Neupro (rotigotine) is a brand-name patch that’s prescribed to treat Parkinson’s disease and relieve symptoms of restless leg syndrome in adults. As with other drugs, Neupro can cause side effects, such as nausea and insomnia.
Neupro can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took Neupro in clinical trials:
- sleepiness
- nausea
- headache
- insomnia (trouble falling asleep and staying asleep)
- skin reactions at application site*
* For more information about this side effect, see “Side effect specifics.”
Mild side effects can occur with Neupro use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Neupro’s prescribing information.
Mild side effects that have been reported with Neupro when prescribed for Parkinson’s disease include:
- sleepiness
- nausea
- dizziness
- insomnia
- loss of appetite
- vision problems
- excessive sweating
- edema (swelling in your hands, ankles, or feet)
- skin reactions at application site*
Mild side effects that have been reported with Neupro when prescribed for restless leg syndrome (RLS) include:
- sleepiness
- nausea
- headache
- insomnia
- skin reactions at application site*
These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while using Neupro and want to tell the FDA about it, visit MedWatch.
* For more information about this side effect, see “Side effect specifics.”
Neupro may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Neupro’s prescribing information.
If you develop serious side effects while using Neupro, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported and their symptoms include:
- problems with impulse control and compulsive behaviors, which may include symptoms such as:
- uncontrollable urges to gamble, spend money, or have sex
- elevated heart rate, which may include symptoms such as:
- shortness of breath
- feeling lightheaded
- fast resting pulse
- significant weight gain and fluid buildup, which may include symptoms such as:
- sudden increase in weight
- swelling in your ankles or legs
- unusual thinking and behaviors, which may include symptoms such as:
- confusion
- hallucinations (seeing or hearing things that aren’t there)
- aggressive behavior
- feeling suspicious or not trusting others
- delusions (strong beliefs or ideas that aren’t true)
- dyskinesia (involuntary muscle movements) in people with Parkinson’s disease, which may include symptoms such as:
- worsening of existing unusual movements
- sudden or uncontrollable muscle movements
- worsening symptoms of RLS, which may include:
- symptoms starting earlier in the day
- symptoms feeling more intense
- falling asleep during daily activities, such as driving
- fainting
- severe skin reactions at the application site*
- changes in blood pressure*
* For more information about this side effect, see “Side effect specifics.”
ALLERGIC REACTIONFor some people, Neupro patches can cause an allergic reaction. In general, symptoms of allergic reaction can be mild or serious.
In addition, Neupro patches contains a sulfite called sodium metabisulfite. This substance can cause serious and life threatening allergic reactions in people with a sulfite sensitivity. (Note a sulfite allergy is not the same as a sulfa allergy.)
Ways to manage
For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep using the medication.
For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Neupro, your doctor may recommend taking a different medication instead.
Neupro may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.
How do side effects of the Neupro patch compare with alternatives such as ropinirole?
Both Neupro and ropinirole (Requip) belong to the same class of drugs called dopamine agonists. They have some similar side effects but some different ones as well.
Mild side effects of Neupro and ropinirole include nausea and vomiting, headache, and dizziness. However, ropinirole may cause nausea and dizziness more often than Neupro. Neupro is a patch that commonly causes skin reactions where it’s applied. Ropinirole is a tablet that’s swallowed, so it doesn’t have this side effect.
Serious side effects of both Neupro and ropinirole include daytime sleepiness, hallucinations, changes in blood pressure, and problems with impulsive control. Withdrawal symptoms are possible with both medications, so the dose must be slowly lowered when stopping treatment. (To learn more about withdrawal and Neupro, see the section just below.)
If you have questions about how the side effects of Neupro and ropinirole compare, talk with your doctor or pharmacist.
Is there a risk of withdrawal symptoms with Neupro?
Yes, stopping treatment with the Neupro patch can cause withdrawal symptoms. They can occur when treatment is suddenly stopped, or may even occur when the dose is slowly lowered. Withdrawal symptoms may include:
- anxiety
- confusion
- fatigue
- muscle stiffness
- sweating
- depression
- insomnia
- high fever
Talk with your doctor right away if you experience withdrawal symptoms from Neupro. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
If you have any questions or concerns about withdrawal symptoms from Neupro or how to safely stop using it, talk with your doctor.
Learn more about some of the side effects that Neupro may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Neupro.
Skin reactions at patch application site
Neupro can cause skin reactions where the patch is applied to the skin. This was a common side effect reported in Neupro’s clinical trials. Most skin reactions are mild and will go away within a few days.
Application site reactions may include symptoms such as:
- itching
- redness or discoloration
- swelling
In rare cases, these reactions may be severe and cause symptoms to worsen over time. They may also spread beyond where the patch was applied, or not go away.
What you can do
To reduce the risk of skin irritation and reactions, apply the patch to a different site each day and avoid putting it in the same place within 14 days. Don’t put the patch on broken, irritated, or discolored skin. If you have skin irritation from the patch, avoid exposing the skin to direct sunlight until it has healed. Exposing it to the sun could cause a change in skin color.
If you have symptoms that are severe or aren’t going away, talk with your doctor right away. They can determine whether you should continue treatment with Neupro patch.
Changes in blood pressure
Neupro may cause changes in blood pressure. It can cause your blood pressure to become too high or too low. This was a common side effect reported in clinical trials of Neupro.
Increases in blood pressure occurred more often when the maximum recommended dose of Neupro was used. High blood pressure typically doesn’t cause any symptoms, but severe high blood pressure may cause symptoms which include:
- headache
- nosebleeds
- blurry or double vision
- dizziness
Neupro may also cause low blood pressure or orthostatic hypotension. With orthostatic hypotension, your blood pressure drops when changing positions too quickly, such as from lying down or sitting to standing. These effects occurred more often at the start of therapy and during dose increases. Low blood pressure or orthostatic hypotension may cause symptoms, such as:
- dizziness or lightheadedness
- fainting or falling
- blurred vision
What you can do
Tell your doctor if you have a history of high blood pressure or heart problems before starting treatment with Neupro. They can determine whether Neupro is the right option for you.
During treatment with Neupro, your doctor will monitor your blood pressure closely. When changing positions, try to do so slowly. For example, if you have been lying down for a long period of time, sit up for a few minutes before standing.
Talk with your doctor if you notice symptoms of high or low blood pressure. They may recommend adjusting your dose or changing to a different medication to treat your condition.
Below is important information you should consider before using Neupro.
Other precautions
Before using Neupro, discuss your health history with your doctor. Neupro may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:
- mental health problems, such as bipolar disorder or schizophrenia
- breathing problems, including asthma
- low or high blood pressure
- daytime sleepiness
- heart problems
- sulfite allergy
- previous allergic reaction to this or a similar drug
- pregnancy
- breastfeeding
- alcohol consumption
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.