Indications 

Mirapex is a prescription medication used to alleviate Parkinson’s disease (PD) symptoms such as tremors, muscle rigidity, slowed movements, and impaired balance, either as a standalone treatment or in combination with other medications. 

Mirapex is also prescribed for treating moderate-to-severe primary restless legs syndrome (RLS), a condition characterized by leg discomfort and an irresistible urge to move the legs, particularly during periods of inactivity or at night. 

As a non-ergot dopamine agonist, Mirapex helps restore the balance of dopamine in the brain, a vital neurotransmitter necessary for movement regulation. 

Uses and Dosage 

Before taking Mirapex and every time you get a refill, thoroughly read its medication guide and patient information leaflet. Do not hesitate to consult your doctor or pharmacist if you have any questions or concerns. 

The dosage of Mirapex depends on the patient’s medical condition and response to treatment.  

Typically, doctors initiate treatment with a low dose and gradually increase it, usually at intervals of 4 to 7 days. It may take a few weeks to achieve the optimal dose. 

Mirapex is available in tablet and extended-release tablet forms with varying administration instructions. If provided with different instruction by your doctor, adhere to it strictly.  

For treating PD, Mirapex tablets are usually taken three times daily, and extended-release tablets are taken once daily. However, extended-release tablets are not prescribed for treating RLS. For RLS treatment, Mirapex tablets are taken once a day, 2 to 3 hours before bedtime. 

Mirapex can be taken with or without food but taking it with food may prevent medication-induced nausea. 

Extended-release tablets should be swallowed whole, not cut, crushed, or chewed.  

Take Mirapex regularly, exactly as directed, around the same time daily. Avoid taking a larger or smaller dose than prescribed or more often than instructed. 

Consult your doctor before discontinuing this medication, as sudden cessation may worsen certain conditions and cause withdrawal symptoms. 

If you discontinue Mirapex, do not resume intake without consulting your doctor. Your doctor will likely recommend a gradual increase in dosage. 

Side Effects 

Listed below are the possible side effects of Mirapex. Tell your doctor promptly if any of them last or worsen. 

Common Side Effects 

• Muscle spasms or weakness 
• Drowsiness, dizziness, and weakness 
• Confusion and memory problems 
• Dry mouth 
• Nausea and constipation 
• Increased urination 
• Sleep problems:
  • Insomnia
  • Unusual dreams 

Serious Side Effects 

• A light-headed feeling with the potential of passing out 
• Hallucinations  
• Extreme drowsiness  
• Sudden onset of sleep even when feeling alert 
• Tremors, twitching, or involuntary muscle movements 
• Unexplained muscle pain, tenderness, or weakness 
• Vision problems 
• Involuntary posture changes such as: 
  • Bending forward of the neck or waist 
  • Tilting sideways while sitting, standing, or walking 

Call your doctor immediately if you experience any of the severe symptoms listed above. 

Heightened sexual impulses, unusual gambling tendencies, or other strong urges may occur while using this medication. Consult your doctor if you experience any of them. 

Allergic Reactions 

Rare but severe allergic reactions may occur while taking Mirapex. Notify your physician immediately if you observe any of the following symptoms: 

• Rash 
• Facial, tongue, or throat itching or swelling 
• Severe dizziness 
• Trouble breathing 

This list of Mirapex side effects is not comprehensive. Inform your doctor promptly if you encounter any unlisted symptoms that cause discomfort. 

Cautions 

Before starting treatment with Mirapex, inform your healthcare provider or pharmacist of any known hypersensitivities, particularly to pramipexole, any other medications, or any ingredients present in Mirapex tablets and extended-release tablets. 

To ensure that Mirapex is safe for you, disclose your medical history to your doctor, particularly of:  

• Hypotension (low blood pressure) 
• Heart problems such as: 
  • Irregular heartbeat 
  • Heart failure 
• Kidney problems 
• Mental/mood disorders such as: 
  • Confusion 
  • Hallucinations 
  • Psychosis 
  • Schizophrenia 
• Sleep disorders such as:  
  • Sleep apnea 
  • Narcolepsy 

Before taking Mirapex, tell your doctor and pharmacist about all your medications, including prescription and over-the-counter medicines, vitamins, and herbal products, to prevent any drug interactions. 

Some products that may interact with Mirapex include:  

• Antipsychotics such as: 
  • Chlorpromazine 
  • Haloperidol 
  • Thiothixene 
• Cimetidine 
• Metoclopramide 

Review the labels of all your medications, including cough-and-cold or allergy products, as they may contain ingredients that cause drowsiness. Consult your pharmacist to ensure the safe use of these products. 

In addition, inform your doctor or pharmacist if you use other products that induce drowsiness, such as: 

• Alcohol 
• Cannabis 
• Antihistamines 
• Sleep or anxiety medications 
• Muscle relaxants 
• Opioid pain relievers 

Mirapex can induce drowsiness or sudden episodes of falling asleep during regular activities. Refrain from driving or operating machinery at the beginning of treatment until the effects of pramipexole are known. 

Mirapex may cause dizziness, lightheadedness, nausea, fainting, or sweating when standing up quickly from a seated or lying position, particularly when initiating or escalating the dosage. To avoid these symptoms, rise slowly from the bed or chair, and rest your feet on the ground for a few minutes before standing up. 

If taking extended-release tablets, you may notice enlarged tablet fragments or entire tablets in your stool. If this occurs, in particular in conjunction with the exacerbation of Parkinson’s disease symptoms, contact your doctor. 

The effects of Mirapex on a developing fetus are unknown. Notify your doctor if you are pregnant or plan to conceive while taking this medication. 

It is unclear if pramipexole passes into the breast milk or endangers nursing infants. Discuss with your doctor before nursing while taking this medication.