Pramipexole

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Administration

  • Type: Dopamine agonist
  • Dosage Forms: TAB, ER TAB
  • Routes of Administration: Oral
  • Common Trade Names: Mirapex

Adult Dosing

Parkinson's Disease

  • Immediate release
    • 0.5-1.5 mg PO TID
      • Start 0.125 mg PO TID x7 days then 0.25 mg x7 days then increase 0.75 mg/day q7days to goal dose
      • Max: 4.5 mg/day
  • Extended Release
    • 0.375-4.5 mg ER PO daily
      • Start 0.375 mg ER PO daily then titrate q7 days as above

Restless legs syndrome

  • 0.125-0.5 mg PO qhs

Rapid eye movement sleep behavior disorder

  • 0.125-1.5 mg PO qhs

Pediatric Dosing

Restless leg syndrome

  • 5+ yo
    • 0.125-0.375 mg PO qhs

Special Populations

Pregnancy Rating

  • Category C
  • Caution advised during pregnancy
  • Risk of embryo-fetal death based on animal data at 4-5 MRHD

Lactation risk

  • Consider alternative
  • Theoretical decreased milk production based on decreased prolactin levels

Renal Dosing

  • Adult:
    • CrCl 30-50: Start 0.125 mg BID or 0.375 gm ER qod then titrate
    • CrCl <30: Avoid use
  • Pediatric: Dose adjustment may be required, but has not been defined.

Hepatic Dosing

  • Adult: No adjustment
  • Pediatric: Not defined

Contraindications

  • Allergy to class/drug
  • Avoid abrupt withdrawal

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 8h (IR); 8.5h (ER)
  • Metabolism: None
  • Excretion: Urine 90%

Mechanism of Action

  • Stimulates dopamine receptors

Comments

See Also

References