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Mirapex ER Disease Interactions

There are 4 disease interactions with Mirapex ER (pramipexole).

Major

Dopamine agonists (applies to Mirapex ER) hypotension

Major Potential Hazard, Moderate 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. Hoehn MM (1975) "Levodopa-induced postural hypotension. Treatment with fludrocortisone." Arch Neurol, 32, p. 50-1
  2. Iwasaki S, Hamaguchi K, Iwasaki A, Takakusagi M, Narabayashi Y (1990) "Hypotensive effect of long-term levodopa in patients with Parkinson's disease." Eur Neurol, 30, p. 194-9
  3. (2001) "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn
  4. (2001) "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals
  5. (2001) "Product Information. Sinemet CR (carbidopa-levodopa)." DuPont Pharmaceuticals
  6. (2001) "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim
  7. (2001) "Product Information. Requip (ropinirole)." SmithKline Beecham
  8. (2001) "Product Information. Comtan (entacapone)." Novartis Pharmaceuticals
  9. (2006) "Product Information. Azilect (rasagiline)." Teva Pharmaceuticals USA
  10. (2007) "Product Information. Neupro (rotigotine)." Schwarz Pharma
  11. (2017) "Product Information. Xadago (safinamide)." US WorldMeds LLC
View all 11 references
Major

Dopamine agonists (applies to Mirapex ER) 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. Friedman JH, Feinberg SS, Feldman RG (1985) "A neuroleptic malignantlike syndrome due to levodopa therapy withdrawal." JAMA, 254, p. 2792-5
  2. Genis D (1985) "Neuroleptic malignant syndrome: impaired dopaminergic systems?" Neurology, 35, p. 1806
  3. Rainer C, Scheinost NA, Lefeber EJ (1991) "Neuroleptic malignant syndrome. When levodopa withdrawal is the cause." Postgrad Med, 89, 175-8,
  4. Gibb WR, Griffith DN (1986) "Levodopa withdrawal syndrome identical to neuroleptic malignant syndrome." Postgrad Med J, 62, p. 59-60
  5. (2001) "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim
View all 5 references
Major

Dopaminergic antiparkinson agents (applies to Mirapex ER) 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.

References

  1. (2001) "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn
  2. (2001) "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim
  3. (2001) "Product Information. Requip (ropinirole)." SmithKline Beecham
  4. (2001) "Product Information. Comtan (entacapone)." Novartis Pharmaceuticals
  5. (2001) "Product Information. Lodosyn (carbidopa)." DuPont Pharma
  6. (2006) "Product Information. Azilect (rasagiline)." Teva Pharmaceuticals USA
  7. (2007) "Product Information. Neupro (rotigotine)." Schwarz Pharma
  8. (2017) "Product Information. Xadago (safinamide)." US WorldMeds LLC
View all 8 references
Major

Pramipexole (applies to Mirapex ER) renal function disorders

Major Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

Pramipexole is eliminated by the kidneys, and approximately 90% of the drug is excreted unchanged in the urine. Renal insufficiency decreases the renal clearance and increases the half-life. Therapy with pramipexole should be administered cautiously and at a reduced dose in patients with compromised renal function. Pramipexole clearance is extremely low in dialysis patients, as a negligible amount of the drug is removed by it.

References

  1. Wright CE, Sisson TL, Ichhpurani AK, Peters GR (1997) "Steady-state pharmacokinetic properties of pramipexole in healthy volunteers." J Clin Pharmacol, 37, p. 520-5
  2. (2001) "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim

Mirapex ER drug interactions

There are 257 drug interactions with Mirapex ER (pramipexole).

Mirapex ER alcohol/food interactions

There is 1 alcohol/food interaction with Mirapex ER (pramipexole).

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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.

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