Neupro (rotigotine) is a brand-name skin patch prescribed for Parkinson’s disease and restless legs syndrome in adults. The patch interacts with some other drugs, including haloperidol (Haldol) and levodopa.

An interaction occurs when one substance causes another substance to have a different effect than expected.

Keep reading to learn more about Neupro’s possible interactions with other drugs, foods, or supplements. For additional information about Neupro, including its uses, see this article.

Before you start treatment with Neupro, tell your doctor and pharmacist which other medications you take, including prescription drugs and those you buy over the counter.

By sharing this information with them, you may help prevent possible interactions. (To learn whether Neupro interacts with supplements, herbs, or vitamins, see the “Neupro and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of Neupro’s possible interactions with other drugs. Keep in mind that this table doesn’t include all drugs that may interact with Neupro. Some of these interactions are described in detail below in the “Drug interactions in depth” section.

Drug class or drug nameDrug examplesInteraction result with Neupro
opioidshydrocodone (Hysingla ER)
• morphine (MS Contin)
• tramadol (Conzip, Qdolo)
can make Neupro and antipsychotics less effective,
can increase the risk of sleepiness and sleep attacks
antipsychotics• clozapine (Clozaril, Versacloz)
• quetiapine (Seroquel)
risperidone (Risperdal)
can increase the risk of sleepiness and sleep attacks
benzodiazepines• alprazolam (Xanax)
diazepam (Valium)
• lorazepam (Ativan)
can increase the risk of sleepiness and sleep attacks
certain antidepressantsamitriptyline
mirtazapine (Remeron)
• venlafaxine (Effexor XR)
can increase the risk of sleepiness and sleep attacks
hypnotics (sleeping pills)• eszopiclone (Lunesta)
• suvorexant (Belsomra)
• zaleplon (Sonata)
can increase the risk of sleepiness and sleep attacks
seizure medications• cenobamate (Xcopri)
gabapentin (Neurontin, Gralise)
• pregabalin (Lyrica)
can increase the risk of sleepiness and sleep attacks
sedating antihistamines• diphenhydramine (Benadryl)
• hydroxyzine
• promethazine
can increase the risk of sleepiness and sleep attacks
levodopa• levodopa/carbidopa (Sinemet, Rytary, Duopa, Inbrija)
• levodopa/carbidopa/entacapone (Stalevo)
can increase the risk of side effects of Neupro and levodopa
buspironecan increase the risk of sleepiness and sleep attacks
metoclopramide (Reglan, Gimoti)can make Neupro and metoclopramide less effective

Some factors or conditions could prevent your doctor from prescribing Neupro due to the risk of harm. These are known as contraindications. The contraindications of Neupro include:

Having had an allergic reaction to Neupro or any of its ingredients

If you have had an allergic reaction to Neupro or its ingredients, your doctor will likely not prescribe Neupro. Using the drug could cause another allergic reaction. You can ask them about other treatments that may be better for you.

Note: Before you start treatment with Neupro, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Neupro.

There aren’t any known interactions between Neupro and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Neupro treatment.

This is because drinking alcohol while taking the drug may worsen some Neupro side effects. For example, you may experience:

Alcohol can also worsen certain symptoms of the condition you’re using Neupro to treat. For example, if you have Parkinson’s disease or restless legs syndrome, drinking alcohol may worsen sleep problems you may have.

If you have questions about drinking alcohol while using Neupro, talk with your doctor.

Here’s a closer look at certain drug interactions of Neupro.

Antipsychotics

Neupro can interact with antipsychotics, which are drugs that treat specific mental health conditions, such as psychosis, schizophrenia, and bipolar disorder.

Interaction result

Taking Neupro with an antipsychotic can make both drugs less effective. It can also increase the risk of sleepiness and sleep attacks.

Interaction explained

Neupro and antipsychotics work in opposite ways in your brain. Neupro increases the action of a chemical called dopamine, while antipsychotics reduce the action of dopamine. So, taking these drugs together can make both drugs less effective.

Neupro and antipsychotics can also both cause sleepiness. Taking them together can increase sleepiness. It can also raise your risk of sleep attacks, which are a possible side effect of Neupro.

Examples of antipsychotic drugs

Here are some antipsychotics that may interact with Neupro:

  • clozapine (Clozaril, Versacloz)
  • haloperidol (Haldol)
  • loxapine
  • quetiapine (Seroquel)
  • risperidone (Risperdal)

Steps you or your doctor may take

Your doctor will usually avoid prescribing Neupro with antipsychotics.

If you take Neupro with an antipsychotic, tell your doctor if you have new or increased sleepiness or sleep attacks. Also, tell your doctor if you have any new or worse problems with movement or any unusual changes in your mood, thoughts, or behavior.

If you have questions about taking Neupro with an antipsychotic, talk with your doctor.

Certain antidepressants

Neupro can interact with certain antidepressant drugs, which treat depression.

Interaction result

Taking Neupro with certain antidepressants can raise your risk of sleepiness and sleep attacks.

Interaction explained

Neupro and certain antidepressants can both cause sleepiness as a side effect. So, taking these drugs together can increase sleepiness. This can also raise your risk of sleep attacks, which are a possible side effect of Neupro.

