR to ER ropinirole?

Some people may wish to switch from ropinirole IR to ropinirole ER. The ER version is only taken once a day, which may be a benefit for some people. And some research has shown it might work better at controlling Parkinson’s disease symptoms.

If you're taking ropinirole IR and you want to switch to the ER version, talk to your healthcare provider. Usually, making the switch is straightforward. Your total daily dose of ropinirole IR will be similar to your new dose of ropinirole ER. 

For example, if you’re taking ropinirole IR 2 mg three times daily (6 mg/day), you’ll switch to ropinirole ER 6 mg daily.

Are there any dosage adjustments for medical conditions?

If you have the most advanced stage of kidney disease, you may need a lower dose of ropinirole. This is called end stage renal disease (ESRD). The starting doses of ropinirole and ropinirole ER are the same in people with ESRD who receive dialysis. But the recommended maximum dose is lower than usual (18 mg/day for Parkinson’s disease and 3 mg/day for RLS).

Even if you don’t have ESRD, you still may need a lower dose of ropinirole if you have severe kidney damage (stage 4 kidney disease). Ropinirole hasn’t been well studied in people with this degree of kidney damage, so talk to your healthcare provider about what the best dose for you would be.

What if you miss a dose of ropinirole?

If you forget to take a dose of ropinirole, what to do next depends on what you’re taking it for. No matter what, don’t take extra or double up on your dose to make up for a missed dose.

Missed dose in Parkinson’s disease

If you’re taking ropinirole IR, take the dose as soon as you remember. But if it’s close to your next dose, skip the missed dose and continue your usual dosing schedule.

If you’re taking ropinirole ER, take your missed dose as soon as you remember it. Then restart your regular dosing schedule the next day. However, if it’s almost time for your next dose by the time you remember, skip the missed dose entirely. Return to your regular dosing schedule, and never “double up” on doses.

Missed dose in RLS

Skip the missed dose and take your next dose as scheduled 1 to 3 hours before the next bedtime.

What should you do if you take too much ropinirole?

If you accidentally take too much ropinirole, let your healthcare provider know. They may need to monitor you for increased side effects, such as nausea, dizziness, and drowsiness. You might also experience heart palpitations, increased sweating, and hallucinations.

If you or a loved one might have taken too much ropinirole, reach out to your healthcare provider and Poison Control at 1-800-222-1222 right away for further guidance. If your symptoms feel severe, seek emergency care immediately.

How to save on ropinirole

GoodRx can help you save over 60% off the average retail price of the generic version of ropinirole IR and ER. Ropinirole IR at certain pharmacies is less than $9.00 with a free GoodRx discount, and ropinirole ER may be less than $.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

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