Indications
Parixol Tablet is used for:
Parkinson's disease, Restless leg syndrome
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)
Child Dose
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
Administration
May be taken with or without food. May be taken w/ meals to minimise GI side effects such as nausea.
Contra Indications
Hypersensitivity. Lactation.
Precautions
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.
Pregnancy-Lactation
There are no adequate data on the developmental risk associated with therapy in pregnant women; no adverse developmental effects reported in animal studies in which pramipexole was administered to rabbits during pregnancy; effects on embryofetal development could not be adequately assessed in pregnant rats; however, postnatal growth was inhibited at clinically relevant exposures
In the U.S. general population, the estimated background risk of major birth defects and of miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively; background risk of major birth defects and miscarriage for the indicated population is unknown
Lactation: Not known if drug secreted in breast milk; may inhibit milk production; discontinue drug, or do not nurse
Interactions
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.
Side Effects
Side effects of Pramipexol :
>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
Mode of Action
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.
Note
Parixol 180mcg Tablet generic name is Pramipexol. Parixol 180mcg Tablet is manufactured by ACI LimitedParixol is availble in all over Bangladesh.
Mes BD drug index information on Parixol Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.