Examples of antidepressant drugs

Here are some antidepressants that may interact with Neupro:

  • amitriptyline
  • mirtazapine (Remeron)
  • venlafaxine (Effexor XR)

Steps you or your doctor may take

If you take Neupro with an antidepressant, tell your doctor if you experience sleepiness or sleep attacks. Your doctor may recommend switching to a different antidepressant that’s less likely to cause sleepiness.

If you have questions about taking Neupro with an antidepressant, talk with your doctor.

Levodopa

Neupro can interact with levodopa, a medication that treats Parkinson’s disease. Doctors sometimes prescribe these medications together for Parkinson’s.

Interaction result

Using Neupro with levodopa can raise your risk of side effects from both medications.

Interaction explained

Neupro and levodopa can cause some similar side effects. These include nausea, dizziness, sleepiness, sleep attacks, and impulse control disorders. So, you may be more likely to have these side effects if you take these drugs together.

Examples of levodopa drugs

Here are some levodopa-containing drugs that may interact with Neupro:

  • levodopa/carbidopa (Sinemet, Rytary, Duopa)
  • levodopa (Inbrija)
  • levodopa/carbidopa/entacapone (Stalevo)

Steps you or your doctor may take

If you take Neupro with levodopa, your doctor may prescribe a levodopa or Neupro dosage that is lower than usual. Do not take a higher dosage of either drug than your doctor recommends.

If you take Neupro and levodopa together, tell your doctor if you have bothersome side effects, especially sleepiness or sleep attacks. If needed, your doctor may recommend switching to alternative treatments for Parkinson’s disease.

Talk with your doctor if you have questions about taking Neupro with levodopa.

Medications may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Neupro.

Neupro and supplements

Drugs can interact with supplements such as vitamins and herbs.

Neupro and herbs

There are no specific reports of herbs interacting with Neupro. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Neupro treatment.

Neupro and vitamins

There are no specific reports of vitamins interacting with Neupro. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Talk with your doctor or pharmacist before taking any vitamin product with Neupro.

Neupro and food

There were no reports of food interactions with Neupro. If you’d like to learn more about eating certain foods during treatment with Neupro, talk with your doctor.

Neupro and vaccines

There aren’t any known interactions between Neupro and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Neupro and lab tests

Neupro isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

NEUPRO INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Neupro.

Using cannabis or cannabis products with Neupro may increase your risk of sleepiness and sleep attacks (suddenly falling asleep during daily activities).

Before you start treatment with Neupro, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level in the United States but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Neupro.

Before you take this drug, be sure to talk with your doctor about your health history. Neupro may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Neupro include:

Mental health conditions

Neupro can cause mental health problems such as hallucinations (seeing or hearing things that aren’t real) and psychosis (loss of touch with reality).

If you have a mental health condition that causes psychosis, such as schizophrenia or bipolar disorder, your doctor will likely not prescribe Neupro for you. It could worsen your condition. You can ask your doctor about other treatments that may be better choices for you.

Sleep problems

Neupro can cause sleepiness and sleep attacks. If you already have a sleep problem that causes daytime sleepiness, such as narcolepsy or insomnia, you may have a raised risk of these Neupro side effects. Your doctor may recommend a Neupro patch alternative for you.

Low blood pressure

Neupro can cause orthostatic hypotension (a drop in blood pressure upon standing). If you already have low blood pressure, you may have a raised risk of this side effect. Talk with your doctor about whether Neupro is right for you.

High blood pressure

Neupro can increase blood pressure in some people. If you already have high blood pressure, Neupro could make this worse. Talk with your doctor about whether Neupro is right for you.

Heart problems

Neupro can cause changes in your blood pressure and heart rate that may be dangerous if you have heart disease. It can also cause fluid buildup that may worsen heart failure. If you have a heart problem, discuss whether Neupro is right for you with your doctor.

Kidney problems

Neupro can cause fluid buildup that may worsen kidney problems. If you have a kidney problem, your doctor will likely monitor you for fluid buildup during Neupro treatment.

Allergic reaction

If you’ve had an allergic reaction to Neupro or any of its ingredients, your doctor will likely not prescribe Neupro. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Breastfeeding

It’s not known whether it’s safe to use Neupro while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Neupro may have on an infant who is breastfed.

If you’re breastfeeding or planning to, talk with your doctor before using Neupro. They can speak with you about treatment options and ways to feed your child.

Pregnancy

There haven’t been enough clinical trials to determine whether Neupro is safe to use while pregnant. Animal studies suggest the drug may cause congenital anomalies (commonly known as congenital disabilities) or pregnancy loss.

However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Neupro. They can advise you on the right treatment plan for you.

Upcoming MRI scan or cardioversion

If you need an MRI scan or cardioversion procedure, talk with your doctor about your Neupro treatment beforehand. They will likely recommend removing a Neupro patch before these procedures. The patch’s backing layer contains aluminum, which could cause skin burns if worn during these procedures.

You can take certain steps to help prevent interactions with Neupro. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol or use cannabis.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.
  • Ask if there are any special instructions when using Neupro with other medications.

It’s also important to read the Neupro label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. The paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Neupro doesn’t come with paperwork, you can ask your pharmacist to print a copy. Ask your doctor or pharmacist for help reading or understanding this information if needed.

You can also help prevent interactions with the Neupro patch by using it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.