Physicians should instruct their patients to read the Patient Information leaflet before starting therapy with Ropinirole hydrochloride and to reread it upon prescription renewal for new information regarding the use of ropinirole hydrochloride. 

Patients should be instructed to take ropinirole hydrochloride only as prescribed. If a dose is missed, patients should be advised not to double their next dose. 

Ropinirole tablets can be taken with or without food. Patients may be advised that taking ropinirole tablets with food may reduce the occurrence of nausea. However, this has not been established in controlled clinical trials. 

Patients should be advised that they may develop postural (orthostatic) hypotension with or without symptoms such as dizziness, nausea, syncope, and sometimes sweating. Hypotension and/or orthostatic symptoms may occur more frequently during initial therapy or with an increase in dose at any time (cases have been seen after weeks of treatment). Accordingly, patients should be cautioned against rising rapidly after sitting or lying down, especially if they have been doing so for prolonged periods, and especially at the initiation of treatment with ropinirole hydrochloride. 

Patients should be alerted to the potential sedating effects associated with ropinirole hydrochloride, including somnolence and the possibility of falling asleep while engaged in activities of daily living. Since somnolence is a frequent adverse event with potentially serious consequences, patients should neither drive a car nor engage in other potentially dangerous activities until they have gained sufficient experience with ropinirole hydrochloride to gauge whether or not it affects their mental and/or motor performance adversely. Patients should be advised that if increased somnolence or episodes of falling asleep during activities of daily living (e.g., watching television, passenger in a car, etc.) are experienced at any time during treatment, they should not drive or participate in potentially dangerous activities until they have contacted their physician. 

Because of possible additive effects, caution should be advised when patients are taking other sedating medications or alcohol in combination with ropinirole hydrochloride and when taking concomitant medications that increase plasma levels of ropinirole (e.g.,ciprofloxacin). 

Because of the possible additive sedative effects, caution should also be used when patients are taking alcohol or other CNS depressants (e.g., benzodiazepines, antipsychotics, antidepressants, etc.) in combination with ropinirole hydrochloride. 

Patients should be informed they may experience hallucinations (unreal visions, sounds, or sensations) while taking ropinirole hydrochloride. These were uncommon in patients taking ropinirole hydrochloride for Restless Legs Syndrome. The risk is greater in patients with Parkinson's disease; the elderly are at greater risk than younger patients with Parkinson's disease; and the risk is greater in patients who are taking ropinirole hydrochloride with L-dopa, or taking higher doses of ropinirole hydrochloride. 

Impulse Control Symptoms Including Compulsive Behaviors: 

There have been reports of patients experiencing intense urges to gamble, increased sexual urges, and other intense urges and the inability to control these urges while taking one or more of the medications that increase central dopaminergic tone, that are generally used for the treatment of Parkinson’s disease, including ropinirole hydrochloride. Although it is not proven that the medications caused these events, these urges were reported to have stopped in some cases when the dose was reduced or the medication was stopped. Prescribers should ask patients about the development of new or increased gambling urges, sexual urges or other urges while being treated with ropinirole hydrochloride. Patients should inform their physician if they experience new or increased gambling urges, increased sexual urges or other intense urges while taking ropinirole hydrochloride. Physicians should consider dose reduction or stopping the medication if a patient develops such urges while taking ropinirole hydrochloride. 

Because of the possibility that ropinirole may be excreted in breast milk, patients should be advised to notify their physicians if they intend to breastfeed or are breastfeeding an infant. 

Because ropinirole has been shown to have adverse effects on embryo-fetal development, including teratogenic effects, in animals, and because experience in humans is limited, patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy (see PRECAUTIONS: Pregnancy).