Pramipexole | Side Effects, Dosage, Uses & More

Generic Name:

pramipexole, Oral tablet

All Brands

  • Mirapex
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Highlights for pramipexole

Oral tablet
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Pramipexole is used to treat Parkinson’s disease and restless legs syndrome.

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This drug is available as an immediate-release and extended-release tablet you take by mouth. The immediate-release and extended-release tablets are used to treat Parkinson’s disease. The immediate-release form of the drug is also used treat restless legs syndrome.

3

Pramipexole is available as the brand-named drugs Mirapex and Mirapex ER. It’s also available as a generic drug.

4

The more common side effects of this drug include drowsiness, nausea, dizziness, confusion, constipation, and dry mouth.

5

In some cases, pramipexole can cause serious side effects. This drug may cause you to fall asleep suddenly. You shouldn’t drive, use machinery, or do other activities that require alertness until you know how this drug affects you.

IMPORTANT INFORMATION

Falling asleep suddenly

This drug may cause you to fall asleep suddenly while doing activities. This may happen without warnings signs, such as drowsiness. Talk to your doctor about driving, using machinery, or doing other activities that require alertness while you take this drug.

Dizziness and fainting

This drug can cause dizziness, lightheadedness, nausea, sweating, or fainting, especially when you stand up quickly from a sitting or lying down position. This is more likely to occur when you first start taking this drug. To reduce your risk, stand up slowly. These side effects may go away over time.

Impulsive or compulsive behaviors

You may have increased urges to gamble, binge eat, or engage in sexual behaviors while taking this drug. If this happens, tell your doctor. They may decrease your dose or have you stop taking this drug.

Hallucinations or psychotic-like behavior

This drug may cause you to have hallucinations (seeing or hearing things that aren’t real) or changes in your behavior. You may feel confused, agitated, or aggressive. If this happens, tell your doctor. They may decrease your dose or have you stop taking this drug.

Drug features

Pramipexole is a prescription drug. It’s available as an immediate-release and extended-release tablet you take by mouth.

Pramipexole is available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Pramipexole may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it’s used

Pramipexole is used to control the symptoms of Parkinson’s disease. This includes trouble with muscle control, movement, and balance.

More Details

How it works

Pramipexole belongs to a class of drugs called dopamine agonists. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

More Details

Why it’s used

Pramipexole is used to control the symptoms of Parkinson’s disease. This includes trouble with muscle control, movement, and balance.

It’s also used to treat the symptoms of restless legs syndrome. This includes discomfort in your legs and a strong desire to move your legs, especially when sitting down or lying in bed.

How it works

Pramipexole belongs to a class of drugs called dopamine agonists. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Pramipexole works by activating certain receptors in your brain. This helps decrease the severity of Parkinson’s disease and restless legs syndrome.

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pramipexole Side Effects

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More common side effects

The more common side effects of pramipexole include:

  • nausea

  • loss of appetite

  • diarrhea

  • constipation

  • unusual body movements

  • weakness

  • dizziness and drowsiness

  • confusion

  • strange thoughts or dreams

  • dry mouth

  • needing to urinate more often or an increased urgency to urinate

  • increased interest in sex

  • swelling in your legs or arms

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Rhabdomyolysis (muscle breakdown). Symptoms can include:

    • dark-colored urine
    • muscle weakness, soreness, or stiffness
  • Hallucinations. Symptoms can include:

    • seeing things that don’t exist
    • hearing things that don’t exist
  • Psychotic-like behavior. Symptoms can include:

    • confusion
    • unusual behavior, such as aggression, agitation, and delirium
    • extreme aggression
  • Vision issues. Symptoms can include:

    • changes in vision that make it harder for you to see
Pharmacist's Advice
Healthline Pharmacist Editorial Team

The use of drinks that contain alcohol can increase the drowsiness caused by pramipexole. You may be more likely to fall asleep without warning. If you drink alcohol, talk to your doctor.

Pramipexole may cause drowsiness. You shouldn’t drive, use machinery, or do other activities that require alertness until you know how this drug affects you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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pramipexole May Interact with Other Medications

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Pramipexole can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interactions

The use of drinks that contain alcohol can increase drowsiness you may experience with pramipexole. If you drink alcohol, talk to your doctor.

Medications that might interact with this drug

Mental health and nausea drugs

These drugs can work against pramipexole. This means it won’t work as well to treat your condition.

These drugs include:

  • metoclopramide
  • phenothiazines, such as:
    • chlorpromazine
    • fluhenazine
    • perphenazine
    • prochlorperazine
    • thioridazine
    • trifluoperazine
  • butyrophenones, such as:
    • droperidol
    • haloperidol

Sleep aid drugs

Taking pramipexole with other drugs that make you sleepy may increase your risk of drowsiness or falling asleep suddenly during the day.

These drugs include:

  • diphenhydramine
  • zolpidem

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with Parkinson’s disease

You may be at greater risk for developing melanoma while taking this drug. This is a type of skin cancer. It isn’t known if medications used to treat Parkinson’s disease increase the risk of melanoma. Talk to your doctor about this risk.

People with kidney disease

You may have a higher risk of side effects. If you have kidney problems, talk to your doctor. Your doctor might change your dose.

Pregnant women

Pramipexole is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

Pramipexole may pass into breast milk and may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

For children

This drug hasn’t been studied in and shouldn’t be used in children younger than 18 years of age.

