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. 2006 Jun 7;11(3):253–272. doi: 10.1111/j.1527-3458.2005.tb00046.x

Ropinirole, a Non‐Ergoline Dopamine Agonist

Wolfgang H Jost 1,✉, Dieter Angersbach 2
PMCID: PMC6741710  PMID: 16389293

ABSTRACT

Dopamine agonists have become indispensable in the treatment of Parkinson's disease. In every‐day practice, however, the decision to select the best compound for an individual patient is rendered difficult because of the large number of substances available on the market. This review article provides a closer look at the experimental and clinical studies with ropinirole published so far.

Ropinirole is a non‐ergoline dopamine agonist which has been proven to be effective in both, monotherapy and combination therapy of idiopathic Parkinson's disease. In addition to ameliorating bradykinesia, rigor, and tremor, ropinirole facilitates the daily life and improves depressive moods of patients with Parkinson's disease. The long‐term complications of levodopa are avoided, and problems commonly associated with levodopa treatment are reduced. Ropinirole appears to have a neuroprotective effect. In addition to Parkinson's disease, ropinirole has also been used successfully in the treatment of restless legs syndrome.

Keywords: Dopamine agonists, Parkinson's disease, Restless legs syndrome Ropinirole

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References

  • 1. Adler CH, Sethi KD, Hauser RA, et al. Ropinirole for the treatment of early Parkinson's disease. Neurology 1997;49:393–399. [DOI] [PubMed] [Google Scholar]
  • 2. Adler CH, Hauser RA, Sethi K, et al. Ropinirole for restless legs syndrome. Neurology 2004;62:1405–1407. [DOI] [PubMed] [Google Scholar]
  • 3. Allen R, Becker PM, Bogan R, et al. Ropinirole decreases periodic leg movements and improves sleep parameters in patients with restless legs syndrome. Sleep 2004;27:907–914. [DOI] [PubMed] [Google Scholar]
  • 4. Anca MH, Giladi N, Korczyn AD. Ropinirole in Gilles de la Tourette syndrome. Neurology 2004;62:1626–1627. [DOI] [PubMed] [Google Scholar]
  • 5. . Anonymous. DA agonists — non‐ergot derivatives: Ropinirole. Mov Disord 2002;17 (Suppl 4): S98–S102. [DOI] [PubMed] [Google Scholar]
  • 6. Barth F, Baum B, Bremen D, Meuser T, Jost WH. Die indirekten Kosten des idiopathischen Parkinson‐Syndroms. Fortschr Neurol Psychiat 2005;73:187–191. [DOI] [PubMed] [Google Scholar]
  • 7. Bliwise DL, Freeman A, Ingram CD, Rye DB, Chakravorty S, Watts RL. Randomized, double‐blind, placebo‐controlled, short‐term trial of ropinirole in restless legs syndrome. Sleep Med 2005;6:141–147. [DOI] [PubMed] [Google Scholar]
  • 8. Bonucelli U. Comparing dopamine agonists in Parkinson's disease. Curr Opin Neurol 2003;16 (Suppl 1): S13–S19. [DOI] [PubMed] [Google Scholar]
  • 9. Brefel C, Thalamas C, Rayet S, et al. Effect of food on the pharmacokinetics of ropinirole in parkinsonian patients. Br J Clin Pharmacol 1998;45:412–415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10. Brooks DJ, Torjanski N, Burn DJ. Ropinirole in the symptomatic treatment of Parkinson's disease. J Neural Transm 1995;45 (Suppl): 231–238. [PubMed] [Google Scholar]
  • 11. Brooks DJ, Abbott RJ, Lees AJ, et al. A placebo‐controlled evaluation of ropinirole, a novel D2 agonist, as sole dopaminergic therapy in Parkinson's disease. Clin Neuropharmacol 1998;21:101–107. [PubMed] [Google Scholar]
