II. Preparations: Non-ergot Dopamine Agonists (as dosed in Parkinson's Disease)

  1. General: Parkinson's Disease related concerns
    1. Less effective than Sinemet, but are less associated with Dyskinesias
    2. Most effective agents at reducing Sinemet off-time
    3. Increased Sleepiness, edema, Nausea and Hallucinations
  2. Pramipexole (Mirapex)
    1. Start at 0.125 mg PO tid
    2. Increase every week to 1.5 mg PO tid
    3. Half life: 7-17 hours
    4. Minimal metabolism
  3. Ropinirole (Requip)
    1. Start at 0.25 mg PO tid
    2. Increase every week to 1 mg PO tid
    3. Half life: 6 hours
    4. Hepatic metabolism
  4. Rotigotine (Neupro) Transdermal
    1. Dopamine Agonist transdermal patch
    2. Dosing
      1. One patch applied daily to a new site
      2. Do not repeat the same site for 14 days
      3. Start at 2 mg/24 hours
      4. May increase weekly to a maximum of 8 mg/24 h
  5. Apomorphine (Apokyn)
    1. Subcutaneous Injectable Non-ergot Dopamine Agonist
    2. Decreases Sinemet off-time
    3. Significant side effects and typically started only by experienced clinicians (started as inpatient)

III. Preparations: Ergot Dopamine Agonists (as dosed in Parkinson's Disease)

  1. Diagnostics required when on Ergot Dopamine Agonists (baseline and annual)
    1. Echocardiogram
    2. Chest XRay
    3. Erythrocyte Sedimentation Rate (ESR)
    4. Renal Function tests
  2. Bromocriptine mesylate (Parlodel)
    1. Start at 1.25 mg PO bid
    2. Increase every 2 weeks to 5-20 mg PO bid
    3. Half life: 3-8 hours
    4. Hepatic metabolism
  3. Pergolide mesylate (Permax): Not recommended (not available in U.S.)
    1. Half life: 27 hours
    2. Hepatic metabolism
    3. Risk of valvular disease and Pulmonary Hypertension
      1. Van Camp (2004) Lancet 363:1179-83 [PubMed]

IV. Adverse Effects

  1. Impulse control behaviors (rare)
    1. Behaviors seen with Dopamine Agonists include Compulsive Gambling, hypersexuality, shopping, eating
    2. Moore (2014) JAMA Intern Med 174(12):1930-3 [PubMed]

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Ontology: Dopamine Agonists (C0178601)

Definition (NCI) Any agent that binds to and activates dopamine receptors.
Definition (MSH) Drugs that bind to and activate dopamine receptors.
Definition (CSP) class of drugs and natural products which enhance dopaminergic function by increasing dopamine biosynthesis, decreasing dopamine degradation or reuptake, or interacting positively with dopamine receptors.
Concepts Pharmacologic Substance (T121)
MSH D018491
SnomedCT 108808007, 395987003, 384952006, 418222008
English Agonists, Dopamine, Agonists, Dopamine Receptor, Dopamine Receptor Agonists, Receptor Agonists, Dopamine, dopamine agonist, Agonist, Dopamine, Agonist, Dopamine Receptor, Agonist, Dopaminergic, Agonists, Dopaminergic, Dopamine Agonist, Dopamine Receptor Agonist, Dopaminergic Agonist, Dopaminergic Agonists, Receptor Agonist, Dopamine, Dopaminergic drugs used in parkinsonism, Dopaminergics in parkinsons, RECEPT AGON DOPAMINE, DOPAMINE AG, DOPAMINERGIC AG, DOPAMINERGIC AGON, AGON DOPAMINERGIC, DOPAMINE RECEPT AG, AGON DOPAMINE RECEPT, DOPAMINE AGON, DOPAMINE RECEPT AGON, Dopaminergics, dopamine receptor agonist, dopamine agonists (medication), dopamine agonists, Dopamine Agonists, dopaminergic agonists, agonist dopamine receptor, agonists dopamine receptor, Dopamine agonists, Dopamine agonist (product), Dopamine agonist, Dopamine receptor agonist (substance), Dopamine receptor agonist, Dopamine--Agonists, Dopamine agonist product (product), Dopamine agonist product, Dopamine agonist (substance), Dopamine agonist agent (substance), Dopamine agonist agent
Spanish agonista de dopamina, agonista dopamínico (sustancia), agonista dopamínico, agonista dopaminérgico (producto), agonista dopaminérgico, agonista del receptor de dopamina (sustancia), agonista del receptor de dopamina, agonista de la dopamina (producto), agonista de la dopamina, agonista dopaminérgico (sustancia), Agonistas de Dopamina, Agonistas de Receptores de Dopamina, Agonistas Dopaminérgicos
French Agonistes de la dopamine, Agonistes du récepteur de la dopamine, Agonistes des récepteurs dopaminergiques, Agonistes dopaminergiques
Swedish Dopaminstimulerare
Czech dopamin agonisté
Finnish Dopamiiniagonistit
Italian Agonista del recettore della dopamina, Agonista della dopamina, Agonisti del recettore della dopamina, Agonista dopaminergico, Agonisti dopaminergici, Agonisti della dopamina
Russian DOFAMINA RETSEPTOROV AGONISTY, DOFAMINERGICHESKIE AGONISTY, DOFAMINA AGONISTY, ДОФАМИНА АГОНИСТЫ, ДОФАМИНА РЕЦЕПТОРОВ АГОНИСТЫ, ДОФАМИНЕРГИЧЕСКИЕ АГОНИСТЫ
Croatian DOPAMINSKI AGONISTI
Polish Agoniści dopaminy, Agoniści dopaminergiczni, Agoniści receptora dopaminowego
Japanese ドーパミン作動剤, ドーパミンアゴニスト, ドーパミン作用薬, ドーパミン受容体作用薬, ドーパミン作用剤, ドーパミン受容体作用物質
German Dopaminagonisten, Dopaminerge Agonisten, Dopaminrezeptoragonisten
Portuguese Agonistas de Dopamina, Agonistas Dopaminérgicos, Agonistas dos Receptores de Dopamina

Ontology: Ergot-derived Dopamine Receptor Agonist [EPC] (C2917378)

Concepts Pharmacologic Substance (T121)
English Ergot-derived Dopamine Receptor Agonist [EPC], Ergot-derived Dopamine Receptor Agonist

Ontology: Nonergot Dopamine Agonist [EPC] (C2917438)

Concepts Pharmacologic Substance (T121)
English Nonergot Dopamine Agonist, Nonergot Dopamine Agonist [EPC]