When to call the doctor

Call your doctor if your symptoms of Parkinson’s disease (uncontrolled movements) get worse while you’re taking pramipexole.

Allergies

Pramipexole can cause a severe allergic reaction. Symptoms can include:

  • rash
  • hives
  • itching
  • red, swollen, blistered, or peeling skin with or without a fever
  • wheezing
  • trouble breathing or talking
  • unusual hoarseness
  • swelling of your mouth, face, lips, tongue, or throat

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take pramipexole (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Parkinson’s disease

Generic: pramipexole

Form: Oral immediate-release tablet
Strengths: 0.125 mg, 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg
Form: Oral extended-release tablet
Strengths: 0.375 mg, 0.75 mg, 1.5 mg, 2.25 mg, 3 mg, 3.75 mg, 4.5 mg

Brand: Mirapex

Form: Oral immediate-release tablet
Strengths: 0.125 mg, 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg

Brand: Mirapex ER

Form: Oral extended-release tablet
Strengths: 0.375 mg, 0.75 mg, 1.5 mg, 2.25 mg, 3 mg, 3.75 mg, 4.5 mg
Adult dosage (18 years and older)
  • Immediate-release tablets:
    • Week 1: 0.125 mg taken 3 times per day
    • Week 2: 0.25 mg taken 3 times per day
    • Week 3: 0.5 mg taken 3 times per day
    • Week 4: 0.75 mg taken 3 times per day
    • Week 5: 1 mg taken 3 times per day
    • Week 6: 1.25 mg taken 3 times per day
    • Week 7: 1.5 mg taken 3 times per day
  • Extended-release tablets:
    • Standard starting dose: 0.375 mg taken once per day
    • Dose increases: Your doctor may increase your dose every 5–7 days.
    • Maximum dose: 4.5 mg taken once per day
Child dosage (ages 0–17 years)

This drug hasn’t been consistently studied and shown to be safe and effective in children younger than 18 years of age. This drug shouldn’t be used in children younger than 18 years of age.

Special considerations

Kidney disease:

  • Immediate-release tablets: Depending on how your kidneys are working, your doctor may have you take pramipexole tablets 3 times per day, 2 times per day, or once per day.
  • Extended-release tablets: The dose is 0.375 mg taken every other day. Your doctor might increase your dose to 0.375 mg every day a week later. The maximum dose is 2.25 mg taken once per day.

Warnings

If you stop taking this drug for a long time and need to start taking it again, you may have to start taking it at a lower dose and slowly work up to the dose you were taking.

Moderate to severe primary restless legs syndrome

Generic: pramipexole

Form: Oral immediate-release tablet
Strengths: 0.125 mg, 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg

Brand: Mirapex

Form: Oral immediate-release tablet
Strengths: 0.125 mg, 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg
Adult dosage (18 years and older)
  • Immediate-release tablets:
    • Standard starting dose: 0.125 mg taken once per day in the evening 2–3 hours before going to bed
    • Dose increases: If needed, your doctor may increase your dose every 4–7 days.
    • Maximum dose: 0.5 mg taken once per day in the evening
Child dosage (ages 0–17 years)

This drug hasn’t been consistently studied and shown to be safe and effective in children younger than 18 years of age. This drug shouldn’t be used in children younger than 18 years of age.

Special considerations

Kidney disease:

  • Immediate-release tablets: Your doctor shouldn’t increase your dose more than once every 14 days.

Warnings

If you stop taking this drug for a long time and need to start taking it again, you may have to start taking it at a lower dose and slowly work up to the dose you were taking.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Pramipexole comes with risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all

Your condition may suddenly get worse if you stop taking pramipexole. Your condition won’t improve if you don’t take the drug at all.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • headache
  • nasal congestion
  • dry mouth
  • nausea
  • vomiting
  • flushing (reddening and warming of your skin)
  • coughing
  • fatigue
  • visual hallucinations (seeing something that isn’t there)
  • heavy sweating
  • claustrophobia
  • unusual movements in your shoulders, hips, and face
  • palpitations (feeling like your heart is skipping a beat)
  • lack of energy
  • nightmares

If you think you’ve taken too much of the drug, act right away. Call your doctor or local poison control center, or go to the nearest emergency room.

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

Your symptoms of Parkinson’s disease or restless legs syndrome will improve.

Pramipexole is used for long-term treatment.

Important considerations for taking pramipexole
You can take pramipexole with or without food You can take pramipexole with or without food
Take pramipexole 2–3 hours before bedtime if you’re taking it for restless legs syndrome Take pramipexole 2–3 hours before bedtime if you’re taking it for restless legs syndrome
You can cut or crush the immediate-release tablets. You cannot cut the extended-release tablets You can cut or crush the immediate-release tablets. You cannot cut the extended-release tablets
Store pramipexole at room temperature Store pramipexole at room temperature See Details
A prescription for this medication is refillable A prescription for this medication is refillable See Details
Travel  Travel See Details
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead. Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
Insurance Insurance See Details

Store pramipexole at room temperature

Keep it from 59°F to 86°F (15°C to 30°C). Keep it away from high temperatures.

Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

What does the pill look like?

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How Much Does pramipexole Cost?

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Lowest price for pramipexole

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These prices represent the lowest priced national pharmacies for pramipexole on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for pramipexole on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on November 30, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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