  • 12. Brooks DJ. Imaging end points for monitoring neuroprotection in Parkinson's disease. Ann Neurol 2003;53 (Suppl 3): S110–S119. [DOI] [PubMed] [Google Scholar]
  • 13. Brunt ER, Brooks DJ, Korczyn AD, et al. A six‐month multicentre, double‐blind, bromocriptine‐controlled study of the safety and efficacy of ropinirole in the treatment of patients with Parkinson's disease not optimally controlled by L‐dopa. J Neural Transm 2002;109:489–502. [DOI] [PubMed] [Google Scholar]
  • 14. Canesi M, Antonini A, Mariani CB, et al. An overnight switch to ropinirole therapy in patients with Parkinson's disease. J Neural Transm 1999;106:925–929. [DOI] [PubMed] [Google Scholar]
  • 15. Cheer SM, Bang LM, Keating GM. Ropinirole. For the treatment of restless legs syndrome. CNS Drugs 2004;18:747–754. [DOI] [PubMed] [Google Scholar]
  • 16. Clarke CE, Deane KHO. Ropinirole vs. bromocriptine for levodopa‐induced complications in Parkinson's disease. Cochrane Database Syst Rev 2001;2:CD001517. [DOI] [PubMed] [Google Scholar]
  • 17. Clarke CE, Guttman M. Dopamine agonist monotherapy in Parkinson's disease. Lancet 2002;360:1767–1769. [DOI] [PubMed] [Google Scholar]
  • 18. Cristina S, Zangaglia R, Mancini F, Martignoni E, Nappi G, Pacchetti C. High‐dose ropinirole in advanced Parkinson's disease with severe dyskinesias. Clin Neuropharmacol 2003;26:146–150. [DOI] [PubMed] [Google Scholar]
  • 19. Elble RJ. Tremor and dopamine agonists. Neurology 2002;58 (Suppl 1): S57–S62. [DOI] [PubMed] [Google Scholar]
  • 20. Etminam M, Gill S, Samii A. Comparison of the risk of adverse events with pramipexole and ropinirole in patients with Parkinson's disease. Drug Safety 2003;26:439–444. [DOI] [PubMed] [Google Scholar]
  • 21. Freeman A, Rye DB, Bliwise D, Krulewicz S, Watts RL. Ropinirole for the restless legs syndrome (RLS): An open‐label and double‐blind placebo‐controlled study. Neurology 2001;56(Suppl 3): A5. [Google Scholar]
  • 22. Frucht S, Rogers JD, Greene PE, Gordon MF, Fahn S. Falling asleep at the wheel: Motor vehicle mishaps in persons taking pramipexole and ropinirole. Neurology 1999;52:1908–1910. [DOI] [PubMed] [Google Scholar]
  • 23. Garcia‐Borreguero D, Odin P, Schwarz C. Restless legs syndrome: An overview of the current understanding and management. Acta Neurol Scand 2004;109:303–317. [DOI] [PubMed] [Google Scholar]
  • 24. Giménez‐Roldán S, Esteban EM, Mateo D. Switching from bromocriptine to ropinirole in patients with advanced Parkinson's disease: Open label pilot responses to three different dose‐ratios. Clin Neuropharmacol 2001;24:346–351. [DOI] [PubMed] [Google Scholar]
  • 25. Goetz CG, Blasucci L, Stebbins GT. Switching dopamine agonists in advanced Parkinson's disease: Is rapid titration preferable to slow Neurology 1999;52:1227–1229. [DOI] [PubMed] [Google Scholar]
  • 26. Goldberg JF, Burdick KE, Endick CJ. Preliminary randomized, double‐blind, placebo‐controlled trial of pramipexole added to mood stabilizers for treatment‐resistant bipolar depression. Am J Psychiatry 2004;161:564–566. [DOI] [PubMed] [Google Scholar]
  • 27. Grosset KA, Grosset DG. Pergolide in Parkinson's disease: time for a change Lancet 2004;363:1907–1908. [DOI] [PubMed] [Google Scholar]
  • 28. Horvath J, Fross RD, Kleiner‐Fisman G, et al. Severe multivalvular heart disease: Anew complication of the ergot derivative dopamine agonists. Mov Disord 2004;19:656–662. [DOI] [PubMed] [Google Scholar]
