Pramipexole
- Atc Codes:N04BC05
- CAS Codes:104632-26-0#191217-81-9
- PHARMGKB ID:104632-26-0#191217-81-9
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Glepark, Mirapexin, Oprymea, Pramipexol, Sifrol, Vasiprax; Belgium: Mirapexin, Sifrol; Cyprus: Sifrol; Czech Republic: Aperixon, Glepark, Medopexol, Mirapexin, Oprymea, Pramipexol, Pramipexole, Pramithan, Pramixil, Sifrol; Denmark: Mirapexin, Sifrol; Estonia: Ezaprev, Miraper, Mirapexin, Miviren, Oprymea, Pramipexole, Sifrol; Finland: Sifrol; France: Sifrol; Germany: Glepark, Mirapexin, Mirastalin, Oprymea, Pramipexol, Pramispes, Pramix, Sifrol; Greece: Glepark, Mariprax, Miraleton, Miraparkin, Mirapexin, Pramipexole, Sifrol; Hungary: Mirapexin, Oprymea, Pramipexol, Pramipexole, Pramitenorm, Sifrol; Ireland: Glepark, Miramel, Mirapexin, Oprymea, Pramipexole, Sifrol; Italy: Mirapexin, Sifrol; Latvia: Mirapexin, Sifrol; Lithuania: Ezaprev, Glepark, Medopexol, Miraper, Mirapexin, Miviren, Oprymea, Pramipexole, Sifrol; Luxembourg: Mirapexin, Sifrol; Malta: Mirapexin, Sifrol; Netherlands: Mirapexin, Oprymea, Pramipexol, Pramipexolane, Pramipexolene, Pramipexoline, Pramipexolune, Sifrol; Poland: Emwepel, Miparkan, Mirapexin, Oprymea, Pramipexole, Ramixole, Sifrol; Portugal: Ezaprev, Mirapexin, Oprymea, Pramipexol, Pramipexole, Sifrol; Romania: Emwepel, Glepark, Medopexol, Mirapexin, Oprymea, Pramipexol, Pramixil, Sifrol; Slovakia: Glepark, Medopexol, Mirapexin, Oprymea, Pramigen, Pramipexol, Pramipexole, Ramixole, Sifrol; Slovenia: Pramipeksol; Spain: Mirapexín; Sweden: Glepark, Mirapexin, Oprymea, Pramipexol, Pramipexole, Prixol, Sifrol; UK: Mirapexin.
North America
Canada: Mirapex, Pramipexole; USA: Mirapex, Pramipexole.
Latin America
Argentina: Maxtenk, Nixol, Nulipar, Parfeno, Parmital, Portiv, Proats, Sifrol, Treminel; Brazil: Mirapex, Sifrol; Mexico: Sifrol.
Asia
Japan: Mirapex.
Drug combinations
Chemistry
Pramipexole: C~10~H~17~N~3~S. Mw: 211.33. 2,6-Benzothiazolediamine, 4,5,6,7-tetrahydro-N^6^-propyl-, (S)-. CAS-104632-26-0 (1995).
Pramipexole Dihydrochloride: C~10~H~17~N~3~S 2HCl H~2~O. Mw: 302.26. (S)-2-Amino-4,5,6,7-tetrahydro-6-(propylamino)benzothiazole dihydrochloride monohydrate. CAS-191217-81-9 (1997).
Pharmacologic Category
Antiparkinsonian Agents; Nonergot-derivative Dopamine Receptor Agonists. (ATC-Code: N04BC05).
Mechanism of action
By binding to D~2~ subfamily dopamine receptor, and to D~3~ and D~4~ receptors, it is thought that pramipexole can stimulate dopamine activity on nerves of striatum and substantia nigra.
Therapeutic use
Treatment of signs and symptoms of idiopathic Parkinson’s disease. Treatment of moderate-to-severe primary restless legs syndrome.
Pregnancy and lactiation implications
Early embryonic loss and postnatal growth inhibition observed in animal studies. There are no adequate, well-controlled studies in pregnant women. Not recommended during lactation. Prolactin secretion may be inhibited.
Unlabeled use
Treatment of depression.
Contraindications
Hypersensitivity to pramipexole or any component of the formulation.
Warnings and precautions
May cause hallucinations, particularly in older patients. Associated with impulsive control disorders (pathological gambling, libido increases (hypersexuality), and/or binge eating), although causality not established. May cause orthostatic hypotension (use with caution in risk of hypotension, such as patients receiving antihypertensive drugs; or where transient hypotensive episodes would be poorly tolerated (cardiovascular disease or cerebrovascular disease)). Ergot-derived dopamine agonists also associated with fibrotic complications (e.g. retroperitoneal fibrosis, pleural thickening, and pulmonary infiltrates). Pathologic degenerative changes observed in retinas of albino rats, but not in retinas of albino mice or other species. Significance for humans of these data remains uncertain. Pramipexole associated with somnolence, particularly at higher dosages (>1.5 mg/day)(use with caution in patients receiving other CNS depressants or psychoactive agents). Effects with other sedative drugs or ethanol may be potentiated. Use with caution in pre-existing dyskinesias (may be exacerbated), and in renal impairment. Augmentation (earlier onset of symptoms in evening/afternoon, increase and/or spread of symptoms to other extremities) or rebound (shifting of symptoms to early morning hours) may occur in some restless legs syndrome patients. Dopaminergic agents associated with syndrome resembling neuroleptic malignant syndrome on abrupt withdrawal or significant dosage reduction after long-term use.