May cause hallucinations (risk may be increased in the elderly). Dopamine agonists used for Parkinson’s disease or restless legs syndrome associated with compulsive behaviors and/or loss of impulse control, manifested as pathological gambling, libido increases (hypersexuality), and/or binge eating (causality not established). Risk for melanoma development increased in Parkinson’s disease patients. May cause orthostatic hypotension. Use with caution in risk of hypotension or where transient hypotensive episodes would be poorly tolerated (cardiovascular disease or cerebrovascular disease). Syncope, sometimes associated with bradycardia, observed in association with ropinirole in both early Parkinson’s disease (without levodopa) and advanced Parkinson’s disease (with levodopa). Risk of fibrotic complications (e.g. pleural effusion/fibrosis, interstitial lung disease) reported in patients receiving ropinirole (drug causation not established). Pathologic degenerative changes observed in retinas of albino rats during studies with this agent, but not observed in retinas of albino mice or other species (significance of these data for humans remains uncertain). Somnolence might occur (caution with concomitant sedating medication). Use with caution in patients receiving other CNS depressants or psychoactive agents (effects with other sedative drugs or ethanol may be potentiated), in pre-existing dyskinesias (may be exacerbated), and in severe hepatic or renal impairment. Avoid use in major psychotic disorder (may exacerbate psychosis). Augmentation (earlier onset of symptoms in evening/afternoon, increase and/or spread of symptoms to other extremities) or rebound (shifting of symptoms to early morning hours) may occur in some RLS patients. Dopaminergic agents associated with syndrome resembling neuroleptic malignant syndrome on abrupt withdrawal or significant dosage reduction after long-term use.