You will start on a low dose of pramipexole which will be increased gradually over a few weeks. Carefully follow the instructions given to you by your doctor.
Your doctor will discuss with you the possibility of unwanted side-effects. The most common ones are feeling dizzy, feeling sick (nausea) and feeling tired.
Each time you collect a new prescription, check to make sure you have been given the same type and strength of tablets that you were expecting. Ask your pharmacist if you have any questions.
|Type of medicine||Dopamine-receptor agonist|
|Used for||Parkinson's disease; restless legs syndrome|
|Also called||Mirapexin®; Oprymea®|
|Available as||Tablets and prolonged-release tablets|
Parkinson's disease is a disorder of the brain. A small part of the brain, called the substantia nigra, is mainly affected. This area of the brain sends messages down nerves to help control the muscles of your body. Messages are passed between brain cells, nerves and muscles by chemicals called neurotransmitters. Dopamine is the main neurotransmitter made by the brain cells in the substantia nigra.
If you have Parkinson's disease, some of the cells in the substantia nigra region of your brain will have become damaged. Over time, this happens to more and more cells. As cells are damaged, the amount of dopamine that is produced is reduced. A combination of the reduction of cells and a low level of dopamine in the cells causes nerve messages to your muscles to become slowed and abnormal. This produces the typical symptoms of Parkinson's disease: shakiness (tremor), stiffness and slow movement.
Pramipexole is a dopamine-receptor agonist. It is a medicine that acts on the same receptors (tiny areas in the brain) as dopamine. In effect, it acts like a substitute for dopamine. It may be used alone or in combination with other medicines used to treat Parkinson's disease.
Pramipexole can also be used to treat restless legs syndrome. This is an uncomfortable feeling in your legs, which gives you the urge to move your legs to get relief. Pramipexole can help when these symptoms are severe enough to cause distress.
Pramipexole is available as immediate-release tablets and as prolonged-release tablets. The immediate-release tablets can be taken by people with Parkinson's disease or people with restless leg syndrome. The prolonged-release tablets are suitable for people who have Parkinson's disease.
Before taking pramipexole
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking pramipexole it is important that your doctor knows:
- If you have a heart condition or a blood vessel disorder.
- If you feel dizzy when you stand up, due to low blood pressure.
- If you have any problems with the way your kidneys work.
- If you have any mental health problems, such as psychosis.
- If you are pregnant or breast-feeding.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take pramipexole
- Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack and any additional information you are given. The manufacturer's leaflet will give you more information about pramipexole and a full list of any side-effects which you may experience from taking it.
- The dose you are prescribed will depend upon the reason you are taking pramipexole and which type of tablet you are given. Your doctor or pharmacist will tell you how many tablets to take and when to take them. Your dose will also be on the label of your pack to remind you. Read the directions from your doctor carefully so that you know what dose is right for you, and take the tablets exactly as you are told to.
- If you are taking pramipexole for the first time, your doctor will give you a small dose to begin with and then gradually increase this over the first few weeks. Slowly increasing your dose like this will help to reduce side-effects such as dizziness and low blood pressure, which can occur when you first start treatment.
- Swallow the tablet with a drink of water. You can take your doses before or after meals.
- If you have been given prolonged-release tablets, you should swallow these tablets whole. You can take them with a drink of water to help you swallow, but do not crush or break them. This is because they have been specially made to release the medicine slowly over the day.
- Try to get into a habit of taking your doses at the same times of day each day, as this will help you to remember to take them.
- If you do forget to take a dose, take one as soon as you remember, unless it is nearly time for your next dose, in which case skip the missed dose and take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.
- If you are being treated for restless legs syndrome, the best time to take your dose is 2-3 hours before your bedtime.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor so your progress can be monitored. Pramipexole may cause your blood pressure to fall (particularly in the early days of your treatment) and your doctor will want to check for this. Your doctor may also advise you to have regular eye tests, as pramipexole can affect some people's vision.
- As the tablets start to work and your movements become easier, be careful not to overdo any physical activities. Increase the exercise you do gradually to allow your body to adjust to the change in balance and co-ordination.
- Each time you collect a new prescription, check to make sure you have been given the same strength of tablets that you were expecting. Pramipexole tablets are available in several different strengths. Ask your pharmacist if you are unsure.
- Occasionally, people taking pramipexole have fallen asleep suddenly with little or no warning of feeling tired beforehand. Until you know how you react, take extra care if you drive or operate machinery. If you do find yourself falling asleep suddenly, you should see your doctor as soon as possible and, in the meantime, do not drive and do not use tools and machines.
- Treatment with medicines like pramipexole can sometimes cause problems with impulsive types of behaviour. If you notice any changes in your behaviour, such as an increased desire to gamble, binge eat, or spend excessively, or an increased sex drive, you must let your doctor know as soon as possible.
- If you are due to have an operation or any other medical treatment, tell the person carrying out the treatment that you are taking pramipexole.
- Keep taking pramipexole tablets until your doctor tells you otherwise. Stopping suddenly can cause problems and your doctor will want you to reduce your dose gradually if this becomes necessary. Also, if for any reason you do not take your tablets for more than a day or so, you should let your doctor know about this, as your dose may need adjusting.
Can pramipexole cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with pramipexole. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common pramipexole side-effects||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting)||Stick to simple meals - avoid rich or spicy foods|
|Feeling dizzy or faint||Try to stand up slowly. If you begin to feel dizzy, lie down so that you do not faint, then sit for a few moments before standing. Do not drive and do not use tools or machines|
|Constipation||Try to eat a well-balanced diet and drink several glasses of water each day|
|Headache||Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headache continues, speak with your doctor|
|Feeling tired||Do not drive and do not use tools or machines|
|Difficulty sleeping, unusual dreams, falling asleep suddenly without warning, involuntary movements, eyesight problems, lack of appetite, swollen hands or feet, feeling confused, seeing things that are not actually there (hallucinating)||Speak with your doctor about these|
Important: speak with your doctor as soon as possible if you notice any of the following:
- Changes in your behaviour, such as a desire to eat excessively or to gamble, or an increased sex drive.
- Falling asleep suddenly. (It is important that you do not drive if this affects you.)
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store pramipexole
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Mirapexin® tablets (0.088 mg, 0.18 mg, 0.35 mg, 0.7 mg and 1.1 mg); Boehringer Ingelheim Limited, The electronic Medicines Compendium. Dated February 2017.
Manufacturer's PIL, Mirapexin® prolonged-release tablets; Boehringer Ingelheim Limited, The electronic Medicines Compendium. Dated February 2017.
British National Formulary 73rd Edition (Mar 2017); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.