#特殊劑型：不建議磨粉、管灌藥品

Treatment of the signs and symptoms of Parkinson's disease.
#仿單變更2021

Pramipexole is a non-ergot dopamine agonist and binds with high selectivity and specificity to the dopamine D2 receptors and has a preferential affinity to D3 receptors; it has full intrinsic activity.

Bioavailability: >90 % , protein binding: very low (<20 %); the volume of distribution is large (400 L). Renal excretion of unchanged pramipexole is the major route of elimination and accounts for about 80% of dose. Elimination half-life: 8-12 hr. Pramipexole is not removed by hemodialysis.

Hypersensitivity to pramipexole or any other component of the product

C

Avoid

In early Parkinson’s disease patients: somnolence, nausea, constipation, dizziness, fatigue, hallucinations, dry mouth, muscle spasms, and peripheral edema.
In advanced Parkinson’s disease patients with concomitant levodopa: dyskinesia, nausea, constipation, hallucinations, headache, and anorexia.

1. The starting dose is 0.375 mg given once per day.
2. Based on efficacy and tolerability, dosages may be increased gradually, not more frequently than every 5 to 7 days, first to 0.75 mg per day and then by 0.75 mg increments up to a maximum recommended dose of 4.5 mg per day.
3. Administer with or without food; administer with food to decrease nausea. Extended-release tablets should be swallowed whole and not chewed, crushed, or divided.
4. Taper gradually when discontinuing therapy in patients with Parkinson disease; dopaminergic agents have been associated with a syndrome resembling neuroleptic malignant syndrome on abrupt withdrawal or significant dosage reduction after long-term use. <20210510>
5. Discontinuation of therapy: Do not discontinue abruptly; the manufacturer of the IR and ER formulations recommends reducing dose by 0.75 mg/day until daily dose is 0.75 mg, then reducing by 0.375 mg/day thereafter.<20231101>

• CrCl 30 to 50 mL/minute: Initial: 0.375 mg every other day; may increase to 0.375 mg once daily no sooner than 1 week after initiation.If necessary, may increase by 0.375 mg per dose not more frequently than every 7 days; maximum recommended dose: 2.25 mg once daily.
• CrCl <30 mL/minute: Use not recommended.
• ESRD requiring hemodialysis: Use not recommended.