Pramipexole

For Parkinson's disease, the recommended adult dose starts at 0.375 mg daily, taken in 3 divided doses. Depending on the response to the medication as well as side effects, the dose may be increased every 5 to 7 days to obtain the desired effects. The maximum recommended dose should not exceed 4.5 mg daily, taken in 3 divided doses.

For restless leg syndrome, the recommended adult dose starts at 0.125 mg once daily, taken 2 to 3 hours before bedtime. The dose may be increased every 4 to 7 days to a maximum of 0.5 mg 2 to 3 hours before bedtime. Pramipexole may be taken with or without food. You should take it with food if you find that you feel sick to your stomach after taking the tablets.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Pramipexole exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Pramipexole at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause constipation - to prevent this, drink plenty of water or juice, and eat more dietary fibre; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause unusual tiredness; it may cause either drowsiness or excitability - use caution until you know how you will react; it may cause nausea or, rarely, vomiting. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

0.125 mg
Each white-to-off-white, round, flat-faced, bevelled-edged tablet, engraved "APO" on one side and "PR" over ".125" on the other, contains 0.125 mg of pramipexole dihydrochloride monohydrate. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, and starch (corn).

0.25 mg
Each white-to-off-white, oval, flat-faced, bevelled-edged tablet, engraved "PR" scoreline ".25" on one side and "APO" on the other, contains 0.25 mg of pramipexole dihydrochloride monohydrate. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, and starch (corn).

0.5 mg
Each white-to-off-white, oval, flat-faced, bevelled-edged tablet, engraved "PR" scoreline ".5" on one side and "APO" on the other, contains 0.5 mg of pramipexole dihydrochloride monohydrate. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, and starch (corn).

0.75 mg
Each white-to-off-white, oval, flat-faced, bevelled-edged tablet, engraved "APO" on one side and "PR.75" on the other, contains 0.75 mg of pramipexole dihydrochloride monohydrate Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, and starch (corn).

1 mg
Each white-to-off-white, round, flat-faced, bevelled-edged tablet, engraved "PR" over score "1" on one side and "APO" on the other, contains 1 mg of pramipexole dihydrochloride monohydrate. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, and starch (corn).

1.5 mg
Each white-to-off-white, round, flat-faced, bevelled-edged tablet, engraved "PR" over score "1.5" on one side and "APO" on the other, contains 1.5 mg of pramipexole dihydrochloride monohydrate. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, and starch (corn).

Pramipexole should not be taken by anyone who is allergic to pramipexole or to any of the ingredients of the medication.

There may be an interaction between pramipexole and any of the following:

• alcohol
• Aldesleukin
• Aliskiren
• alpha blockers (e.g., Alfuzosin, Doxazosin, Silodosin, Tamsulosin)
• alpha agonists (e.g., Clonidine, methyldopa)
• amantadine
• amifostine
• Amiodarone
• angiotensin converting enzyme inhibitors (ACEIs; Captopril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., candasartan, Irbesartan, Losartan)
• antihistamines (e.g., cetirizine, Chlorpheniramine, Diphenhydramine, doxylamine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• brimonidine
• Bupropion
• Buspirone
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• chloral hydrate
• Cimetidine
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Domperidone
• efavirenz
• Entacapone
• general anesthetics (medications used to put people to sleep before surgery)
• Guanfacine
• Hydralazine
• kava kava
• levodopa
• Methylphenidate
• Metoclopramide
• Minoxidil
• MAO inhibitors (e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• Mirtazapine
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine, Tizanidine)
• narcotic medications (e.g., Codeine, Fentanyl, Hydromorphone, Morphine)
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• Obinutuzumab
• Olopatadine
• Pentoxifylline
• phosphodiesterase 5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• scopolamine
• seizure medications (e.g., Carbamazepine, Clobazam, Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• Tapentadol
• Tramadol
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Pramipexole. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription) and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or illegal drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Pramipexole.

Behaviour changes: People taking pramipexole have experienced abnormal behaviour such as compulsive gambling, compulsive shopping, hypersexuality, and binge eating. If you experience these symptoms or any other behaviour change while taking Pramipexole, contact your doctor immediately.

Blood pressure: Pramipexole can lower blood pressure for some people. People taking Pramipexole may feel dizzy or lightheaded when rising from a sitting or lying position. Make sure to tell your doctor if you experience this effect. If you have severe heart disease, discuss with your doctor how Pramipexole may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Pramipexole, and whether any special monitoring is needed.

Drowsiness/sudden onset of sleep: Pramipexole and similar mediations can cause drowsiness and sudden onset of sleep or sleep attacks. Sudden onset of sleep can occur without warning or drowsiness. People taking Pramipexole should avoid driving or operating heavy machinery. If you experience any daytime drowsiness or sudden onset of sleep while taking Pramipexole, contact your doctor immediately.

Hallucinations: People taking Pramipexole should be aware that hallucinations (mainly seeing things that are not really there) can occur and may affect their ability to drive and perform other daily activities. Make sure to tell your doctor if you experience this effect.

Kidney function: Decreased kidney function or Kidney Disease can cause Pramipexole to build up in the body, causing side effects. People with reduced kidney function should discuss with their doctor how Pramipexole may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Pramipexole, and whether any special monitoring is needed. Pramipexole is not recommended for people with end-stage renal disease.

Melanoma: People with Parkinson's disease may be at increased risk of developing melanoma (a type of Skin Cancer). It is not known if this increased risk is due to Parkinson's disease or to the medications used to treat Parkinson's disease. Your doctor will monitor you for skin cancer while you are taking Pramipexole. Talk to your doctor if you have any concerns.

Neuroleptic malignant syndrome (NMS): As with other medications that have an effect on movement disorders, pramipexole can trigger a potentially fatal set of symptoms known as neuroleptic malignant syndrome (NMS). If you experience symptoms of NMS, such as high Fever; muscle stiffness; confusion or loss of consciousness; sweating; or rapid or irregular heartbeat, seek immediate medical attention.

This is more likely to occur if pramipexole is stopped suddenly or the dose is decreased rapidly. If you are considering stopping Pramipexole, talk with your doctor about the appropriate way to reduce pramipexole.

Restless leg syndrome: When Pramipexole is used to treat the symptoms of restless leg syndrome, it may cause a worsening of symptoms in the early morning hours. It may also cause earlier onset of symptoms in the evening or an increase in symptoms. If you experience this, let your doctor know.

Stopping treatment: Do not stop taking Pramipexole without consulting with your doctor. Stopping this mediation suddenly can cause symptoms such as fever, rigid muscles, and blood pressure changes. If you and your doctor decide that stopping Pramipexole is best for you, your doctor will gradually reduce your dose over a week.

Suicidal or agitated behaviour: People with Parkinson's disease are at risk of experiencing thoughts and intent of self-harm or suicide. These feelings may not pass when the symptoms of PD are relieved. If you have Depression or bipolar disorder, you may be at an increased risk of feeling agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or wanting to hurt themselves or others. If you experience these side effects or notice them in a family member who is taking Pramipexole, contact your doctor immediately.

Pregnancy: Pramipexole should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Pramipexole, contact your doctor immediately.

Breast-feeding: It is not known if pramipexole passes into breast milk. Since the medication reduces the amount of breast milk produced, women who are breast-feeding should not take Pramipexole.

Children: The safety and effectiveness of using pramipexole has not been established for children.

Seniors: Seniors may be more likely to experience hallucinations (hearing, seeing or feeling things that are not there) while taking pramipexole.

This medication is typically used 3 times a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food.