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Pramipexole Dosing
The pramipexole dosing guidelines your healthcare provider will follow are based on several factors, such as how you respond to the medication and how well your kidneys function, among other things. Pramipexole dosing guidelines for treating Parkinson's disease and restless legs syndrome are different, so make sure to carefully follow your healthcare provider's instructions.
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The dose of pramipexole dihydrochloride (Mirapex®) that your healthcare provider recommends will vary, depending on a number of factors, including:
- How you respond to pramipexole (especially if you develop bothersome side effects)
- How well your kidneys function
- Other medications you are taking
- Other medical conditions you may have.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
The starting dose of pramipexole for treating restless legs syndrome (RLS) is pramipexole 0.125 mg once daily, taken two to three hours before bedtime. After four to seven days, your healthcare provider may increase the dose to pramipexole 0.25 mg once daily if your RLS symptoms are still bothersome. If necessary, your healthcare provider may further increase your dose to pramipexole 0.75 mg after another four to seven days.
If you have kidney disease, your healthcare provider should wait 14 days between dose increases. instead of the usual four to seven days.
Previously, it was thought that it was unnecessary to slowly taper the dose when stopping pramipexole for RLS (that it could usually be stopped "cold turkey"). However, one study showed that suddenly stopping pramipexole can cause RLS symptoms to "rebound" and become worse than they were originally. In order to prevent or lessen this effect, your healthcare provider may have you stop the medication gradually, rather than abruptly.
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD