Drug Information Table

Direct-acting Dopamine Receptor Agonists pramipexole (Mirapex)

Therapeutic Use
Relieves symptoms of
Parkinsons disease (PD)
Restless leg syndrome

Side/Adverse Effects

Administration
Give 3 hr before bedtime for
restless leg syndrome
When increasing dosage, allow
4 to 7 days between each
increase
Interventions

Patient Instructions

Nausea and other GI symptoms

Monitor for nausea

Inform patient that nausea can

lessen over time
Instruct patient to take drug
with food if nausea occurs

Drowsiness, sleep attacks

Monitor for drowsiness or

sudden sleepiness and keep
patient safe from accidents

Instruct patient to avoid driving

or performing activities that
require mental alertness if
drowsiness occurs
Advise patient to avoid alcohol
and other CNS depressants
which increase risk for
drowsiness
If taking once daily, make sure
patient is taking before bedtime

Muscle weakness

Monitor for muscle weakness

and prevent falls
Monitor blood CPK levels if
weakness occurs

Instruct patient to report muscle

weakness to provider

Orthostatic hypotension

Monitor cardiac status

Instruct patients to move slowly

to a sitting/standing position if
orthostatic hypotension occurs
Advise to notify provider if these
effects occur

Dyskinesias (abnormal muscle

movements)

Observe for abnormal muscle

movement/dyskinesia (tremors,
etc.)

Advise patient to notify provider

if these effects occur
If pramipexole is discontinued,
taper dosage slowly over 1
week

Contraindications
Allergy to pramipexole or
ropinirole

Precautions
Renal dysfunction
Existing compulsive behaviors
Children

Interactions
Cimetidine increases levels of
pramipexole
Metoclopramide and
phenothiazine antipsychotics
decrease therapeutic effect
Alcohol and other CNS
depressants increases risk for
adverse effects