This leaflet gives information on dopamine agonists, one of the medications prescribed for Parkinson’s.
Dopamine agonists can be prescribed alone or with other Parkinson’s medications such as levodopa. Commonly used dopamine agonists are ropinirole and pramipexole tablets which can be taken once a day or three times a day. They are started at low doses and built up gradually. Other forms are rotigotine skin patches and apomorphine injections.
Dopamine agonists are safe and effective and have been used in thousands of people with Parkinson’s. They are generally well tolerated but, like any medicines, do have side-effects. Most of the side-effects are mild and will settle down. It is not usually necessary to discontinue the treatment. You can discuss your treatment plan with your Consultant or Parkinson’s nurse.
Ropinirole is also known as Aimpart, Ardatrel, Eppinix, Ralnea, Raponer, Repinix, Requip, Ropilynz and Spiroco in immediate and prolonged release preparations.
Rotigotine also known as Neupro patches.
Apomorphine also known as (Apo-go) intermittent injections and pump infusions.
Pramipexole also known as Mirapexin.
Side-effects
The following list covers the most important side effects with dopamine agonist drugs used in Parkinson’s. Discuss any concerns with your Consultant or Parkinson’s nurse.
Low blood pressure and dizziness: please bear this in mind if you drive or operate machinery.
Nausea: this usually settles down after a few weeks and may be lessened if you take the tablet with food rather than on an empty stomach. Sometimes domperidone is prescribed to help with the nausea but speak to your GP, Consultant or Parkinson’s nurse for advice.
Drowsiness or feeling sleepy: usually this comes on gradually but occasionally people develop sudden onset of sleep without any warning. If in doubt you should not drive or operate machinery The DVLA states that you must not drive if you develop sudden onset of sleepiness.
Local skin reactions: rotigotine patches can cause redness or irritation. Apply to a different area every day.
Hallucinations: seeing, hearing or sensing things that are not real. These can be worrying and may respond to a change in dose, so discuss with your Consultant or Parkinson’s nurse.
Swollen ankles: can occur with dopamine agonists. Discuss this with your Consultant or Parkinson’s nurse.
Important information please read
Impulse control disorders: occur in about 15% of patients taking dopamine agonists. It is important for you to be aware that behavioural changes may occur and to recognise that a change in your usual behaviour could be related to your medication and is reversible. It is important your family are aware of this potential side-effect as the behaviours such as gambling or change in sexual behaviour can also affect families and carers.
As soon as possible, you should seek advice from your Consultant or Parkinson’s nurse to reduce your medication under supervision.
Possible symptoms of impulse control disorders are:
- Risk taking behaviour.
- Gambling.
- Changed sexual behaviour.
- Binge eating/compulsive shopping.
Please do:
- Read the information leaflet supplied with your medication
- Discuss any concerns with your Consultant, Parkinson’s nurse or GP.
- Report any side effects to your Consultant, Parkinson’s nurse or GP.
- Inform your Consultant or Parkinson’s nurse about any other medications you are taking, including products bought over the counter or prescribed by a another doctor.
Please do not:
- Stop taking your medication without advice from your Consultant, Parkinson’s nurse or GP
Who do I contact for further advice and information?
Parkinson’s nurse specialist
You can get in touch with your local Parkinson’s nurse specialist on:
Parkinson’s UK
You can obtain information from Parkinson’s UK via their national advice line on: