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Pramipexole Dihydrochloride ER
Pramipexole Dihydrochloride ER (extended-release) is a dopamine agonist used to treat the symptoms of Parkinson’s disease. It mimics the effects of dopamine, a neurotransmitter that is deficient in Parkinson’s disease, helping to improve motor control, reduce tremors, and decrease muscle rigidity. The extended-release formulation is designed to provide once-daily dosing for better control of symptoms throughout the day and night.
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Frequently Asked Questions
How long does it take for Pramipexole ER to start working?
Improvements in Parkinson’s symptoms may be noticed within a few days to a week of starting treatment, but it may take longer to see the full benefits.
Can I stop taking Pramipexole ER if my symptoms improve?
No, Pramipexole ER is intended for long-term use in managing Parkinson’s disease. Stopping the medication suddenly can lead to withdrawal symptoms or worsening of Parkinson’s symptoms. Always consult your healthcare provider before making any changes to your medication.
Can Pramipexole ER cause weight gain?
Pramipexole ER may be associated with weight gain, particularly if patients develop compulsive eating behaviors as part of an impulse control disorder.
What should I do if I miss a dose of Pramipexole ER?
If you miss a dose, take it as soon as you remember, unless it is close to the time for your next dose. Do not take two doses at once to make up for a missed dose.
Can Pramipexole ER be used for restless legs syndrome (RLS)?
Although the extended-release form is primarily indicated for Parkinson’s disease, immediate-release Pramipexole is commonly used for RLS. Always follow your healthcare provider’s guidance on the appropriate formulation and dose for your condition.
Comprehensive Drug Guide
How Does Pramipexole Dihydrochloride ER Work?
Pramipexole Dihydrochloride ER works by stimulating dopamine receptors in the brain, which compensates for the lack of dopamine in individuals with Parkinson’s disease. This helps normalize motor function, reducing the symptoms of tremors, rigidity, and bradykinesia (slowness of movement).
Common Dosages
- Tablets: 0.375 mg, 0.75 mg, 1.5 mg, 2.25 mg, 3 mg, 3.75 mg, 4.5 mg
Typical Dosing
- For Parkinson’s disease, the typical starting dose is 0.375 mg once daily, with gradual increases every 5 to 7 days. The maximum recommended dose is 4.5 mg once daily.
- Dose adjustments may be necessary based on individual response and side effects.
Typical Dosing
FDA Approved Indications
- Treatment of Parkinson’s disease, both as monotherapy and in combination with other medications like levodopa.
Who Shouldn't Take Pramipexole Dihydrochloride ER?
- Known hypersensitivity to pramipexole or any of its components.
- Severe cardiovascular conditions that may worsen with dopamine agonist therapy.
Advice From The Pharmacist
- Take Pramipexole ER once daily, at the same time each day. It can be taken with or without food; taking it with food may help reduce nausea.
- Do not crush, chew, or break the extended-release tablet, as this can interfere with the controlled release of the medication.
- Do not stop taking Pramipexole ER suddenly, as this can worsen Parkinson’s symptoms or cause withdrawal effects. Consult your healthcare provider before making any changes to your dose.
- Be aware that Pramipexole ER can cause drowsiness or sudden sleep episodes, so use caution when driving or operating machinery.
Side Effects of Pramipexole Dihydrochloride ER
Common Side Effects
- Nausea
- Drowsiness
- Dizziness
- Constipation
- Hallucinations (particularly in older patients)
Uncommon/Severe Side Effects
- Sudden sleep episodes
- Impulse control disorders (e.g., compulsive gambling, binge eating)
- Orthostatic hypotension (dizziness upon standing)
- Hallucinations or psychosis
Risks and Warnings of Pramipexole Dihydrochloride ER
- Sudden Sleep Onset: Pramipexole ER may cause patients to experience sudden sleep attacks without warning. Patients should be cautious when engaging in activities that require full alertness.
- Impulse Control Disorders: Patients may develop compulsive behaviors, such as gambling, shopping, or binge eating. It is important to report these behaviors to a healthcare provider.
- Hallucinations: Especially in older adults, Pramipexole ER can cause visual hallucinations or confusion. Close monitoring is advised.
- Orthostatic Hypotension: This medication may cause low blood pressure when standing up, increasing the risk of falls.
Interactions with Pramipexole Dihydrochloride ER
Common Drug Interactions
- Antipsychotic medications: These may reduce the effectiveness of pramipexole due to their opposing effects on dopamine receptors.
- Levodopa: While these two medications are often used together, the combination may increase the risk of dyskinesia (involuntary movements).
- Sedatives (e.g., benzodiazepines): May increase the risk of drowsiness and sudden sleep episodes.
Alternatives to Pramipexole Dihydrochloride ER
- Ropinirole ER (Requip XL®): Another dopamine agonist used for Parkinson’s disease with a similar extended-release formulation.
- Levodopa-carbidopa CR: Commonly used to manage motor symptoms in Parkinson’s disease.
- Rotigotine (Neupro®): A dopamine agonist delivered via a transdermal patch for Parkinson’s disease.
