Pramipexole

Antiparkinsonian Drug

Drug class: Dopaminergic Antiparkinsonian Agent

Pramipexole (MIRAPEX)（中文：普拉克索）

Common Strengths of Pramipexole

• Immediate-release tablets: 0.125 mg, 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg.
• Extended-release tablets: 0.375 mg, 0.75 mg, 1.5 mg, 2.25 mg, 3 mg, 3.75 mg, 4.5 mg.

Drug Trad Names

• Mirapex, Mirapex ER

Drug Usage

Pramipexole is indicated for:

• Parkinson's Disease: Alleviates symptoms like tremors and rigidity.
• Restless Legs Syndrome: Reduces discomfort and the urge to move the legs.

Mechanism of Action

Pramipexole selectively Stimulates dopamine D2 and D3 receptors in the brain, which helps restore the balance of dopamine levels associated with motor control and movement.

Route of Administration

• Oral

Dosage

• Parkinson's Disease: Start at 0.125 mg three times daily, titrate up to 4.5 mg/day.
• RLS: Start at 0.125 mg once daily, titrate up to 0.5 mg/day.

Side Effects

Frequency	Adverse reactions
Common Side Effects	Drowsiness,dizziness, dry mouth, nausea, constipation, hallucinations.
Serious Side Effects	Sudden sleep onset during activites, increased risk of heart failure in some patients.

Pharmacokinetics

• Onset Time: Typically within a few hours.
• Duration: Approximately 8-12 hours depending on patient age and health status.
• Half-life: About 8 hours in young adults; extended in elderly patients.

Drug Precautions

Pregnancy

Safety is unclear; use only if benefits outweigh risks.

Breastfeeding

Limited data; consult healthcare providers.

Drug Monitoring Items

Regular monitoring for side effects such as orthostatic hypotension and mental status changes is recommended during treatment.

Drug Interactions

Pramipexole has several interactions:

• Severe Interactions: Apomorphine, levodopa.
• Moderate Interactions: Cimetidine, digoxin.

Some of the notable drug interactions include:

• Antipsychotics (e.g. clorpromazine, haloperidol, thiothixene): May decrease the effects of pramipexole.
• Cimetidine: May increase pramipexole levels by reducing its renal clearance.
• CNS depressants (e.g. alcohol, antihistamines, anxiety medications, muscle relaxants, opioid pain relievers): May increase drowsiness and dizziness.
• Dopamine antagonists (e.g. metoclopramide, antipsychotics): May reduce pramipexole's effectiveness.
• Drugs that affect renal function: May alter pramipexole levels as it is primarily eliminated through the kidneys.

FAQ

How Should I Take the Tablet?

Take pramipexole with or without food as directed by your physician. Do not crush or chew exetended-release tablets.

What Should I Avoid While Taking?

Avoid activities that require alertness until you know how pramipexole affects you.

What Happens if I Miss a Dose?

Take the missed dose as soon as you remember unless it is almost time for your next dose. Do not double doses to catch up.