Pramipexole

— THERAPEUTIC CATEGORIES —
  • Parkinsonism
  • Restless legs syndrome

Pramipexole Generic Name & Formulations

General Description

Pramipexole dihydrochloride 0.125mg, 0.25mg+, 0.5mg+, 0.75mg, 1mg+, 1.5mg+; tabs; +scored.

Pharmacological Class

Dopamine agonist (non-ergot).

See Also

How Supplied

Tabs—contact supplier; ER tabs 0.375mg, 0.75mg, 1.5mg—7, 30; 2.25mg, 3mg, 3.75mg, 4.5mg—30

Pramipexole Indications

Indications

Idiopathic Parkinson's disease.

Pramipexole Dosage and Administration

Adult

May take with food. Gradually increase from initial dose at intervals of 5–7 days. Initially 0.125mg three times daily; max 1.5mg three times daily. Renal impairment (CrCl 30–50mL/min): initially 0.125mg twice daily; max 0.75mg three times daily; (CrCl 15–<30mL/min): initially 0.125mg once daily; max 1.5mg once daily; (CrCl <15mL/min, hemodialysis): not recommended.

Children

Not established.

Pramipexole Contraindications

Not Applicable

Pramipexole Boxed Warnings

Not Applicable

Pramipexole Warnings/Precautions

Warnings/Precautions

See full labeling. Consider discontinuing if excessive daytime sleepiness or falling asleep during activities occurs. Monitor for drowsiness or sleepiness, orthostatic hypotension, or compulsive behaviors. Consider dose reduction or discontinuation if urges/compulsive behaviors develop. Sleep disorder. Psychotic disorder. Dyskinesia. Postural deformity; consider dose reduction or discontinuation if occurs. Potential withdrawal symptoms; monitor during and after discontinuation. Avoid abrupt cessation (withdraw over 1 week). Renal impairment. Elderly may have higher risk of hallucinations. Pregnancy. Nursing mothers: not recommended.

Pramipexole Pharmacokinetics

Elimination

Renal.

Pramipexole Interactions

Interactions

Consider reducing concomitant levodopa dose. Pramipexole levels increased by cimetidine, possibly other renally-excreted basic drugs (eg, ranitidine, diltiazem, triamterene, verapamil, quinidine, quinine). Caution with alcohol, other CNS depressants. May be antagonized by dopamine antagonists (eg, neuroleptics, metoclopramide).

Pramipexole Adverse Reactions

Adverse Reactions

Early disease: somnolence (including sudden sleep onset), nausea, constipation, dizziness, fatigue, hallucinations, dry mouth, muscle spasms, peripheral edema, insomnia, asthenia, accidental injury, dyspepsia, others. Late disease: dyskinesia, nausea, constipation, hallucinations, headache, anorexia, postural hypotension, extrapyramidal syndrome, insomnia, dizziness, accidental injury, dream abnormalities, confusion, asthenia, somnolence, dystonia, abnormal gait, hypertonia, dry mouth, amnesia, urinary frequency, leg cramps, others; rhabdomyolysis.

Pramipexole Clinical Trials

See Literature

Pramipexole Note

Notes

Formerly known under the brand name Mirapex.

Pramipexole Patient Counseling

See Literature

Pramipexole Generic Name & Formulations

General Description

Pramipexole dihydrochloride 0.125mg, 0.25mg+, 0.5mg+, 0.75mg, 1mg+, 1.5mg+; tabs; +scored.

Pharmacological Class

Dopamine agonist (non-ergot).

See Also

    How Supplied

    Tabs—contact supplier; ER tabs 0.375mg, 0.75mg, 1.5mg—7, 30; 2.25mg, 3mg, 3.75mg, 4.5mg—30

    Pramipexole Indications

    Indications

    Moderate to severe primary restless legs syndrome.

    Pramipexole Dosage and Administration

    Adult

    Initially 0.125mg once daily 2–3 hrs before bedtime. If needed, may double dose every 4–7 days. Max 0.5mg/day (doses of 0.75mg/day have been used). Renal impairment (CrCl: 20–60min/mL): increase titration interval to every 14 days if needed.

    Children

    Not established.

    Pramipexole Contraindications

    Not Applicable

    Pramipexole Boxed Warnings

    Not Applicable

    Pramipexole Warnings/Precautions

    Warnings/Precautions

    See full labeling. Consider discontinuing if excessive daytime sleepiness or falling asleep during daily activities occurs. Monitor for drowsiness or sleepiness, orthostatic hypotension, or compulsive behaviors. Consider dose reduction or discontinuation if compulsive behaviors develop. Sleep disorder. Psychotic disorder. Dyskinesia. Postural deformity; consider dose reduction or discontinuation if occurs. Avoid abrupt cessation (withdraw over 1 week). Symptoms may shift to early morning hours (rebound) or have an earlier onset (afternoon or evening). Renal impairment. Elderly may have higher risk of hallucinations. Pregnancy. Nursing mothers: not recommended.

    Pramipexole Pharmacokinetics

    Elimination

    Renal.

    Pramipexole Interactions

    Interactions

    Consider reducing concomitant levodopa dose. Pramipexole levels increased by cimetidine, possibly other renally-excreted basic drugs (eg, ranitidine, diltiazem, triamterene, verapamil, quinidine, quinine). Caution with alcohol, other CNS depressants. May be antagonized by dopamine antagonists (eg, neuroleptics, metoclopramide).

    Pramipexole Adverse Reactions

    Adverse Reactions

    GI upset, somnolence, fatigue, headache, pain, dizziness, influenza, nasal congestion, abnormal dreams; rhabdomyolysis.

    Pramipexole Clinical Trials

    See Literature

    Pramipexole Note

    Notes

    Formerly known under the brand name Mirapex.

    Pramipexole Patient Counseling

    See Literature