  • 29. Hubble J, Koller WC, Atchison P, et al. Linear pharmacokinetic behavior of ropinirole during multiple dosing in patients with Parkinson's disease. J Clin Pharmacol 2000;40:641–646. [PubMed] [Google Scholar]
  • 30. Im JH, Ha JH, Cho IS, Lee MC. Ropinirole as an adjunct to levodopa in the treatment of Parkinson's disease. A 16‐week bromocriptine controlled study. J Neurol 2003;250:90–96. [DOI] [PubMed] [Google Scholar]
  • 31. Inzelberg R, Schechtman E, Nisipeanu O. Cabergoline, pramipexole and ropinirole used as monotherapy in early Parkinson's disease. Drugs Aging 2003;20:847–855. [DOI] [PubMed] [Google Scholar]
  • 32. Iskedjian M, Einarson TR. Cost analysis of ropinirole versus levodopa in the treatment of Parkinson's disease. Pharmacoeconomics 2003;21:115–127. [DOI] [PubMed] [Google Scholar]
  • 33. Joo‐Hyuk I, Jeong‐Ho H, In‐Sook C, Myoung CL. Ropinirole as an adjunct to levodopa in the treatment of Parkinson's disease. A 16‐week bromocriptine controlled study. J Neurol 2003;250:90–96. [DOI] [PubMed] [Google Scholar]
  • 34. Jost WH, Bellon AK, Kaiser T, Schrank B. The impact of ropinirole on blood pressure and noradrenaline concentration after active orthostasis in Parkinsonian patients. Parkinsonism Rel Disord 1998;4:61–63. [DOI] [PubMed] [Google Scholar]
  • 35. Jost WH. Equivalent doses of ropinirole and bromocriptine. Eur J Neurol 1999;6:618. [DOI] [PubMed] [Google Scholar]
  • 36. Joyce JN, Gurevich EV. Dopamine D3‐receptors: From anatomy to neuropsychiatry. Neurosci News 1999;2:11–21. [Google Scholar]
  • 37. Kakar RS, Kushida CA. Ropinirole in the treatment of restless legs syndrome. Exp Rev Neurother 2005;5:35–42. [DOI] [PubMed] [Google Scholar]
  • 38. Kaye CM, Nicholls B. Clinical pharmacokinetics of ropinirole. Clin Pharmakokinet 2000;39:243–254. [DOI] [PubMed] [Google Scholar]
  • 39. Konofal E, Arnulf I, Lecendreux M, Mouren MC. Ropinirole in a child with attention‐deficit hyperactivity disorder and restless legs syndrome. Pediatr Neurol 2005;32:350–351. [DOI] [PubMed] [Google Scholar]
  • 40. Korczyn AD, Brooks D, Brunt ER, Poewe WH, Rascol O, Stocchi F. Ropinirole versus bromocriptine in the treatment of early Parkinson's disease: A 6‐month interim report of a 3‐year study. Mov Disord 1998;13:46–51. [DOI] [PubMed] [Google Scholar]
  • 41. Korczyn AD, Brunt ER, Larsen JP, Nagy Z, Poewe WH, Ruggieri S. A 3‐year randomized trial of ropinirole and bromocriptine in early Parkinson's disease. Neurology 1999;53:364–370. [DOI] [PubMed] [Google Scholar]
  • 42. Korczyn AD, Thalamas C, Adler CH. Dosing with ropinirole in a clinical setting. Acta Neurol Scand 2002;106:200–204. [DOI] [PubMed] [Google Scholar]
  • 43. Lemke MR. Depression und Morbus Parkinson. Bremen : Uni‐Med Verlag, 2002;52–53. [Google Scholar]
  • 44. Lieberman A, Olanow CW, Sethi K, et al. A multicenter trial of ropinirole as adjunct treatment for Parkinson's disease. Neurology 1998;51:1057–1062. [DOI] [PubMed] [Google Scholar]
  • 45. Lund BC, Neiman RF, Perry PJ. Treatment of Parkinson's disease with ropinirole after pergolide‐induced retroperitoneal fibrosis. Pharmacotherapy 1999;19:1437–1438. [DOI] [PubMed] [Google Scholar]
  • 46. Matheson AJ, Spencer CM. Ropinirole: A review of its use in the management of Parkinson's disease. Drugs 2000;60:115–137. [DOI] [PubMed] [Google Scholar]
