Rare cases of pleural, retroperitoneal fibrosis and/or cardiac valvulopathy reported in patients treated with ergot-derived dopamine agonists, generally with prolonged use (potential of rotigotine to cause similar fibrotic complications unknown). May cause hallucinations. Dopamine agonists used for Parkinson’s disease or restless legs syndrome associated with compulsive behaviors and/or loss of impulse control. Risk for melanoma development increased in Parkinson’s disease patients. Dopamine agonists may cause orthostatic hypotension and syncope. Use with caution in risk of hypotension (such as patients receiving antihypertensive drugs) or where transient hypotensive episodes would be poorly tolerated (cardiovascular disease or cerebrovascular disease). Use commonly associated with somnolence. Use with caution in patients receiving other CNS depressants or psychoactive agents. Effects with other sedative drugs or ethanol may be potentiated. Use with caution in pre-existing cardiovascular disease (therapy associated with inconsistent increases in blood pressure, increased heart rate, and fluid retention). Use with caution in pre-existing dyskinesia (may be exacerbated). Patch may contain aluminum and sodium metabisulfite. Patch exposure to heat sources should be avoided (may result in severalfold increases in drug absorption). Therapy should not be discontinued abruptly. Other dopaminergic agents associated with syndrome resembling neuroleptic malignant syndrome on withdrawal and/or significant dosage reduction.