Mirapex

Generic name: Pramipexole dihydrochloride

What is Mirapex?

Mirapex is used to treat the signs and symptoms of Parkinson's disease—a progressive disorder marked by muscle rigidity, weakness, shaking, tremor, and eventually difficulty walking and talking.

Mirapex is also used for moderate-to-severe primary Restless Leg Syndrome (RLS). RLS is an urge to move the legs usually accompanied or caused by uncomfortable and unpleasant leg sensations; symptoms begin or worsen during periods of rest or inactivity such as lying or sitting; symptoms are partially or totally relieved by movement such as walking or stretching at least as long as the activity continues; and symptoms are worse or occur only in the evening or night. Difficulty falling asleep may frequently be associated with symptoms of RLS.

What is the most important information I should know about Mirapex?

Mirapex may cause severe drowsiness or tiredness, which may cause you to fall asleep during your daily activities. Some people who have taken Mirapex have had car accidents because they fell asleep while driving. Although many of these patients reported drowsiness while on Mirapex tablets, some perceived that they had no warning signs such as excessive drowsiness, and believed that they were alert immediately prior to the event. Some of these events had been reported as late as one year after the initiation of treatment. You should not drive a car or engage in activities that require mental alertness until you know how Mirapex will affect you.

Certain medications that may also cause drowsiness or that increase the Mirapex levels in your body greatly increase your chances of experiencing sedation or spontaneously falling asleep. Report any new onset or worsening of the symptoms to your doctor immediately.

Who should not take Mirapex?

You should not take Mirapex if you are allergic or sensitive to pramipexole or any other ingredient in the medication.

What should I tell my doctor before I take the first dose of Mirapex?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Mirapex. Also, talk to your doctor about your complete medical history, especially if you have low blood pressure, kidney problems, or trouble controlling your muscles. Let your doctor know if you feel sleepy during the day due to any other problem aside from RLS or if you feel dizzy or faint, especially after standing from a sitting or lying down position. You should also talk be sure to tell your doctor if you are pregnant or plan to become pregnant, are breastfeeding, or if you drink alcohol.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Parkinson's disease

Adults: For the initial treatment of Parkinson's disease, Dosages should be increased gradually from a starting dose of 0.375 milligrams (mg) per day given in three divided doses and should not be increased more frequently than every 5 to 7 days. The typical ascending dosage schedule is: week 1, 0.375 mg/day; week 2, 0.75 mg/day; week 3, 1.5 mg/day; week 4, 2.25 mg/day; week 5, 3 mg/day; week 6, 3.75 mg/day; week 7, 4.5 mg/day.

The maintenance dose of Mirapex for Parkinson's disease is 0.5-1.5 mg, 3 times per day.

Restless Leg Syndrome

Adults: The usual starting dose of Mirapex for RLS is 0.125 milligrams (mg) taken once daily 2-3 hours before bedtime. Your doctor may increase your individual dose every 4-7 days up to a maximum of 0.5 mg per day based on your individual condition.

How should I take Mirapex?

Mirapex should be taken exactly as prescribed and should be taken at the same time every day. Mirapex can be taken with or without food, however taking it with food may lower your chances of experiencing nausea. You should not suddenly stop taking Mirapex without first talking to your doctor. If you have Parkinson's disease and are stopping Mirapex you should slowly decrease your dose over 7 days before stopping all together.

What should I avoid while taking Mirapex?

You should not drive a car, operate machinery, or do anything that requires mental alertness until you know how Mirapex affects you. You should not drink alcohol while taking Mirapex.

What are possible food and drug interactions associated with Mirapex?

If Mirapex is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Mirapex with the following: amantadine; carbidopa/levodopa; cimetidine; tranquilizers or sedatives that belong to classes of medications known as phenothiazines, butyrophenones, or thioxanthenes; diltiazem; metoclopramide; quinidine; quinine; ranitidine; triamterene; and verapamil.

What are the possible side effects of Mirapex?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: arthritis, body discomfort or fatigue, chest pain, constipation, dizziness, drowsiness or sleepiness, dry mouth, hallucinations (your chances are greater of experiencing hallucinations if you are over 65 years old), insomnia, low blood pressure when you sit or stand, nausea, swelling of the lower limbs, vision abnormalities, weakness

Can I receive Mirapex if I am pregnant or breastfeeding?

The effects of Mirapex during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Mirapex?

If you miss a dose of Mirapex, take it as soon as you remember. If it is almost time for your next dose, skip the dose you missed and take your next regular dose. Do not double your next dose.

How should I store Mirapex?

Store Mirapex at room temperature, away from light and heat. Keep away from children.