  • 47. Millan MJ, Maiofiss L, Cussac D, et al. Differential actions of antiparkinson agents at multiple classes of monoaminergic receptor. I. A multivariate analysis of the binding profiles of 14 drugs at 21 native and cloned human receptor subtypes. J Pharmacol Exp Ther 2002;303:791–804. [DOI] [PubMed] [Google Scholar]
  • 48. Müller T, Fritze J. Fibrosis associated with dopamine agonist therapy in Parkinson's disease. Clin Neuropharmacol 2003;26:109–111. [DOI] [PubMed] [Google Scholar]
  • 49. Müngersdorf M, Sommer U, Sommer M, Reichmann H. High‐dose therapy with ropinirole in patients with Parkinson's disease. J Neural Transm 2001;108:1309–1317. [DOI] [PubMed] [Google Scholar]
  • 50. Newman‐Tancredi A, Cussac D, Audinot V, et al. Differential actions of antiparkinson agents at multiple classes of monoaminergic receptor. II. Agonist and antagonist properties at subtypes of dopamine D2‐like receptor and α1/α2‐adrenoreceptor. J Pharmacol Exp Therap 2002;303:805–814. [DOI] [PubMed] [Google Scholar]
  • 51. Newman‐Tancredi A, Cussac D, Quentric Y, et al. Differential actions of antiparkinson agents at multiple classes of monoaminergic receptor. III. Agonist and antagonist properties at serotonin, 5‐HT1 and 5‐HT2, receptor subtypes. J Pharmacol Exp Therap 2002;303:815–822. [DOI] [PubMed] [Google Scholar]
  • 52. Ondo W. Ropinirole for restless legs syndrome. Mov Disord 1999;14:138–140. [DOI] [PubMed] [Google Scholar]
  • 53. Pahwa R, Lyons KE, Hauser RA. Ropinirole therapy for Parkinson's disease. Exp Rev Neurother 2005;4:581–588. [DOI] [PubMed] [Google Scholar]
  • 54. Paus S, Brecht HM, Köster J, Seeger G, Klockgether T, Wüllner U. Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson's disease. Mov Disord 2003;18:659–667. [DOI] [PubMed] [Google Scholar]
  • 55. Pearce RKB, Banerji T, Jenner P, Marsden CD. De novo administration of ropinirole and bromocriptine induces less dyskinesia than L‐dopa in the MPTP‐treated marmoset. Mov Disord 1998;13:234–241. [DOI] [PubMed] [Google Scholar]
  • 56. Perugi G, Toni C, Ruffolo G, Frare F, Akiskal H. Adjunctive dopamine agonists in treatment‐resistant bipolar II depression: An open case series. Pharmacopsychiatry 2001;34:137–141. [DOI] [PubMed] [Google Scholar]
  • 57. Pluck GC, Brown RG Apathy in Parkinson's disease. J Neurol Neurosurg Psychiatry 2002;73:636–642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 58. Rascol O, Lees AL, Senard JM, Pirtosek Z, Montastruc JL, Fuell D. Ropinirole in the treatment of levodopa‐induced motor fluctuations in patients with Parkinson's disease. Clin Neuropharmacol 1996;19:234–245. [DOI] [PubMed] [Google Scholar]
  • 59. Rascol O, Brooks DJ, Korczyn AD, De Deyn PP, Clarke CE, Lang AE. A five‐year study of the incidence of dyskinesia in patients with early Parkinson's disease who were treated with ropinirole or levodopa. N Engl J Med 2000;342:1484–1491. [DOI] [PubMed] [Google Scholar]
  • 60. Rascol O, Korczyn AD, De Deyn PP, Lang AE. Incidence of dyskinesias in a 10‐year naturalistic follow‐up of patients with early Parkinson's disease initially receiving ropinirole compared with L‐dopa. Mov Disord 2005;20(Suppl 10): S63. [Google Scholar]
  • 61. Rogers DC, Costall B, Domeney AM, et al. Anxiolytic profile of ropinirole in the rat, mouse and common marmoset. Psychopharmacology (Berl) 2000;151:91–97. [DOI] [PubMed] [Google Scholar]
