Clinical and pharmacological group: & nbsp

Dopaminomimetics

Anti-Parkinsonics

Included in the formulation
  • Mipexol®
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  • Mirapex®
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  • Mirapex® PD
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  • Pramipexole
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  • Pramipexole
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  • Pramipexol-Teva
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  • Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):

    VED

    ONLS

    АТХ:

    N.04.B.C.05   Pramipexole

    Pharmacodynamics:

    The drug is an agonist of dopamine receptors, stimulates dopamine receptors in the striatum. It is also assumed that the drug is able to inhibit the secretion of prolactin in humans.

    Pharmacokinetics:

    Quickly absorbed from the gastrointestinal tract, eating does not affect the absorption of the drug. Maximum concentration in plasma is reached after about 2 hours. Absolute bioavailability of pramipexole exceeds 90%. The connection with plasma proteins is 15%, the drug accumulates in erythrocytes. The half-life is 8 hours, in elderly patients - 12 hours. The drug is not biotransformation, excreted by the kidneys (90%).

    Indications:

    Parkinson's disease (in the form of monotherapy and in combination with levodopa).

    Symptomatic treatment of idiopathic syndrome of restless legs.

    VI.G20-G26.G20   Parkinson's disease

    VI.G20-G26.G21   Secondary Parkinsonism

    Contraindications:

    Hypersensitivity. Age to 18 years.

    Carefully:
    • Arterial hypotension
    • Kidney Diseases
    • Severe cognitive impairment
    • Visual disturbances
    • Severe diseases of the cardiovascular system
    • Pregnancy
    • Lactation
    Pregnancy and lactation:

    Category FDA - C. Adequate and strictly controlled studies of the safety of pramipexole during pregnancy have not been conducted. It is believed that the application is possible in cases where the intended use for the mother exceeds the potential risk to the fetus.

    It is not known whether pramipexole with breast milk. If necessary, use during lactation should stop breastfeeding.

    Dosing and Administration:

    Adults: an initial dose of 375 mcg per day for 3 doses. Every 5-7 days the dose should be increased to achieve the maximum therapeutic effect (usually at a dose of 1.5-4.5 mg per day).

    If the patient has kidney disease, the initial dose should be 125 mcg per day, the frequency of reception 1-3 times a day.

    The maximum single dose of 1.5 mg.

    The cessation of treatment should be gradual, usually within 1 week.

    Side effects:

    From the nervous system: asthenia, drowsiness or insomnia, hallucinations, delirium, amnesia, confusion, dizziness, anxiety, depression, dysphagia, dystonia, akathisia, thinking disorders, suicidal tendencies, extrapyramidal syndrome, dyskinesia, tremor, hyposthenia, hypokinesia, myoclonus, ataxia, coordination disorder movements, diplopia, paralysis of accommodation, conjunctivitis, hearing impairment; in isolated cases (with a rapid dose reduction or abrupt withdrawal) - malignant neuroleptic syndrome (hyperthermia, muscle rigidity, impaired consciousness, autonomic lability).

    From the side of the cardiovascular system: arterial hypotension, orthostatic hypotension, tachycardia, arrhythmia.

    From the gastrointestinal tract: constipation, nausea.

    From the musculoskeletal system: hypertonic muscle, muscle cramps in the legs, muscle twitching, myasthenia gravis, arthritis,bursitis.

    On the part of the respiratory system: shortness of breath, rhinitis, pharyngitis, sinusitis, flu-like syndrome, coughing.

    Other: fever; peripheral edema, sweating, increased intraocular pressure, decreased libido, impotence, weight loss; increased frequency of urination, urinary tract infections; pain syndrome, including pain in the chest, abdominal pain, pain in the lumbosacral spine, pain in the neck; change of voice; increased activity creatine phosphokinase; allergic reactions.

    Overdose:

    Symptoms: nausea, vomiting, hyperkinesia, hallucinations, agitation, lowering blood pressure.

    Treatment symptomatic: gastric lavage, maintenance therapy - intravenous liquid injection, control ECG; when signs of excitement appear CNS neuroleptics (phenothiazines, butyrophenones) may be indicated. The specific antidote is unknown.

    Interaction:

    Cimetidine - increases the bioavailability of the drug by 50%, diltiazem, verapamil, triamterene, quinine, quinidine (drugs, which are secreted by the cationic transport system of the kidneys) - by 20%.

    Dopamine receptor antagonists neuroleptics (phenothiazines, butyrophenones, thioxanthenes and metoclopramide) reduce the effectiveness of the drug.

    Levdopa - an increase in the plasma concentration of levodopa by 40%.

    Special instructions:

    Patients should be warned about the risk of hallucinations (especially elderly patients), the possibility of developing orthostatic hypotension (at the beginning of treatment or with increasing doses). Caution is prescribed in patients with a history of renal insufficiency. The abolition of pramipexole is recommended to be carried out gradually (within 1 weeks).

    Impact on the ability to drive vehicles and manage mechanisms

    Do not use during work drivers of vehicles and people whose profession is associated with increased concentration of attention.

    Instructions
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