Pramipexole interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

  What to do: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

  4 sources

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):

Conditions

Conditions in which Pramipexole needs care, as documented in this source.

• Hypotension

  Major

  Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension, especially during dose escalation. Therapy with dopamine agonists should be monitored carefully in patients with Parkinson's disease since they may have an impaired ability to respond to an orthostatic challenge, and also in patients receiving antihypertensive drugs.

  11 sources

  1. Hoehn MM "Levodopa-induced postural hypotension. Treatment with fludrocortisone." Arch Neurol 32 (1975): 50-1
  2. Iwasaki S, Hamaguchi K, Iwasaki A, Takakusagi M, Narabayashi Y "Hypotensive effect of long-term levodopa in patients with Parkinson's disease." Eur Neurol 30 (1990): 194-9
  3. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn (2001):
  4. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals (2001):
  5. "Product Information. Sinemet CR (carbidopa-levodopa)." DuPont Pharmaceuticals (2001):
  6. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim (2001):
  7. "Product Information. Requip (ropinirole)." SmithKline Beecham (2001):
  8. "Product Information. Comtan (entacapone)." Novartis Pharmaceuticals (2001):

  Show all 11 sourcesShow fewer sources

  9. "Product Information. Azilect (rasagiline)." Teva Pharmaceuticals USA (2006):
  10. "Product Information. Neupro (rotigotine)." Schwarz Pharma (2007):
  11. "Product Information. Xadago (safinamide)." US WorldMeds LLC (2017):

• Kidney Failure, Chronic

  Major

  Pramipexole is eliminated by the kidneys, and approximately 90% of the drug is excreted unchanged in the urine. Renal insufficiency decreases the renal clearance and increases the half-life. Therapy with pramipexole should be administered cautiously and at a reduced dose in patients with compromised renal function. Pramipexole clearance is extremely low in dialysis patients, as a negligible amount of the drug is removed by it.

  2 sources

  1. Wright CE, Sisson TL, Ichhpurani AK, Peters GR "Steady-state pharmacokinetic properties of pramipexole in healthy volunteers." J Clin Pharmacol 37 (1997): 520-5
  2. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim (2001):

• Neuroleptic Malignant Syndrome

  Major

  The use of dopamine agonists is contraindicated in patients with neuroleptic malignant syndrome (NMS). NMS is characterized by hyperthermia, muscle rigidity, altered mental status, irregular pulse or blood pressure, tachycardia, and diaphoresis. The syndrome may rarely be precipitated by abrupt discontinuation of the dopamine agonist.

  5 sources

  1. Friedman JH, Feinberg SS, Feldman RG "A neuroleptic malignantlike syndrome due to levodopa therapy withdrawal." JAMA 254 (1985): 2792-5
  2. Genis D "Neuroleptic malignant syndrome: impaired dopaminergic systems?" Neurology 35 (1985): 1806
  3. Rainer C, Scheinost NA, Lefeber EJ "Neuroleptic malignant syndrome. When levodopa withdrawal is the cause." Postgrad Med 89 (1991): 175-8,
  4. Gibb WR, Griffith DN "Levodopa withdrawal syndrome identical to neuroleptic malignant syndrome." Postgrad Med J 62 (1986): 59-60
  5. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim (2001):

• Psychotic Disorders

  Major

  Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinson agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs.

  8 sources

  1. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn (2001):
  2. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim (2001):
  3. "Product Information. Requip (ropinirole)." SmithKline Beecham (2001):
  4. "Product Information. Comtan (entacapone)." Novartis Pharmaceuticals (2001):
  5. "Product Information. Lodosyn (carbidopa)." DuPont Pharma (2001):
  6. "Product Information. Azilect (rasagiline)." Teva Pharmaceuticals USA (2006):
  7. "Product Information. Neupro (rotigotine)." Schwarz Pharma (2007):
  8. "Product Information. Xadago (safinamide)." US WorldMeds LLC (2017):