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Generic Name: rotigotine (transdermal) (roe TIG oh teen)
Brand Names: Neupro
Neupro Skin Patches (rotigotine) are used to treat early signs and symptoms of Parkinson's disease and Restless Legs Syndrome. Includes Neupro side effects, interactions and indications.
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Drug Information:
Neupro (rotigotine) has some of the same effects as a chemical called dopamine, which occurs naturally in your body. Low levels of dopamine in the brain are associated with Parkinson's disease. Neupro skin patches are used to treat symptoms of Parkinson's disease, such as stiffness, tremors, muscle spasms, and poor muscle control. Neupro is also used to treat restless legs syndrome (RLS). Some people using Neupro have fallen asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Tell your doctor if you have any problems with daytime sleepiness or drowsiness. If you are unsure of how rotigotine will affect you, be careful if you drive or do anything that requires you to be awake and alert. Learn more

Neupro Side Effects

Neupro Side Effects

Note: This document contains side effect information about rotigotine. Some of the dosage forms listed on this page may not apply to the brand name Neupro.

In Summary

Common side effects of Neupro include: application site reaction, insomnia, nausea, and vomiting. Other side effects include: dizziness, dyspepsia, increased blood pressure, increased heart rate, orthostatic hypotension, and orthostatic dizziness. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to rotigotine: transdermal patch extended release

Along with its needed effects, rotigotine (the active ingredient contained in Neupro) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking rotigotine:

More common

  • Burning, itching, redness, skin rash, swelling, or soreness at the application site
  • swelling of the hands, ankles, feet, or lower legs

Less common

  • Bladder pain
  • bloody or cloudy urine
  • blurred vision or other changes in vision
  • difficult, burning, or painful urination
  • dizziness
  • frequent urge to urinate
  • headache
  • lower back or side pain
  • nervousness
  • pounding in the ears
  • seeing, hearing, or feeling things that are not there
  • slow or fast heartbeat

Get emergency help immediately if any of the following symptoms of overdose occur while taking rotigotine:

Symptoms of overdose

  • Confusion
  • convulsions
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • nausea
  • sweating
  • unusual tiredness or weakness
  • vomiting

Some side effects of rotigotine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Sleepiness or unusual drowsiness

Less common

  • Acid or sour stomach
  • belching
  • difficulty having a bowel movement (stool)
  • difficulty with moving
  • dreaming abnormal
  • dry mouth
  • feeling of constant movement of self or surroundings
  • heartburn
  • indigestion
  • loss of appetite
  • muscle pain or stiffness
  • pain in the joints
  • sensation of spinning
  • sleeplessness
  • stomach discomfort, upset, or pain
  • trouble sleeping
  • unable to sleep
  • weight loss

For Healthcare Professionals

Applies to rotigotine: transdermal film extended release


Very common (10% or more): Peripheral edema (up to 14%), orthostatic hypotension (up to 32%)

Common (1% to 10%): Abnormal ECG T wave, first degree AV block, hypertension, palpitations

Uncommon (0.1% to 1%): Atrial fibrillation

Rare (less than 0.1%): Supraventricular tachycardia

The incidence of significant decreases in blood pressure or orthostatic hypotension increased during periods of dose escalation and titration. In patients taking maximum recommended doses, orthostatic hypotension occurred (compared to placebo) at 29% (vs 11%), 27% (vs 23%), and 8% (vs 7%), in those with early stage Parkinson's disease (PD), advanced-stage PD, and restless legs syndrome, respectively.

The incidence of peripheral edema was 3% and 2% for patients with early-stage PD compared with 9% and 1% for patients with advanced-stage PD receiving drug and placebo, respectively.


Very common (10% or more): Nausea (up to 41%), vomiting (up to 20%),

Common (1% to 10%): Dyspepsia, constipation, diarrhea, dry mouth,

Uncommon (0.1% to 1%): Abdominal pain

Nausea and vomiting may occur at the beginning of therapy but these are usually mild or moderate in intensity and transient even if treatment is continued.

Nervous system

Very common (10% or more): Somnolence (up to 32%), dizziness (up to 23%), dyskinesia (up to 14%), headache (up to 21%)

Common (1% to 10%): Balance disorder, paresthesia, tremor, hypoesthesia, sleep attacks

Rare (less than 0.1%): Convulsion

Postmarketing reports: Dropped head syndrome

In clinical trials, 2% of patients receiving maximum doses of this drug for restless legs syndrome reported sleep attacks compared with 0% of patients receiving placebo.


Very common (10% or more): Arthralgia (up to 11%)

Common (1% to 10%): Muscle spasms

Frequency not reported: Elevated creatine phosphokinase


Common (1% to 10%): Sinus congestion, nasal congestion, cough, nasopharyngitis, hiccups


Common (1% to 10%): Visual disturbances

Uncommon (0.1% to 1%): Blurred vision, visual impairment, photopsia


Common (1% to 10%): WBC in urine

Uncommon (0.1% to 1%): Erectile dysfunction


Common (1% to 10%): Hypersensitivity including tongue edema and lip edema


Uncommon (0.1% to 1%): Hepatic enzyme increases (ALT, AST, GGT)


Common (1% to 10%): Anorexia, increased weight, decreased weight

Frequency not reported: Decreased serum glucose


Frequency not reported: Elevated BUN


Common (1% to 10%): Decreased serum ferritin

Frequency not reported: Decreased hemoglobin/hematocrit


Very common (10% or more): Application site reactions (up to 46%), hyperhidrosis (up to 11%)

Common (1% to 10%): Erythema, pruritus,

Uncommon (0.1% to 1%): Contact dermatitis

Rare (less than 0.1%): Generalized rash

Application site reactions (ASRs) exhibited a dose-dependent relationship for all doses in patients with both Parkinson's disease and restless legs syndrome. Reactions included localized erythema, edema, or pruritus, generally limited to the patch area; although generalized skin reactions such as allergic rash, including erythematous, macular-papular rash, or pruritus were reported at a lower incidence. Rotation of application sites has been shown to reduce the incidence of ASRs.

When applied as instructed, 34.2% (n=748) of patients experienced ASR; the majority were mild or moderate in intensity. Discontinuation occurred in 7.2% of patients


Very common (10% or more): Disturbances in initiating and maintaining sleep (up to 14%), hallucinations (up to 13%)

Common (1% to 10%): Abnormal dreams, nightmare, irritability, sleep disorder, depression, impulse-control disorders

Uncommon (0.1% to 1%): Obsessive-compulsive disorder, disorientation, agitation

Rare (less than 0.1%): Aggressive behavior, binge eating, delusion, delirium


Asthenic conditions included asthenia, malaise, and fatigue.

Very common (10% or more): Fatigue (up to 18%), asthenic conditions (up to 14%)

Common (1% to 10%): Tinnitus, vertigo


Common (1% to 10%): Menstrual disorder, sexual desire disorder


The most common adverse reactions experienced among patients with Parkinson's disease included nausea, vomiting, somnolence, application site reactions, dizziness, anorexia, disturbances in initiating and maintaining sleep, hyperhidrosis, visual disturbances, peripheral edema, and dyskinesia. For patients with Restless Legs Syndrome, the most common adverse reactions included application site reactions, nausea, disturbances in initiating and maintaining sleep, somnolence, and headache.


Common (1% to 10%): Basal cell carcinoma

Editorial References and Review

Medically reviewed by BestRx Medical Team Last updated on 1/1/2020.

Source: Drugs.com Neupro