Rotigotine

NEUPRO

Pronunciation: roe-TIG-oe-teen (NOO-proe)

What it isNon-ergot dopamine agonist delivered transdermally; Parkinson disease and restless legs.

Why this oneContinuous delivery avoids the pulsatile stimulation of oral agonists and works when swallowing fails.

What limits itApplication-site reactions are common. Impulse-control disorders and sudden sleep onset; heat increases absorption.

FDA-approved for

FDA dosing	Population	Start	Target	Max
Parkinson's disease, early-stage	Adults	2 mg/24h patch QD	4 mg/24h (lowest effective)	6 mg/24h
Parkinson's disease, advanced-stage	Adults	4 mg/24h patch QD	—	8 mg/24h
Restless legs syndrome	Adults	1 mg/24h patch QD	1 mg/24h (lowest effective)	3 mg/24h

Titration Increase at weekly intervals (by 2 mg/24h for PD, 1 mg/24h for RLS).

Renal Undefined

Hepatic Undefined

Apply one patch once daily to clean, dry, intact skin (abdomen, thigh, hip, flank, shoulder, or upper arm)
Press firmly for 30 seconds; rotate sites and do not reuse a site within 14 days
Do not apply to oily, irritated, or damaged skin
Discontinue by gradually reducing the dose

Available strengths

Contains sodium metabisulfite — allergic reactions in sulfite-sensitive patients
Falling asleep during activities of daily living / somnolence
Hallucinations / psychosis; dyskinesia
Postural hypotension and syncope, esp. during titration
Impulse control / compulsive behaviors
Elevation of blood pressure and heart rate
Application site reactions (may be severe)
Withdrawal-emergent hyperpyrexia and confusion

Pregnancy No adequate human data; animal studies show adverse embryofetal development.

Lactation No human data; may inhibit lactation (decreases prolactin secretion).

Rotigotine (NEUPRO)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/unit	brand $/unit	CostPlus
1 mg/24 hr	patch	per unit	—	$28.29/ea	not offered
2 mg/24 hr	patch	per unit	—	$28.26/ea	not offered
3 mg/24 hr	patch	per unit	—	$28.25/ea	not offered
4 mg/24 hr	patch	per unit	—	$28.32/ea	not offered
6 mg/24 hr	patch	per unit	—	$28.18/ea	not offered
8 mg/24 hr	patch	per unit	—	$28.24/ea	not offered

Generic entry2032 est.

NO BOXED WARNINGS

Principal riskApplication-site reactions; impulse-control disorders

Therapeutic safety burden2 / 4

Overdose danger2 / 4

Weight-gain liability2 / 4

Sedation liability1 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryC

Defining liabilityOrthostasis, hallucinations, dyskinesia and impulse-control symptoms; abrupt withdrawal can be hazardous.

no kinetic interactions