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Generic Name: Pramipexole [pram-i-PEX-ole] [pram-iPEX-ole]
The Brand Names are Mirapex and Mirapex ER.
Forms of Dosage: Oral tablet (0.125 mg; 0.25 mg; 0.5 mg; 0.75 mg; 1 mg; 1.5 mg); oral tablet extended release (0.375 mg; 0.75 mg; 1.5 mg; 2.25 mg; 3 mg; 3.75 mg; 4.5 mg).
The class of Drug: Dopaminergic antiparkinsonism agents

Which is Pramipexole?

Pramipexole can have similar effects to a chemical called dopamine that occurs naturally within the body. Dopamine levels that are low in the brain are linked with Parkinson's disease.

Pramipexole can be used to treat the symptoms that are associated with Parkinson's illness (stiffness in the legs, tremors, muscle spasms, and insufficient muscle control). It is also employed to help treat symptoms of restless leg syndrome (RLS).Only pramipexole with immediate release (Mirapex) is approved for treating Parkinson's signs or RLS. Pramipexole with extended release (Mirapex


) is only approved for treating Parkinson's symptoms.

Parkinson's disease and RLS are two distinct diseases. Being diagnosed with one of these conditions doesn't mean that you're suffering from the other.Pramipexole can also be employed for other purposes that are not covered in this guideline for medication.

Side effects of Pramipexole

Seek medical attention immediately. If you are experiencing warning signs of an allergic reaction, such as symptoms of hives, breathing difficulties, and swelling of your lips, face, and tongue,Some people who are taking pramipexole may have experienced sleepiness during normal routine activities during the day, such as eating, working, talking, or driving. Inform your doctor if you are experiencing any issues with nighttime sleepiness or tiredness.

Pramipexole may cause serious side effects. Contact your physician immediately if you suffer from:

  • A feeling of lightheadedness, as if you're passing out;

  • The hallucinations (seeing as well as hearing objects that don't exist)

  • extreme drowsiness, falling asleep suddenly, even after feeling alert;

  • Tremors, twitching, or uncontrollable muscles;

  • Unanswered muscular discomfort or tenderness; weakness;

  • Vision issues 

  • Posture shifts that are not your own to control, such as the involuntary bent forward in your neck, bending to the lower waistline, or tilting to the side while you stand, sit, or walk.

Confusion or hallucinations could be more frequent in older adults.

There is a possibility that you will experience increased desires to sexualize, unusual cravings towards gambling, or other extreme desires while taking pramipexole. Discuss this with your doctor in the event of this

Common adverse effects of pramipexole could be:

  • Muscular spasm or weakness of muscles;

  • Drowsiness, dizziness, weakness;

  • Memory problems, confusion;

  • Dry mouth;

  • Nausea, constipation;

  • An increase in urination;

  • Sleep problems (insomnia), unusual dreams

This isn't an exhaustive list of possible side effects, and other side effects could be present. Consult your physician to seek medical advice on adverse effects. You can report any side effects to the FDA at 1-800-FDA-1088.


Follow the instructions on the medicine label and the package. Be sure to inform your health professionals about your medical ailments and allergies, as well as the medicines you are taking.

Before you Take this Drug

It is recommended not to use pramipexole if you are allergic to it.

Speak to your doctor if you have ever suffered from:

  • Lower blood pressure;

  • The feeling of being dizzy after getting up too quickly;

  • Daytime drowsiness;

  • Kidney disease

  • Problems controlling your muscle movements.

People suffering from Parkinson's disease could be more susceptible to skin cancer (melanoma). Discuss with your doctor the risk and symptoms of the skin you are looking for.It is unclear if pramipexole could harm an unborn baby. Inform your doctor if you are expecting or planning to become pregnant while taking pramipexole.

It is unclear if pramipexole is absorbed into breast milk or whether it is harmful to nursing infants. It is not recommended to breastfeed while taking this medicine.

How to take Pramipexole?

Follow the instructions on the prescription label and review all medication guides and instruction sheets. The doctor might alter the dosage. Make sure you take the medication precisely as prescribed.If you are taking immediate-release pramipexole (Mirapex), you shouldn't use extended-release pramipexole (Mirapex ER) at the same time.

