Pramipexole

Pramipexole (active ingredient: pramipexole) is what is known as a dopamine agonist – a compound that activates the dopamine receptors in the brain. This has a positive effect on muscle control and can reduce symptoms characteristic of restless legs syndrome. If you wish to order Pramipexole online, you can do so through one of the pharmacies working with Dokteronline.com.

• Used to treat the symptoms of Parkinson’s disease
• Be careful with alcohol/driving while taking this medicine
• Do not use while pregnant or breastfeeding

Pramipexole is used to treat the symptoms of primary Parkinson’s disease in adults. It contains the active substance pramipexole and belongs to a group of medicines known as dopamine agonists which stimulate dopamine receptors in the brain. Stimulation of the dopamine receptors triggers nerve impulses in the brain that help to control body movements. This helps to improve certain symptoms of Parkinson's disease, such as stiffness and slowness of movement. Pramipexole can be used alone or in combination with levodopa (another medicine for Parkinson’s disease).

Take your tablet with a drink of water. Pramipexole can be taken either with or without food. The daily dose is to be taken divided into three equal doses. Space the doses evenly throughout the day for more stable levels.

Dosage

Treatment with Pramipexole is gradually increased. During the first week, you will start with a low dose. This will be increased every five to seven days as directed by your doctor until your symptoms are controlled (maintenance dose).

The guidelines for use in adults are:

• Week 1: one tablet Pramipexole 0.088 mg three times a day (equivalent to 0.264 mg daily).
• Week 2: one tablet Pramipexole 0.18 mg three times a day (equivalent to 0.54 mg daily).
• Week 3: one tablet Pramipexole 0.35 mg three times a day (equivalent to 1.1 mg daily).

The usual maintenance dose is 1.1 mg a day.

If necessary, your doctor may increase your tablet dose up to a maximum of 3.3 mg of pramipexole a day. A lower maintenance dose of three Pramipexole 0.088 mg tablets a day is also possible.

If you have moderate or severe kidney disease, your doctor will prescribe a lower dose.

This medicine is not recommended for children under 18 years of age. For more information about dosage and use of Pramipexole, see the package leaflet.

Driving/alcohol

Driving

Pramipexole can cause hallucinations (seeing, hearing or feeling things that are not there). If affected, do not drive or use machines.

Pramipexole has been associated with sleepiness and episodes of suddenly falling asleep, particularly in patients with Parkinson’s disease. If you experience these side effects, you must not drive or operate machinery. You should tell your doctor if this occurs.

Alcohol

You should be cautious while drinking alcohol during treatment with Pramipexole. Alcohol can increase the risk of sleepiness and episodes of suddenly falling asleep.

If you use too much/forget to use/stop using Pramipexole

If you accidentally take too many tablets, contact your doctor or nearest hospital casualty department immediately for advice.

If you forget to take a dose of Pramipexole, simply leave out that dose completely and then take your next dose at the right time. Do not use a double dose to make up for the forgotten one.

Do not stop using Pramipexole talking to a doctor first. If you have to stop taking this medicine, your doctor will reduce the dose gradually.

Do not use Pramipexole if you are allergic to any of its ingredients (see section 'What Pramipexole contains').

When should this medicine be used with caution?

Tell your doctor if you have (had) or develop any medical conditions or symptoms, especially any of the following:

• Kidney disease.
• Hallucinations (seeing, hearing or feeling things that are not there). Most hallucinations are visual.
• Dyskinesia (abnormal, uncontrolled movements of the limbs). If you have advanced Parkinson’s disease and are also taking levodopa, you might develop dyskinesia during the uptitration of Pramipexole.
• Sleepiness and episodes of suddenly falling asleep.
• Psychosis (e.g., comparable with symptoms of schizophrenia).
• Vision impairment. You should have regular eye examinations during treatment with Pramipexole.
• Severe heart or blood vessels disease. You will need to have your blood pressure checked regularly, especially at the beginning of treatment.

