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 D ₃) receptors in striatum. Rapidly absorbed. Peak levels: 2 hr. Food increases time for maximum levels to occur. t 1/2, 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, C _CR, over 60 mL/min: Start with 0.125 mg t.i.d., up to maximum of 1.5 mg t.i.d. C _CR, 25-59 mL/min: Start with 0.125 mg b.i.d., up to maximum of 1.5 mg b.i.d. C _CR, 15-24 mL/min: Start with 0.125 mg once daily, up to maximum of 1.5 mg once daily.