Pramipexole, which is widely known by its trade name, Mirapex®, is a medication manufactured by Boehringer Ingelham Pharmaceuticals®. It is a dopamine agonist, which means it stimulates some of the dopamine receptors by binding to them, essentially replicating the action of dopamine in the body. The uses of this medication are multiple, but it is recognized mostly as a medication to treat Restless Legs Syndrome (RLS) and Parkinson’s disease in early stages, or occasionally late stages. Established off-label uses include for cluster headaches and sexual dysfunction arising from medications that treat depression. Like all medications, pramipexole has both benefits and side effects.
Mirapex® is generally given orally, and specific dosage can depend on the condition being treated. Since pramipexole comes in both a regular and extended release form, dose within conditions can also vary. Often, this medication begins with a smaller dose that increases over a week or two. For Parkinson’s disease total dose tends not to exceed 4.5 mg per day, and for RLS, dose is much smaller, usually not larger than half a milligram per day.
There are a few people who may be at greater risk for complications if they take pramipexole. The safety of the medicine has not be proven for the fetus or nursing infant, so pregnant or nursing mothers may want to avoid this medication. Sometimes low blood pressure, movement disorders, or diseases of the kidney call for changing dose. Patients who have sexual or gambling addiction could be at greater risk taking pramipexole because a high number of anecdotal reports suggest the drug may fuel certain compulsivity conditions, even if a person had no problems with these issues prior to taking medication. Additionally, elderly patients need careful observation while using Mirapex® because they are more prone to developing side effects like hallucinations.
Some of the common and more benign side effects associated with pramipexole, which not all users develop, include tiredness, drowsiness, forgetfulness, sexual dysfunction, water retention in the lower limbs and feet, stomach upset, changes in bowel movements, dizziness, headache, loss of appetite, and vision problems. More serious side effects that require immediate medical attention include anaphylaxis or severe allergic response to the medication, hallucinations, increase in involuntary movements, anorexia, extreme nausea accompanied by perspiration and fainting, arrythmias, and bouts of unintended sleeping. Though occurring rarely, compulsive gambling, shopping, eating, and et cetera are also serious and should be reported to a doctor by the patient or caregivers.
Pramipexole may need dose adjustment or may be the wrong choice when patients take other medications. The drug can interact with a wide variety of medications and patients should have a list of all drugs, including over the counter ones and herbal or vitamin supplements, that they can give to their doctors before accepting any new prescriptions. Patients are also advised not to discontinue the medication abruptly as this may cause side effects. Tapering off the medication slowly is recommended.