Tell your doctor if you or your family/carer notices that you are developing urges or cravings to behave in ways that are unusual for you and you cannot resist the impulse, drive or temptation to carry out certain activities that could harm yourself or others (e.g., addictive gambling, excessive eating or spending, an abnormally high sex drive or preoccupation with an increase in sexual thoughts or feelings). Your doctor may need to adjust or stop your dose.

Tell your doctor if you or your family/carer notices that you are developing mania (agitation, feeling elated or over-excited) or delirium (decreased awareness, confusion, loss of reality). Your doctor may need to adjust or stop your dose.

See the package leaflet for more information.

Pregnancy and breastfeeding

Pramipexole is not recommended for women who are pregnant or breastfeeding. Ask your doctor for advice.

Other medicines and Pramipexole

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription, herbal medicines or other natural products.

You should avoid taking Pramipexole together with antipsychotic medicines.

Take care if you are taking the following medicines:

• Cimetidine (to treat excess stomach acid and stomach ulcers).
• Amantadine (which can be used to treat Parkinson’s disease).
• Mexiletine (to treat irregular heartbeats, a condition known as ventricular arrhythmia).
• Zidovudine (which can be used to treat AIDS).
• Cisplatin (to treat various types of cancers).
• Quinine (which can be used for the prevention of painful nighttime leg cramps and for the treatment of a type of malaria).
• Procainamide (to treat irregular heartbeat).

If you are taking levodopa, the dose of levodopa is recommended to be reduced when you start treatment with Pramipexole. Take care if you are using any medicines that calm you down (have a sedative effect) or if you are drinking alcohol. In these cases, Pramipexole may affect your ability to drive and operate machinery.

Like all medicines, this medicine can cause side effects, although some people may not experience any. You should get immediate medical help if you experience any of the following symptoms:

• Pneumonia.
• Heart failure.
• Severe allergic reactions.
• Inappropriate antidiuretic hormone secretion.

(Please refer to the package leaflet for more information.)

You may also experience the following side effects:

• Inability to resist the impulse, drive or temptation to perform an action that could be harmful to yourself or to others (e.g., strong impulse to gamble excessively).
• Altered or increased sexual interest and behaviour of significant concern to you or to others.
• Uncontrollable excessive shopping or spending.
• Binge eating or compulsive eating.
• Delirium (decreased awareness, confusion, loss of reality).
• Mania (agitation, feeling elated or overexcited).

(For more information on these side effects, see the package leaflet.)

Other possible side effects associated with Pramipexole include:

Very common (may affect more than 1 in 10 people):

• Dyskinesia (abnormal, uncontrolled movements of the limbs).
• Sleepiness.
• Dizziness.
• Nausea.

Common (may affect up to 1 in 10 people):

• Hallucinations.
• Confusion.
• Tiredness.
• Sleeplessness (insomnia).
• Excess of fluid, usually in the legs (peripheral oedema).
• Headache.
• Low blood pressure.
• Abnormal dreams.
• Constipation.
• Visual impairment (blurred/double vision).
• Vomiting.
• Weight loss including decreased appetite.

Uncommon (may affect up to 1 in 100 people):

• Paranoia (excessive fear for one’s own wellbeing).
• Delusion.
• Excessive daytime sleepiness and suddenly falling asleep.
• Amnesia (memory disturbance).
• Hyperkinesia (increased movements and inability to keep still).
• Weight gain.
• Altered or increased sexual interest.
• Skin irritation and itching.
• Fainting.
• Restlessness.
• Dyspnoea (breathing difficulties, shortness of breath).
• Hiccups.

For a complete list of possible side effects, see the package leaflet. If you experience side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in the leaflet.

The active substance is pramipexole.

• Each 0.088mg tablet contains 0.088 mg of pramipexole (as 0.125 mg pramipexole dihydrochloride monohydrate).
• Each 0.18mg tablet contains 0.18 mg of pramipexole (as 0.25 mg pramipexole dihydrochloride monohydrate).
• Each 0.35mg tablet contains 0.35 mg of pramipexole (as 0.5 mg pramipexole dihydrochloride monohydrate).
• Each 0.7mg tablet contains 0.7 mg of pramipexole (as 1.0 mg pramipexole dihydrochloride monohydrate).