Uses of Parixol: - Parkinson's disease - Restless leg syndrome Parkinson's disease, Restless leg syndrome Hypersensitivity. Lactation.

How to use Pramipexol: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Pramipexol is to be taken with food. Administration: May be taken with or without food. May be taken w/ meals to minimise GI side effects such as nausea. Adult Dose: Parkinson Disease Immediate-release: 0.125 mg PO q8hr initially; gradually titrated upward at weekly intervals to target range of 1.5-4.5 mg/day PO divided q8hr Restless Legs Syndrome 0.125 mg/day PO 2-3 hr before bedtime initially; may be increased every 4-7 days up to 0.5 mg/day (every 14 days if CrCl 20-60 mL/min) Renal Dose: Parkinson disease Immediate release CrCl >50 mL/min: Dosage adjustment not necessary CrCl 30-50 mL/min: 0.125 mg twice daily initially; not to exceed 0.75 mg TID CrCl 15-29 mL/min: 0.125 mg qDay; not to exceed 1.5 mg qDay CrCl <15 mL/min: Dosage adjustment not provided in manufacturer's labeling; not studied ESRD requiring hemodialysis: Dosage adjustment not provided in manufacturer's labeling; not studied Restless legs syndrome Immediate release CrCl >60 mL/min: Dosasge adjustment not necessary CrCl 20-60 mL/min: Dosage adjustment not necessary but duration between titration should be increased to 14 days CrCl<20 mL/min: Dosage adjustment not provided by manufacturer's labeling; not studied

Inhibits active tubular secretion of basic cationic drugs eg, cimetidine. Reduced clearance w/ drugs eliminated by active renal tubular secretion eg, amantadine. Alcohol & other sedatives.

Hypersensitivity. Lactation.

Common - Dizziness - Sleepiness - Nausea - Dryness in mouth - Fatigue - Hallucination - Constipation - Peripheral edema >10% Somnolence,Dyskinesia,Hallucinations,Insomnia,Dizziness,Postural hypotension,Nausea,Constipation 1-10% (partial list) Abnormal dreams, thoughts, or vision,Amnesia,Confusion,Paranoia or delusion,Akathisia,Asthenia,Dry mouth

Precaution: Psychotic disorder, severe CV disease, augmentation (earlier onset, increase and spread of symptoms). Risk of neuroleptic malignant syndrome w/ abrupt withdrawal. Taper dose at 750 mcg/day for a wk, then reduce by 375 mcg/day thereafter. Renal impairment. Pregnancy and lactation. Patient Counselling Patients should be informed to refrain from activities involving mental alertness and physical coordination after drug intake. Monitoring Parameters Monitor BP, signs and symptoms of fibrosis and orthostatic hypotension, development of impulse control disorder, behavioural changes. Perform periodic skin examinations. Regular ophthalmological testing due to risk of visual disorders.

Pramipexole is a nonergot-derivative dopamine receptor agonist which alleviates Parkinsonian motor deficits by directly stimulating postsynaptic dopamine activity on the striatum and substantia nigra It is used as an adjunct to levodopa for the symptomatic management of parkinsonian syndrome in patients w/ advanced disease. It is also used as monotherapy for the initial symptomatic management of parkinsonian syndrome.