Pergolide therapy is associated with low rate of transient serum enzyme elevations during treatment and has been implicated in rare cases of acute liver injury.
Pergolide (per' goe lide) is an ergot derivative similar to bromocriptine which acts as a dopamine receptor agonist. Pergolide, unlike bromocriptine, has agonist activity on both D1 and D2 dopamine receptors and acts directly on the substantia nigra.
Pergolide was approved for use in the United States in 1988 and has been in use since in the therapy of symptomatic Parkinson disease, usually in combination with levodopa/carbidopa.
Pergolide is available in tablets of 0.05, 0.25 and 1.0 mg in generic forms and under the brand name of Permax. The typical initiating dose of pergolide is 0.05 mg once daily for the first 2 days, with gradual increase thereafter based upon tolerance and effect. The average therapeutic dose in clinical studies was 3 mg per day given in 3 divided doses.
Common side effects include profound hypotension (with the first dose), somnolence, fatigue, vivid dreams, insomnia, anxiety, confusion, depression, dizziness, headache, nausea and gastrointestinal upset.
