Neurosciences
See separate leaflet for apomorphine
This leaflet is to help you understand your medicine. It is not intended to be a comprehensive guide about your medicine and it is not an official manufacturer’s patient information leaflet.
Always consult the manufacturer’s Patient Information Leaflet for the most up to date information regarding dopamine agonists.
Why have I been prescribed a dopamine agonist?
In Parkinson’s dopamine is lacking in certain areas of the brain; dopamine agonists affect the brain in a similar way to natural dopamine.
Dopamine agonists are used to help improve some of the motor symptoms of Parkinson’s (slowness and reduction in movement, rigidity and tremor).
Are dopamine agonists safe to take?
Dopamine agonists are generally safe to take as directed but may not suit everyone. There are some conditions where dopamine agonists are not always used.
Tell your Parkinson’s team if any of the following apply to you:
- If you are allergic to any of the ingredients.
- If you have liver disease
If you have a serious heart complaint
If you have a history of, or ongoing mental health problems
If you have a history of, or ongoing unusual urges or behaviours
How should I take dopamine agonists?
Ropinirole and pramipexole are taken by mouth as tablets; they are either given three times per day or once daily if they are the slow/prolonged/modified release tablets. Rotigotine is a patch and should be placed on hair free skin every 24 hours. please ensure you remove the last patch and change the location of where you apply the patch daily.
Take ropinirole or pramipexole with a glass of water, they may be taken with or without food. If you forget a dose, take it as soon as you remember. If it is at or near your usual dose, just take the next dose (do not double your dose).
Do I need any blood tests?
If you are prescribed tolcapone you will need to have regular blood tests to monitor your Many people taking dopamine agonists do not need blood tests. Your Parkinson’s team will continue to monitor your blood pressure.
What unwanted effects of COMT inhibitors might I experience?
Unfortunately, you may experience some side effects. Most of these are quite mild and should go away after a week or two as you get used to your dopamine agonist. The table (below) is a guide to what to do if you get any side effects. Not everyone will get the side effects shown, and most people do not.
The more serious side effects are often dose related and may be avoided or minimised by using the smallest effective dose.
| Side effects | How common? | What should I do? |
|---|---|---|
| Drowsiness | Common | If affected do not drive or operate machinery |
| Dizziness | Common | Do not drive or operate machinery. If problem persists, contact your Parkinson’s team |
| Dyskinesia (involuntary movements). | Very common | Contact your Parkinson’s team to review your dosage and, or timings |
| Nausea and vomiting | Common | This should be short lived, contact your Parkinson’s team if it persists |
| Hallucinations | Common | Contact your Parkinson’s team |
| Constipation | Common | Eat plenty of fruit and fibre. Drink plenty of fluids. |
| Swelling of lower legs | Common | Contact your Parkinson’s team |
| Allergic reaction | Rare | Seek urgent medical attention if there is swelling of the face, mouth or throat |
| Sudden onset of sleep | Unknown | Do not drive or operate machinery, contact your Parkinson’s team |
| Skin reaction (site of rotigotine patch) | Common | Contact your Parkinson’s team |
| Mental health problems – impulse control problem | Unknown | Contact your Parkinson’s team |
| Urge to take more Parkinson’s medication | Unknown | Contact your Parkinson’s team |
Impulse control problems
Sometimes people taking dopamine agonists can develop irresistible urges to behave in damaging ways including; hobbyism, pathological gambling, hypersexuality, compulsive spending, binge eating and overusing medication.
These impulse control problems have generally been shown to be reversible on reduction of these medications.
Sudden onset of sleep
Dopamine agonists can sometimes cause extreme daytime drowsiness and sudden onset of sleep (with no warning signs). If you are affected, you must not drive or operate machinery.
What about alcohol?
Generally, you should not drink alcohol while taking a dopamine agonist because both can make you drowsy, so taking them together may increase this further. However, once you are used to taking your medication you might wish to try a glass of your normal drink. If you do not suffer any adverse effects, you may be able to drink in moderation.
It is important that you do not stop taking your dopamine agonist just because you fancy an alcoholic drink.
If my Parkinson’s is well controlled, can I stop taking it?
NO. This can be dangerous and result in a serious deterioration in your Parkinson’s. You and your Parkinson’s team will need to decide when you can stop taking it. Never change your dose or stop taking your dopamine agonist yourself.
Something not right?
Out of hours please contact NHS 111 or visit A&E in an emergency.
Contact us
If you require further information please contact us on:
Telephone: 01642 854319 (Monday, Wednesday and Friday 0900-1100)
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]
The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.
Telephone: 01642 850850
DISCLAIMER: This information was correct at the time of printing. While the Trust makes every reasonable effort to keep its information leaflets up to date, very recent changes may not yet be reflected in the guidance and you should discuss this with the clinical staff at the time of your appointment.