Mirapex (Pramipexole)

Do’s

• Before starting Mirapex, review the Patient Information Leaflet from your pharmacist. If you have any queries, seek clarification from your healthcare provider.
• This medication should be taken orally, with or without food, as per your healthcare provider's instructions. Taking it with food can help reduce nausea.
• Your healthcare provider may advise initiating the medication at a low dose and gradually increasing it to minimize the risk of side effects such as drowsiness and low blood pressure. Adhere to their instructions diligently.
• The appropriate dosage is determined based on your medical condition and your response to the treatment. Use this medication regularly to derive the maximum benefit. Taking it at the same time(s) each day can help you remember.
• If you temporarily cease taking this medication, it may be necessary to recommence at a low dose and gradually increase it. Consult your healthcare provider for guidance on restarting this medication.
• The effects of this medication may take a few weeks to become noticeable. If there is no improvement in your condition or if it worsens, promptly inform your healthcare provider

Don’ts

• Do not exceed the prescribed dosage or take this medication more frequently than directed.
• Do not discontinue this medication without consulting your healthcare provider. Abruptly stopping the medication may exacerbate certain conditions. Furthermore, withdrawal symptoms such as anxiety, depression, confusion, fever, and muscle stiffness may manifest if usage is suddenly halted. To mitigate the risk of withdrawal, your healthcare provider may recommend a gradual reduction in dosage, particularly if you have been using Mirapex for an extended period or in high doses.

• Muscle spasms or weakness
• Drowsiness, dizziness, weakness
• Confusion, memory problems
• Dry mouth
• Nausea, constipation
• Increased urination
• Sleep problems (insomnia), unusual dreams
• Worsening of Restless Legs Syndrome (RLS) in some cases
• Augmentation
• Nausea and vomiting
• Fatigue
• Swelling of the feet
• Orthostatic hypotension (drop in blood pressure upon standing)
• Hallucinations or confusion
• Dyskinesias (spontaneous involuntary movements)
• Potential risk of heart failure

This is not an exhaustive list of side effects, and others may occur. If you experience any unusual symptoms, seek medical advice promptly.

Since Mirapex is a dopamine agonist, dopamine antagonists such as neuroleptics or metoclopramide may diminish its effectiveness. 

Patients may develop postural (orthostatic) hypotension, with or without symptoms such as dizziness, nausea, fainting, or blackouts, especially at the initiation of treatment with Mirapex ER. Caution against rising rapidly after sitting or lying down is advised. 

Patients should be alerted about the potential for impulse control symptoms while taking Mirapex, including compulsive behaviors.

In animal studies, Mirapex caused damage to the retinas of the eyes in rats. Similar problems have been reported in human studies, but it is unclear if the risks are greater in people taking the drug, compared to the general public. 

In clinical trials, patients reported a worsening of restless legs syndrome (RLS) symptom severity when Mirapex treatment was suddenly withdrawn. 

This is not an exhaustive list of warnings and precautions. Consult with a healthcare provider for personalized advice and review the Patient Information Leaflet for comprehensive information.