The dosage as well as the timing for pramipexole when treating Parkinson's disease are different from the dosage and timing for treating RLS. Follow the instructions on the prescription label. Contact your pharmacist if you have any questions regarding the type of pramipexole that you get from the pharmacy.

Pramipexole is a medication that can be taken without or with food. Consume the medication in conjunction with food if it causes upset in your stomach.Don't crush, chew, or break the extended-release tablet (Mirapex ER). Suck it up completely.

If you're taking this medication to treat RLS, Inform your doctor in the event that your symptoms worsen when they happen early in the morning or later than usual in the evening, or if you notice unrestful symptoms in your arms or hands.Don't stop taking pramipexole abruptly; otherwise, you might experience uncomfortable withdrawal effects. Follow the advice of your doctor regarding the process of tapering your dose.Maintain at room temperature and free of heat, moisture, and light.

Details on Dosage

Usual Adult Dose for Parkinson's Disease:


Initial dosage: 0.125 mg orally three times per day.

Titration: Increase gradually, in small doses, but not more often than every 5–7 days.

Dosage for maintenance: 1.5 to 4.5 mg daily, based on the effectiveness and tolerability

Maximum dose: 4.5 mg per day.

Comment: The following dose titration method was utilized in clinical trials:

Week 2: 0.25 mg, 3 times every day

Week 3: 0.5 mg three times a day

4th week: 0.75 mg three times per day

The week 5 dose is 1 mg, 3 times per day.

The week 6, 1.25 mg, 3 times per day

Week 7: 1.5 mg three times per day.

In combination with levodopa, the levodopa dosage was decreased by a mean of 27 percent over the baseline, resulting in a dose of about 800 mg daily.


Initial dosage: 0.375 mg orally once every day.

Titration: Increase slowly, but not more often than every five to seven days. The first increase in dose should be 0.75 mg daily and then gradually increase to 0.75 mg. You should evaluate the therapeutic reaction and tolerability after five days following every dose increment.

Maximum dose: 4.5 mg per day.


Patients may switch overnight from immediate-release tablets to longer-release tablets at the same dose daily and closely monitor to determine whether dose adjustments are necessary.


If a significant interruption to treatment occurs, re-titration could be required. If the therapy is stopped, dosages should be reduced.

Use: Treatment for Parkinson's disease

Usual Adult Dose for Restless Legs Syndrome:


Initial dosage: 0.125 mg orally once every day for up to three hours prior to bedtime.

Titration: If necessary, dosage can be adjusted upwards by increasing by 0.125 mg every up to 7 days.

Maximum dosage: 0.5 mg orally once every day.


Extended-release tablets should not be used as a treatment for restless leg syndrome.

Doses of 0.75 mg daily were tested in clinical trials; however, they did not provide more benefit when compared to the 0.5 mg dosage.

Use: To treat severe to moderate primary restless leg syndrome.

What Happens If I Miss a Dose?

Do not take the medicine for as long as you can. However, do not take any missed doses if it's close to the time of the next dose. Don't take two doses at once.

What Happens If I Overdose?

For medical emergencies, seek emergency medical attention or contact the Poison Help line at 1-800-222-1222.

What Should be Avoided?

Don't drink alcohol. Dangerous side effects are possible when alcohol is mixed with pramipexole.

Avoid driving or engaging in hazardous activities until you understand how pramipexole affects you. Your reaction may be impaired.

Don't get up too quickly from sitting or lying down

. You could get dizzy.

Interaction with Other Drugs

Utilizing pramipexole in conjunction with other medications that cause you to become drowsy could increase the severity of this effect. Consult your physician before taking opioids, sleeping pills, muscle relaxers, or medication to treat anxiety as well as seizures.

Discuss with your doctor your other medications, particularly:

  • Cimetidine;

  • Metoclopramide

  • Medications to treat mental illnesses medicines to treat mental illness, such as chlorpromazine, droperidol, fluphenazine, haloperidol, perphenazine, prochlorperazine, thioridazine, and many more.

This list isn't exhaustive. Other medications can affect pramipexole, such as prescription and over-the-counter medicines, vitamins, and herbal products. There are many possible interactions between drugs that are listed here.



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