Neurology Book

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Mirapex

Aka: Mirapex, Pramipexole
  1. See Also
    1. Dopamine Agonist
    2. Ropinirole (Requip)
  2. Indications
    1. Parkinson's Disease
    2. Restless Leg Syndrome
      1. Symptoms for at least 2 days/week for 3 months
  3. Mechanism
    1. Non-ergot selective Dopamine receptor agonist
  4. Adverse Effects
    1. Nausea (common)
    2. Drowsiness (Limited to higher dosages)
      1. May be sudden, severe without warning
      2. May occur up to one year after starting Mirapex
      3. Has resulted in falling asleep while driving
    3. Augmentation of Restless Leg Symptoms
      1. Occurs in 25% of RLS patients on longterm therapy
      2. May progress in severity, and involve arms, trunk
      3. Often better if dose timing changed to earlier in day
      4. May be worse if dose increased
    4. Other uncommon adverse effects (rare at low dose)
      1. Hallucinations
      2. Pathologic Gambling (related to Dopamine receptor agonist activity, D3)
      3. Orthostatic Hypotension
      4. Hypersexuality
  5. Dosing: Restless Leg Syndrome
    1. Start: Mirapex 0.125 mg orally taken 2-3 hours before bedtime
    2. Interval for increasing dose if ineffective is based on Renal Function
      1. GFR >60 ml/min: Increase dose every 3-7 days
      2. GFR 20-60 ml/min: Increase dose every 14 days
    3. Titrating dose: Increase at set interval as above by one tablet if ineffective at current dose
      1. Start at 0.125 mg one tablet nightly for set interval in days
      2. Increase to two tablets (0.25 mg) nightly for set interval if ineffective at 0.125 mg
      3. Increase to three tablets (0.375 mg) nightly for set interval if ineffective at 0.25 mg
    4. Maximum dose: 6 tablets (0.75 mg) taken at bedtime
    5. Stopping: No titration needed
  6. Efficacy
    1. At least 50% reduction in symptoms in 60% of patients
      1. Placebo had similar reduction in 42%
    2. Number Needed to Treat: 6
    3. Symptoms recur when Mirapex is stopped
  7. References
    1. Jarvis (2007) Am Fam Physician 75:1239-40 [PubMed]
    2. Montplasir (2006) Eur J Neurol 13:1306-11 [PubMed]
    3. Silber (2003) Sleep 26:819-21 [PubMed]
    4. Winkelman (2006) Neurology 67:1034-9 [PubMed]
Medication Costs
mirapex (on 1/4/2017 at Medicaid.Gov Pharmacy Drug pricing)
MIRAPEX ER 0.375 MG TABLET $16.84 each
MIRAPEX ER 0.75 MG TABLET Generic $10.62 each
MIRAPEX ER 1.5 MG TABLET Generic $11.64 each
MIRAPEX ER 3 MG TABLET Generic $11.94 each
MIRAPEX ER 4.5 MG TABLET Generic $11.83 each
pramipexole (on 2/22/2017 at Medicaid.Gov Pharmacy Drug pricing)
PRAMIPEXOLE 0.125 MG TABLET Generic $0.07 each
PRAMIPEXOLE 0.25 MG TABLET Generic $0.06 each
PRAMIPEXOLE 0.5 MG TABLET Generic $0.05 each
PRAMIPEXOLE 0.75 MG TABLET Generic $0.09 each
PRAMIPEXOLE 1 MG TABLET Generic $0.08 each
PRAMIPEXOLE 1.5 MG TABLET Generic $0.06 each
PRAMIPEXOLE ER 0.75 MG TABLET Generic $10.62 each
PRAMIPEXOLE ER 1.5 MG TABLET Generic $11.64 each
PRAMIPEXOLE ER 3 MG TABLET Generic $11.94 each
PRAMIPEXOLE ER 4.5 MG TABLET Generic $11.83 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Pramipexole (C0074710)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C061333
SnomedCT 108471007, 386852009
English 2,6-Benzothiazolediamine, 4,5,6,7-tetrahydro-N6-propyl-, (S)-, 2-amino-4,5,6,7-tetrahydro-6-propylaminobenzothiazole, 2-amino-6-propylaminotetrahydrobenzothiazole, Pramipexole, 4,5,6,7-tetrahydro-N6-propyl-2,6-benzothiazole-diamine, pramipexole, pramipexol, PRAMIPEXOLE, Pramipexole (product), Pramipexole (substance)
Spanish pramipexol (producto), pramipexol (sustancia), pramipexol
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Mirapex (C0721754)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C061333
English Mirapex, mirapex, Boehringer Ingelheim brand of pramipexole dihydrochloride
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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