How does this medication work? What will it do for me?

Pramipexole belongs to the class of medications called dopamine agonists. It is used to treat signs and symptoms of Parkinson's disease. It is also used to treat symptoms of moderate to severe restless leg syndrome. It helps to improve muscle control and movement by affecting the balance of a chemical in the brain called dopamine.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

0.25 mg
Each white to off-white, oval, flat-faced, bevelled edge tablet, scored and engraved "PR .25" on one side and "APO" on the other side, contains pramipexole dihydrochloride monohydrate 0.25 mg. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, and starch (corn).

0.5 mg
Each white to off-white, oval, flat-faced, bevelled edge tablet, scored and engraved "PR .5" on one side and "APO" on the other side, contains pramipexole dihydrochloride monohydrate 0.5 mg. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, and starch (corn).

1 mg
Each white to off-white, round, flat-faced, bevelled edge tablet, scored and engraved "PR" over "1" on one side and "APO" on the other side, contains pramipexole dihydrochloride monohydrate 1 mg. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, and starch (corn).

1.5 mg
Each white to off-white, round, flat-faced, bevelled edge tablet, scored and engraved "PR" over "1.5" on one side and "APO" on the other side, contains pramipexole dihydrochloride monohydrate 1.5 mg. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, and starch (corn).

How should I use this medication?

For Parkinson's disease, the recommended adult dose starts at 0.375 mg daily, taken in 3 divided doses. Depending on the response to the medication as well as side effects, the dose may be increased every 5 to 7 days to obtain the desired effects. The maximum recommended dose should not exceed 4.5 mg daily, taken in 3 divided doses.

For restless leg syndrome, the recommended adult dose starts at 0.125 mg once daily, taken 2 to 3 hours before bedtime. The dose may be increased every 4 to 7 days to a maximum of 0.5 mg 2 to 3 hours before bedtime. For restless leg syndrome, the safety and effectiveness of treatment longer than 12 weeks has not been established.

Pramipexole may be taken with or without food. You should take it with food if you find that you feel sick to your stomach after taking the tablets.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Pramipexole should not be taken by anyone who is allergic to pramipexole or to any of the ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abnormal dreams
  • constipation
  • decreased sexual drive or ability
  • dizziness
  • dry mouth
  • headache
  • heartburn, indigestion, or acid stomach
  • increased sweating
  • loss of appetite
  • nausea
  • stuffy nose
  • weight loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abnormal thinking
  • accidental injury
  • behavioural changes (compulsive gambling, compulsive shopping)
  • delusions (false beliefs)
  • difficult, burning, or painful urination
  • difficulty swallowing
  • dizziness, lightheadedness, or fainting, especially when standing up
  • double vision or other changes in vision
  • drowsiness
  • falling asleep without warning
  • frequent urge to urinate
  • hallucinations (seeing, hearing, smelling, tasting, or feeling something that is not there)
  • joint or muscle pain
  • loss of bladder control
  • muscle or joint pain
  • paranoia (unrealistic and excessive anxiety and worry)
  • restlessness or need to keep moving
  • swelling of arms or legs
  • tightness or pain in chest
  • trouble sleeping
  • twitching, twisting, or other unusual body movements
  • unusual tiredness or weakness confusion

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a severe allergic reaction (hives; difficulty breathing; swelling of the face, mouth, throat, or tongue)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Behaviour changes: People taking pramipexole have experienced abnormal behaviour such as compulsive gambling, compulsive shopping, hypersexuality, and binge eating. If you experience these symptoms or any other behaviour change while taking this medication, contact your doctor immediately.

Blood pressure: Pramipexole can lower blood pressure for some people. People taking this medication may feel dizzy or lightheaded when rising from a sitting or lying position. Make sure to tell your doctor if you experience this effect. People with severe heart disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/sudden onset of sleep: Pramipexole and other similar mediations can cause drowsiness and sudden onset of sleep or sleep attacks. Sudden onset of sleep can occur without warning or drowsiness. People taking this medication should avoid driving or operating heavy machinery. If you experience any daytime drowsiness or sudden onset of sleep while taking this medication, contact your doctor immediately.

Hallucinations: People taking this medication should be aware that hallucinations (mainly see things that are not really there) can occur and may affect their ability to drive and perform other daily activities. Make sure to tell your doctor if you experience this effect.

Kidney function: People with reduced kidney function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Pramipexole is not recommended for people with end-stage renal disease.

Restless leg syndrome: When this medication is used to treat the symptoms of restless leg syndrome, it may cause a worsening of symptoms in the early morning hours. It may also cause earlier onset of symptoms in the evening or an increase in symptoms. If you experience this, let your doctor know.

Stopping treatment: Do not stop taking this medication without consulting with your doctor. Stopping this mediation suddenly can cause symptoms such as fever, rigid muscles, and blood pressure changes. If you and your doctor decide that stopping this medication is best for you, your doctor will gradually reduce your dose over a week.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if pramipexole passes into breast milk. Since the medication reduces the amount of breast milk produced, women who are breast-feeding should not take this medication.

Children: The safety and effectiveness of using pramipexole has not been established for children.

Seniors: Seniors may be more likely to experience hallucinations (hearing, seeing or feeling things that are not there) while taking pramipexole.

What other drugs could interact with this medication?

There may be an interaction between pramipexole and any of the following:

  • alcohol
  • amantadine
  • cimetidine
  • diltiazem
  • levodopa
  • loxapine
  • metoclopramide
  • phenothiazines (e.g., chlorpromazine, fluphenazine
  • olanzapine
  • quetiapine
  • quinidine
  • quinine
  • ranitidine
  • risperidone
  • triamterene
  • verapamil
  • ziprasidol

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription) and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or illegal drugs can affect the action of many medications, you should let your prescriber know if you use them.