Formulary
Pramipexole: Indications, Dosing, Side Effects and Interactions
Pramipexole clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Pramipexole: Indications, Dosing, Side Effects and Interactions
Pramipexole clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Parkinson's disease, used alone or as an adjunct to co-beneldopa or co-careldopa**
- **Adult** (By Mouth Using Immediate-Release Medicines): Initially 88 micrograms 3 times a day, if tolerated dose to be increased by doubling dose every 5-7 days, increased to 350 micrograms 3 times a day, then increased in steps of 180 micrograms 3 times a day if required, dose to be increased at weekly intervals, during dose titration and maintenance, levodopa dose may be reduced, maximum daily dose to be given in 3 divided doses; maximum 3.3 mg per day.
- **Adult** (By Mouth Using Modified-Release Medicines): Initially 260 micrograms once daily, dose to be increased by doubling dose every 5-7 days, increased to 1.05 mg once daily, then increased in steps of 520 micrograms every week if required, during dose titration and maintenance, levodopa dose may be reduced according to response; maximum 3.15 mg per day.
**Moderate to severe restless legs syndrome**
- **Adult** (By Mouth Using Immediate-Release Medicines): Initially 88 micrograms once daily, dose to be taken 2-3 hours before bedtime, dose to be increased by doubling dose every 4-7 days if necessary, repeat dose titration if restarting treatment after an interval of more than a few days; maximum 540 micrograms per day.
Cautions
Psychotic disorders; risk of visual disorders (ophthalmological testing recommended); severe cardiovascular disease
Side effects
Common or very common Appetite abnormal; behaviour abnormal; confusion; constipation; dizziness; drowsiness; fatigue; hallucination; headache; hypotension; movement disorders; nausea; peripheral oedema; psychiatric disorders; sleep disorders; vision disorders; vomiting; weight changes Uncommon Anxiety; binge eating; delirium; delusions; dyspnoea; heart failure; hiccups; mania; memory loss; pathological gambling; pneumonia; sexual dysfunction; SIADH; skin reactions; sudden onset of sleep (can occur without warning); syncope Frequency not known Depression; dopamine agonist withdrawal syndrome; generalised pain; sweating abnormal
Interactions
**Other interactions (1):**
- Concomitant use of pramipexole or ropinirole with Anquil should be avoided as there may be antagonism of their effect.
Pregnancy
Use only if potential benefit outweighs risk-no information available.
Breast feeding
May suppress lactation; avoid-present in milk in animal studies.
Renal impairment
For immediate-release tablets in restless legs syndrome, use with caution if creatinine clearance less than 20 mL/minute (no information available). M For modified-release tablets, avoid if creatinine clearance less than 30 mL/minute (no information available). M Dose adjustments For immediate-release tablets in Parkinson's disease, initially 88 micrograms twice daily (max. 1.57 mg daily in 2 divided doses) if creatinine clearance 20-50 mL/minute; initially 88 micrograms once daily (max. 1.1 mg once daily) if creatinine clearance less than 20 mL/minute. If renal function declines during treatment, reduce dose by the same percentage as the decline in creatinine clearance. M For modified-release tablets, initially 260 micrograms on alternate days if creatinine clearance 30-50 mL/minute, increased to 260 micrograms once daily after 1 week, further increased if necessary by 260 micrograms daily at weekly intervals to max. 1.57 mg daily. M See Prescribing in renal impairment .
Medicinal forms
Tablet,Tablet
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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