Indications
Pramipexole is used to treat the signs and symptoms of Parkinson’s disease (shaking, stiffness and slow movement), either alone or together with Levodopa. It is also used for moderate to severe restless legs syndrome, a condition causing an uncomfortable urge to move the legs, mostly at night.
How It Works
Pramipexole is a dopamine agonist. In Parkinson’s disease the brain makes too little dopamine, a chemical messenger that controls movement. Pramipexole acts like dopamine on the brain’s dopamine receptors, which improves movement and eases restless legs symptoms.
Dosage and Administration
Take exactly as prescribed. The dose is started low and increased slowly over several weeks by your doctor to find the right amount. For restless legs it is usually taken once daily, 2 to 3 hours before bedtime. It can be taken with or without food; taking it with food may reduce nausea. Extended-release tablets must be swallowed whole. Do not stop suddenly: your doctor will reduce the dose gradually.
Interactions
- Antipsychotics (such as Haloperidol) and Metoclopramide block dopamine and can reduce its effect.
- Cimetidine and Amantadine can raise its blood levels.
- Alcohol, sleeping tablets and other sedating medicines increase drowsiness.
- With Levodopa, the Levodopa dose may need lowering to avoid unwanted movements.
Contraindications
Do not use if you are allergic to Pramipexole or any ingredient of the tablet.
Side Effects
Common effects include nausea, dizziness, sleepiness, constipation, headache, tiredness, swelling of the legs, and low blood pressure on standing. It can cause hallucinations, confusion and uncontrolled movements, especially in older people. Some people develop compulsive behaviours such as gambling, overeating, shopping or increased sexual urges. It may also cause sudden sleep attacks during daily activities.
Get urgent medical help if you have fainting, severe confusion or hallucinations, sudden falling asleep while driving, fever with muscle stiffness, or signs of allergy such as swelling of the face or difficulty breathing.
Pregnancy and Lactation
There is little information on use in pregnancy, so it should only be used if your doctor thinks it is clearly needed. It reduces milk production and may pass into breast milk, so it is not recommended while breastfeeding.
Precautions and Warnings
- Do not drive or operate machinery if you feel sleepy or have had sleep attacks.
- Tell your doctor or family about any new urges or unusual behaviour.
- Use with care in kidney disease (dose may need lowering), heart disease, or mental health conditions.
- Have regular skin checks, as Parkinson’s disease is linked with a higher melanoma risk.
- Stopping suddenly may cause fever, stiffness and confusion.
Overdose
Overdose may cause severe nausea, vomiting, restless movements, hallucinations, agitation and low blood pressure. Seek emergency medical help.
Therapeutic Class
Antiparkinson agent, non-ergot dopamine agonist.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.