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Pramipexole
Pramipexole (Mirapex)
Pramipexole
(prah-mih-PEX-ohl)
Pregnancy Category: C
Mirapex (Rx)
Classification:
Antiparkinson drug
Action/Kinetics:
Thought to act by stimulating dopamine (especially D3) receptors in striatum. Rapidly absorbed. Peak levels: 2 hr. Food increases time for maximum levels to occur. t1/2, terminal: About 8 hr (12 hr in geriatric clients). Excreted mainly unchanged in urine. Clearance decreases with age.
Uses:
Idiopathic Parkinson's disease.
Contraindications:
Lactation.
Special Concerns:
Possible sudden, overwhelming urge to sleep. Safety and efficacy have not been determined in children.
Side Effects:
CNS: Hallucinations (especially in elderly), dizziness, somnolence, insomnia, confusion, amnesia, hypesthesia, dystonia, akathisia, abnormal thinking, decreased libido, myoclonus. CV: Orthostatic hypotension. Body as a whole: Asthenia, general edema, malaise, fever. GI: Nausea, constipation, anorexia, dysphagia. Miscellaneous: Vision abnormalities, impotence, peripheral edema, decreased weight.
Drug Interactions:
- Butyrophenones / Possible
effect of pramipexole
- Cimetidine /
Levodopa levels and half-life
- CNS Depressants / Additive CNS depression
- Levodopa /
Levodopa levels; also, may cause or worsen pre-existing dyskinesia
- Metoclopramide / Possible
effect of pramipexole
- Phenothiazines / Possible
effect of pramipexole
- Thioxanthines / Possible
effect of pramipexole
How Supplied:
Tablets: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 1.5 mg
Dosage
•Tablets
Parkinsonism.
Initial: Start with 0.125 mg t.i.d.; then increase dose by 0.125 mg t.i.d. weekly for seven weeks (i.e., dose at week seven is 1.5 mg t.i.d.). Maintenance: 1.5-4.5 mg/day in equally divided doses t.i.d. with or without comcomitant levodopa (about 800 mg/day).
Impaired renal function, CCR, over 60 mL/min: Start with 0.125 mg t.i.d., up to maximum of 1.5 mg t.i.d. CCR, 25-59 mL/min: Start with 0.125 mg b.i.d., up to maximum of 1.5 mg b.i.d. CCR, 15-24 mL/min: Start with 0.125 mg once daily, up to maximum of 1.5 mg once daily. |
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