Pramipexole

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Information about Pramipexole[edit source]

Pramipexole is a selective dopamine receptor agonist used in the therapy of Parkinson disease


Liver safety of Pramipexole[edit source]

Pramipexole therapy is associated with a low rate of transient serum enzyme elevations during treatment, but has not been implicated in cases of clinically apparent acute liver injury.

Mechanism of action of Pramipexole[edit source]

Pramipexole (pram" i pex' ole) is synthetic, nonergot derivative and dopamine receptor agonist that has selective activity for the D2 class of dopamine receptors and little agonist activity for the D1 class.  For this reason, pramipexole may be better tolerated than bromocriptine or pergolide which have activity for both D1 and D2 receptors.  Pramipexole was approved for use in the United States in 1997 for the therapy of symptomatic Parkinson disease

Dosage and administration for Pramipexole[edit source]

Pramipexole is available in tablets of 0.125, 0.25, 0.5, 1 and 1.5 mg generically and under the brand name of Miraplex.  It is used often, but not always in combination with levodopa/carbidopa.  Pramipexole is typically initiated in low doses (0.375 mg in 3 divided doses daily), with adjustment upwards based upon tolerance and clinical effects.  The typical maintenance dose for Parkinson disease is 1.5 to 4.5 mg daily in three divided doses.  Pramipexole can be initiated more quickly than bromocriptine or pergolide, and does not cause the profound hypotension and nausea that are typical of the ergot derivatives. 

Use in Restless leg syndrome[edit | edit source]

Pramipexole is also use in treating [restless leg syndrome]].

Side effects of Pramipexole[edit source]

Common side effects include somnolence, fatigue, vivid dreams, anxiety, confusion, depression, dizziness, headache and gastrointestinal upset.


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Contributors: Prab R. Tumpati, MD