  • 62. Saletu B, Gruber G, Saletu M, et al. Sleep laboratory studies in restless legs syndrome patients as compared with normals and acute effects of ropinirole. 1. Findings on objective and subjective sleep and awakening quality. Neuropsychobiology 2000;41:181–189. [DOI] [PubMed] [Google Scholar]
  • 63. Saletu M, Anderer P, Saletu B, et al. Sleep laboratory studies in periodic limb movement disorder (PLMD) patients as compared with normals and acute effects of ropinirole. Hum Psychopharmacol 2001;16:177–187. [DOI] [PubMed] [Google Scholar]
  • 64. Schapira AHV. Neuroprotection and dopamine agonists. Neurology 2002;58 (Suppl 1): S9–S18. [DOI] [PubMed] [Google Scholar]
  • 65. Schrag AE, Brooks DJ, Brunt E, et al. The safety of ropinirole, a selective non‐ergoline dopamine agonist, in patients with Parkinson's disease. Clin Neuropharmacol 1998;21:169–175. [PubMed] [Google Scholar]
  • 66. Schrag A, Keens J, Warner J. Ropinirole for the treatment of tremor in early Parkinson's disease. Eur J Neurol 2002;9:253–257. [DOI] [PubMed] [Google Scholar]
  • 67. Sethi KD, O'Brien CF, Hammerstad JP, et al. Ropinirole for the treatment of early Parkinson's disease. Arch Neurol 1998;55:1211–1216. [DOI] [PubMed] [Google Scholar]
  • 68. Stocchi F, Destée A. Co‐administration of ropinirole and domperidone during rapid dose escalation of dopamine agonist. Parkinsonism Rel Disord 1998;4:183–188. [DOI] [PubMed] [Google Scholar]
  • 69. Stocchi E, Vacca L, Berardelli A. Dual dopamine agonist treatment in Parkinson's disease. J Neurol 2003;250:822–826. [DOI] [PubMed] [Google Scholar]
  • 70. Taylor A, Beerahee A, Citerone D, et al. The effect of steady‐state ropinirole on plasma concentrations of digoxin in patients with Parkinson's disease. Br J Clin Pharmacol 1999;47:219–222. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 71. Thalamas C, Taylor A, Brefel‐Courbon C, Eagle S, Fitzpatrick, Rascol O. Lack of pharmacokinetic interaction between ropinirole and theophylline in patients with Parkinson's disease. Eur J Clin Pharmacol 1999;55:299–303. [DOI] [PubMed] [Google Scholar]
  • 72. Thorpy MJ. New paradigms in the treatment of restless legs syndrome. Neurology 2005;64 (Suppl 3): S28–S33. [DOI] [PubMed] [Google Scholar]
  • 73. Trenkwalder C, Garcia‐Borreguero D, Montagna P, et al. Ropinirole in the treatment of restless legs syndrome: Results from the TREAT‐RLS 1 study, a 12 week, randomized, placebo controlled study in 10 European countries. J Neurol Neurosurg Psychiatry 2004;75:92–97. [PMC free article] [PubMed] [Google Scholar]
  • 74. Tulloch IF. Pharmacologic profile of ropinirole. Neurology 1997;49 (Suppl 1): S58–S62. [DOI] [PubMed] [Google Scholar]
  • 75. Van Camp G, Flamez A, Cosyns B, et al. Treatment of Parkinson's disease with pergolide and relation to restrictive valvular heart disease. Lancet 2004;363:1179–1183. [DOI] [PubMed] [Google Scholar]
  • 76. Walters AS, Ondo WG, Dreykluft T, et al. Ropinirole is effective in the treatment of restless legs syndrome. Mov Disord 2004;19:1414–1423. [DOI] [PubMed] [Google Scholar]
  • 77. Whone AL, Watts RL, Stoessl AJ, et al. Slower progression of Parkinson's disease with ropinirole versus levodopa: The REAL‐PET study. Ann Neurol 2003;54:93–101. [DOI] [PubMed] [Google Scholar]
  • 78. Worthington JJ 3rd, Simon NM, Korbly NB, et al. Ropinirole for antidepressant‐induced sexual dysfunction. Int Clin Psychopharmacol 2002;17:307–310. [DOI] [PubMed] [Google Scholar]

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