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Rotigotine: Dopamine Patch

Sometimes taking pills can be hard for people who have difficulty with swallowing. Rotigotine is a dopamine patch that can be worn for 24 hours a day. Rotigotine was first approved by the US Food and Drug Administration (FDA) in 2007 to treat Parkinson's symptoms and in 2008 to treat Restless Legs symptoms.



How it works

Rotigotine is thought to be made to connect, or synapse, to the same receptors as dopamine to help replace the dopamine that is lost from PD. However, the exact mechanism is unknown.


One patch supplies 24 hours of medication. Since it is not an oral medication, timing your meals around medications to ensure effectiveness of the medication is no longer necessary.


Rotigotine is approved to treat both early and advanced PD, so the patch comes in varying degrees of dosage. The higher dosage you need, the bigger the patch it, but it is still only one patch.






How does rotigotine help with PD symptoms?

Ikeda et al in 2016 found that rotigotine helped with freezing of gait and helped reduce fall risk. One possible reason is that the medication offers a 24 hour supply of the dosage.


Valldeoriola et al in 2018 found that those who took rotigotine showed a 14.6% reduction in non-motor symptoms like sleep, mood/cognition, and incontinence.


Castrioto et al in 2020 found that rotigotine was correlated with a reduction in anxiety.


The RECOVER study found a correlation with a reduction in pain and showed improvements in early morning motor function. It is suspected that the early morning motor function benefits are seen due to most people waiting for oral medications to enter the blood stream after taking them when they first wake up.


Ruan et al in 2021 found that rotigotine was associated with a greater increase in quality of life than other dopamine agonists.



What are the risks of rotigotine?

No medications come without some type of risk. Rotigotine is no different.


An increased rate of vomiting and nausea are seen, especially with higher dosages in those with early PD. Less people with advanced PD experience nausea compared to early PD.

Just like other dopamine agolosist medications, rotigotine is more likely to cause or worsen impulse control disorders.


Other side effects:

  • rash, redness, swelling or itching of the skin that was covered by the patch (most common)

  • swelling of the hands, feet, ankles, or lower legs (most common)

  • constipation

  • loss of appetite

  • difficulty falling asleep and/or staying asleep

  • abnormal dreams

  • drowsiness

  • dizziness and/or feeling that you or the room is moving

  • rapid and/or irregular heartbeat

  • joint pain

  • headache

  • loss of energy

  • dry mouth

  • abnormal vision

  • fainting

  • weight gain

  • increased sweating

  • worsening of symptoms of Parkinson's or Restless Leg Syndrome

  • allergic reactions, including anaphylactic or asthmatic episodes in people with allergy to sulfites




Rotigotine is not the gold standard of PD treatment, so it is not always mentioned by neurologists. This medication can be used as your primary, secondary, or tertiary medication, meaning it can be prescribed as your only PD medication or to help supplement what you are already taking. For those of you who struggle with oral medications for whatever reason, it may be a good idea to discuss different options with your neurologist.



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