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Permax (pergolide) Disease Interactions

There are 5 disease interactions with Permax (pergolide):

Major

Dopamine agonists (applies to Permax) hypotension

Major Potential Hazard, High plausibility.

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension, especially during dose escalation. Therapy with dopamine agonists should be monitored carefully in patients with Parkinson's disease since they may have an impaired ability to respond to an orthostatic challenge, and also in patients receiving antihypertensive drugs.

References

  1. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  2. Iwasaki S, Hamaguchi K, Iwasaki A, Takakusagi M, Narabayashi Y "Hypotensive effect of long-term levodopa in patients with Parkinson's disease." Eur Neurol 30 (1990): 194-9
  3. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim, Ridgefield, CT.
  4. Hoehn MM "Levodopa-induced postural hypotension. Treatment with fludrocortisone." Arch Neurol 32 (1975): 50-1
  5. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn, Kalamazoo, MI.
  6. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
View all 6 references
Major

Dopamine agonists (applies to Permax) neuroleptic malignant syndrome

Major Potential Hazard, Low plausibility.

The use of dopamine agonists is contraindicated in patients with neuroleptic malignant syndrome (NMS). NMS is characterized by hyperthermia, muscle rigidity, altered mental status, irregular pulse or blood pressure, tachycardia, and diaphoresis. The syndrome may rarely be precipitated by abrupt discontinuation of the dopamine agonist.

References

  1. Gibb WR, Griffith DN "Levodopa withdrawal syndrome identical to neuroleptic malignant syndrome." Postgrad Med J 62 (1986): 59-60
  2. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim, Ridgefield, CT.
  3. Genis D "Neuroleptic malignant syndrome: impaired dopaminergic systems?" Neurology 35 (1985): 1806
  4. Rainer C, Scheinost NA, Lefeber EJ "Neuroleptic malignant syndrome. When levodopa withdrawal is the cause." Postgrad Med 89 (1991): 175-8,
  5. Friedman JH, Feinberg SS, Feldman RG "A neuroleptic malignantlike syndrome due to levodopa therapy withdrawal." JAMA 254 (1985): 2792-5
View all 5 references
Major

Dopamine agonists (applies to Permax) psychoses/depression

Major Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis

The use of dopamine agonists has been associated with psychiatric effects such as hallucinations, psychosis, confusion, anxiety, mania, hypomania, depression, rapid mood cycling, nightmares, and hypersexuality. Therapy with dopamine agonists should be administered cautiously in psychotic patients and all patients should be carefully observed for development of depression and suicidal tendencies.

References

  1. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
  2. Glantz RH, Bieliauskas L, Paleologos N "Behavioral indicators of hallucinosis in levodopa-treated Parkinson's disease." Adv Neurol 45 (1987): 417-20
  3. Maricle RA, Nutt JG, Carter JH "Mood and anxiety fluctuation in parkinson's disease associated with levodopa infusion: preliminary findings." Mov Disord 10 (1995): 329-32
  4. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  5. Ryback RS, Schwab RS "Manic response to levodopa therapy. Report of a case." N Engl J Med 285 (1971): 788-9
  6. Nausieda PA, Glantz R, Weber S, Baum R, Klawans HL "Psychiatric complications of levodopa therapy of Parkinson's disease." Adv Neurol 40 (1984): 271-7
  7. Banerjee AK, Falkai PG, Savidge M "Visual hallucinations in the elderly associated with the use of levodopa." Postgrad Med J 65 (1989): 358-61
  8. Vazquez A, Jimenez-Jimenez FJ, Garcia-Ruiz P, Garcia-Urra D ""Panic attacks" in Parkinson's disease. A long-term complication of levodopa therapy." Acta Neurol Scand 87 (1993): 14-8
  9. Friedman JH "The management of the levodopa psychoses." Clin Neuropharmacol 14 (1991): 283-95
  10. Ko GN, Leckman JF, Heninger GR "Induction of rapid mood cycling during L-dopa treatment in a bipolar patient." Am J Psychiatry 138 (1981): 1624-5
  11. Harsch HH, Miller M, Young LD "Induction of mania by L-dopa in a nonbipolar patient." J Clin Psychopharmacol 5 (1985): 338-9
View all 11 references
Major

Dopaminergic antiparkinson agents (applies to Permax) psychosis

Major Potential Hazard, Moderate plausibility.

Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinson agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs.

Major

Pergolide (applies to Permax) cardiac valve disease/arrhythmias

Major Potential Hazard, Moderate plausibility. Applicable conditions: Valvular Heart Disease

The use of pergolide has been shown to increase the risk of cardiac valvular disease involving one or more valves. Some patients have required valve replacement, and deaths have been reported. Specific risk factors predisposing patients to developing cardiac valvular disease with pergolide have not been identified. Cardiac valvulopathy has been reported with all doses of pergolide; however, available data suggest that the risk may be greater with higher doses. Pergolide is not recommended for use in patients with a history of cardiac valvulopathy. Additionally, caution should be exercised when administering pergolide to patients prone to cardiac dysrhythmias. Before initiating treatment with pergolide, all patients should undergo a cardiovascular evaluation, including an echocardiogram, to determine whether valvular disease is present and to provide a baseline for subsequent monitoring.

References

  1. Ahlskog JE, Muenter MD "Treatment of Parkinson's disease with pergolide: a double-blind study." Mayo Clin Proc 63 (1988): 969-78
  2. Lamberts SW, Quik RF "A comparison of the efficacy and safety of pergolide and bromocriptine in the treatment of hyperprolactinemia." J Clin Endocrinol Metab 72 (1991): 635-41
  3. Robin DW "Pergolide in the treatment of Parkinson's disease." Am J Med Sci 301 (1991): 277-80
  4. "Product Information. Permax (pergolide)." Athena Neurosciences Inc, South San Francisco, CA.
  5. Ahlskog JE, Muenter MD "Pergolide: long-term use in Parkinson's disease." Mayo Clin Proc 63 (1988): 979-87
  6. Pezzoli G, Martignoni E, Pacchetti C, Angeleri VA, Lamberti P, Muratorio A, Bonuccelli U, Demari M, Foschi N, Cossutta E, Nicolet "Pergolide compared with bromocriptine in parkinsons disease - a multicenter, crossover, controlled study." Mov Disord 9 (1994): 431-6
  7. Olanow CW, Alberts MJ "Double-blind controlled study of pergolide mesylate in the treatment of Parkinson's disease." Clin Neuropharmacol 10 (1987): 178-85
View all 7 references

Permax (pergolide) drug interactions

There are 248 drug interactions with Permax (pergolide)

Permax (pergolide) alcohol/food interactions

There is 1 alcohol/food interaction with Permax (pergolide)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.