Precautions and Warnings With Pramipexole

It is important to understand precautions and warnings with pramipexole before starting this medication. Certain existing medical conditions -- such as a sleep disorder, kidney disease, or low blood pressure -- need to be reported to your healthcare provider before you start pramipexole. Precautions and warnings also apply to people who have certain allergies and to women who are pregnant or breastfeeding.

Pramipexole: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking pramipexole dihydrochloride (Mirapex®) if you have:
  • A sleep disorder other than restless legs syndrome
  • Low blood pressure (hypotension)
  • Dyskinesia (a muscle movement disorder)
  • Kidney disease, including kidney failure (renal failure) or milder forms of kidney disease
  • Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Pramipexole

Warnings and precautions to be aware of prior to taking pramipexole include the following:
  • The medication may cause you to fall asleep during the day, sometimes without warning. This can be especially dangerous if you are driving a car or operating heavy machinery. Sometimes, this can happen long after you start taking pramipexole. Ask your healthcare provider if you should stop driving a car or operating heavy machinery while taking the drug.
  • Pramipexole can cause low blood pressure, especially when standing or sitting up too quickly. Take your time getting up, and let your healthcare provider know if you experience fainting or frequent dizziness while taking the drug.
  • The medication can cause hallucinations. This side effect is most common in people taking pramipexole for Parkinson's disease and in elderly people. It is not a rare side effect; in some studies, up to 16.5 percent of people taking pramipexole experienced hallucinations. Let your healthcare provider know if you develop hallucinations while taking the drug. Also, let your friends, family, or caretakers know about this potential side effect, as they may be better able to identify the problem.
  • There has been one case of rhabdomyolysis (a breakdown of muscle tissue that can lead to kidney damage) that may have been caused by pramipexole. If you experience any severe muscle pain or weakness while taking the drug, report this immediately to your healthcare provider.
  • Pramipexole can worsen dyskinesia (a movement disorder that is a common side effect of levodopa, another Parkinson's medication). If you take pramipexole with a medication that contains levodopa (Parcopa®, Sinemet®, Sinemet® CR, Stalevo®), your healthcare provider may need to decrease your levodopa dosage.
  • In animal studies, pramipexole caused damage to the retina of the eyes in rats. Similar problems have been reported in human studies, but it is unclear if the risks are greater in people taking the drug, compared to the general public.
  • Medications similar to pramipexole can cause serious problems if they are stopped too quickly. Signs of such problems include high fever, stiff muscles, and an altered state of consciousness. Although these problems have not been reported with pramipexole, the possibility cannot be ruled out.
  • The kidneys remove pramipexole from the body. Therefore, if your kidneys are not functioning well, your healthcare provider may recommend a lower pramipexole dosage.
  • Medications similar to pramipexole can cause serious lung, chest, and heart problems as the result of excessive formation of fibrous connective tissue. Rare cases of such problems have been reported, but it is not clear if these problems were caused by pramipexole or something else.
  • People with Parkinson's disease have a higher risk of melanoma (a type of skin cancer). It is not known if this is due to Parkinson's disease medications or to other factors. Although pramipexole does not seem to increase the risk of melanoma, it cannot be ruled out, and regular skin cancer screenings are recommended.
  • There have been a few reports of unusual compulsive behaviors, such as gambling, binge eating, or hypersexuality, in people taking pramipexole (see Mirapex and Gambling for more information). Let your healthcare provider know if you develop any such behaviors while taking the drug. Also, let your friends, family, or caretakers know about this potential side effect, as they may be better able to identify the problem.
  • Pramipexole can potentially interact with several medications (see Drug Interactions With Pramipexole).
  • Pramipexole is considered a pregnancy Category C medication. This means it may not be safe for use during pregnancy, although the full risks are not known (see Mirapex and Pregnancy).
  • It is not known whether pramipexole passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Mirapex and Breastfeeding).
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Pramipexole Dihydrochloride Information

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