Generic
Pramipexol
2 brands available in the market
At a glance
Pramipexol is used for the treatment of Parkinson's disease and restless leg syndrome. It acts as a dopamine receptor agonist and alleviates Parkinsonian motor deficits by stimulating dopamine receptors in the striatum of the brain.
Description
Pramipexole is a non-ergot dopamine receptor agonist that shows specificity and strong activity at the D2 subfamily of dopamine receptors in vitro, with preference for the D3 receptor subtype. It stimulates dopamine receptors in the striatum to alleviate Parkinsonian motor deficits.
Indications
- Parkinson's disease (alone or as adjunct to levodopa)
- Moderate to severe restless legs syndrome
Therapeutic class
Antiparkinson drugs
Pharmacological class
Dopamine Agonist (Non-ergot)
Pharmacology
Pramipexole is a non-ergot dopamine agonist with specificity for the D2 subfamily of dopamine receptors, with preference for the D3 receptor subtype. It stimulates dopamine receptors in the striatum of the brain to alleviate Parkinsonian motor deficits.
Mechanism of action
Improves motor control by stimulating dopamine receptors in the brain.
Dosage
Adult Dose (Oral):
- Parkinson's disease: Initial 88 mcg three times daily; double every 5-7 days up to 350 mcg three times daily; further increase by 180 mcg three times daily at weekly intervals; max 3.3 mg/day in 3 divided doses
- Restless legs syndrome: Initial 88 mcg once daily (2-3 hours before bedtime); double every 4-7 days up to 350 mcg daily; max 540 mcg daily
- Renal impairment: CrCl 30-50 mL/min: 0.125 mg twice daily initially; max 0.75 mg TID; CrCl 15-29 mL/min: 0.125 mg/day; max 1.5 mg/day
Administration
- Take with food (to reduce nausea)
- Swallow tablet whole; do not chew, crush, or break
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Dizziness
- Sleepiness
- Nausea
- Dry mouth
- Fatigue
- Hallucinations
- Constipation
- Peripheral edema
- Dyskinesia
- Hypotension
- Abnormal dreams
- Confusion
- Headache
- Hyperkinesia
- Increased eating
- Insomnia
- Libido disorders
- Paranoia
- Pathological gambling
- Hypersexuality
- Weight increase
- Sudden onset of sleep
Precautions & warnings
- May affect driving ability; do not drive if drowsy or dizzy
- Inform doctor if hallucinations or compulsive behaviors (binge eating, gambling, spending, sexual urges) occur
- May cause sudden drop in blood pressure when changing positions; rise slowly
- Caution in psychotic disorders, severe cardiovascular disease, renal impairment
- Regular ophthalmologic monitoring recommended
Contraindications
- Hypersensitivity to pramipexole or any excipient
- Lactation
Drug interactions
- Cimetidine, amantadine: May reduce renal clearance of pramipexole
- Sedating medications or alcohol: Additive effects
Food interactions
Alcohol with Pramipexol may cause excessive drowsiness.
Use in pregnancy
Use in Pregnancy: May be unsafe during pregnancy; animal studies have shown harmful effects; use only if clearly needed.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe; suppresses prolactin secretion and may interfere with breastfeeding; discontinue breastfeeding if use is necessary.
Pediatric use
Not recommended for children below 18 years.
Geriatric use
Caution required in elderly patients; dose adjustment may be needed.
Renal / hepatic impairment
Renal Impairment: Caution in kidney disease; dose adjustment based on CrCl; consult your doctor.
Hepatic Impairment: Safe in liver disease; dose adjustment may not be needed; consult your doctor.
Overdose effects
Overdose: Nausea, vomiting, hyperkinesia, hallucinations, agitation, hypotension; no established antidote; gastric lavage, IV fluids, activated charcoal, EKG monitoring.
Storage conditions
Store in a cool and dry place; protect from light.
Chemical structure
Pramipexol