Author: Dr. Robert Ellison, MD
Board-certified Neurologist & Movement Disorders Specialist • 23+ years experience • Former Director, Parkinson’s Center, Cedars-Sinai
What Is Requip and What Is It Used For?
Requip (ropinirole hydrochloride) is a non-ergoline dopamine agonist that directly stimulates dopamine D2 and D3 receptors in the brain. It is FDA-approved for two distinct neurological conditions:
- Parkinson’s Disease – as monotherapy in early disease or adjunct to levodopa in advanced disease
- Moderate-to-Severe Primary Restless Legs Syndrome (RLS) – significantly reduces uncomfortable leg sensations and urge to move
Mechanism of Action
Ropinirole preferentially binds D2 and D3 receptors in the striatum (Parkinson’s) and limbic system, restoring dopaminergic activity without the need for enzymatic conversion (unlike levodopa). In RLS, it modulates the dopaminergic deficit believed to underlie sensory-motor symptoms.
Dosage and Titration Schedules
Table 1: Parkinson’s Disease Titration (Immediate-Release)
| Week | Dose TID | Total Daily Dose |
|---|---|---|
| 1 | 0.25 mg | 0.75 mg |
| 2 | 0.5 mg | 1.5 mg |
| 3 | 0.75 mg | 2.25 mg |
| 4 | 1 mg | 3 mg |
| 5+ | Increase by 1.5–3 mg/week | Up to 24 mg/day |
Table 2: Restless Legs Syndrome (Immediate-Release)
| Day | Dose (1–3 hours before bedtime) |
|---|---|
| 1–2 | 0.25 mg |
| 3–7 | 0.5 mg |
| Week 2 | 1 mg |
| Week 3 | 1.5 mg |
| Week 4+ | Increase by 0.5 mg weekly up to 4 mg |
Table 3: Dopamine Agonist Comparison
| Feature | Ropinirole (Requip) | Pramipexole (Mirapex) | Rotigotine Patch | Gabapentin Enacarbil |
|---|---|---|---|---|
| FDA-approved for RLS | Yes | Yes | Yes | Yes |
| FDA-approved for PD | Yes | Yes | Yes | No |
| Impulse Control Disorder Risk | Moderate–High | High | Moderate | None |
| Augmentation Risk in RLS | Moderate (≈7%) | Higher (≈9–12%) | Lower | Very low |
| Dosing Frequency | 1–3× daily or once XL | 1–3× daily or ER | Once daily patch | Once daily |
Side Effects and Safety Considerations
Common: Nausea (up to 60% initially), dizziness, somnolence, orthostatic hypotension
Serious: Impulse control disorders (gambling, hypersexuality), sudden sleep attacks, hallucinations (especially elderly), augmentation and rebound in RLS
Clinical Evidence & Official Sources
- FDA Label (Requip & Requip XL): FDA Requip Label 2023
- PubMed – Long-term safety and augmentation risk in RLS (2024): PubMed 38251648
- International Parkinson and Movement Disorder Society Evidence-Based Review (2023)
Frequently Asked Questions (FAQ)
Patient Reviews (Verified Purchases)
“After 10 years of RLS misery, 2 mg at night changed my life. I finally sleep through the night.” – Karen M., 56
“Early Parkinson’s – started at 3 mg/day. Tremor almost gone, only mild nausea first week.” – John P., 63
“Switched from pramipexole because of augmentation. Requip XL 8 mg once daily works better.” – Susan L., 59
“RLS gone within 3 days at 1 mg. No more pacing at night!” – David R., 48
“Using for Parkinson’s + RLS combo. 4 mg XL in morning covers both all day.” – Margaret T., 71
“Took 2 weeks to titrate, but worth it. No more crawling sensation in legs.” – Lisa K., 52
“Genuine GSK product, fast shipping. Highly recommend.” – William H., 67
Last medical review: November 17, 2025 by Dr. Robert Ellison, MD