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Mirapex (pramipexole) Disease Interactions

There are 4 disease interactions with Mirapex (pramipexole):

Major

Dopamine agonists (applies to Mirapex) 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. "Product Information. Sinemet CR (carbidopa-levodopa)." Dupont Pharmaceuticals, Wilmington, DE.
  2. "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. 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
  4. "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim, Ridgefield, CT.
  5. Hoehn MM "Levodopa-induced postural hypotension. Treatment with fludrocortisone." Arch Neurol 32 (1975): 50-1
  6. "Product Information. Sinemet (carbidopa-levodopa)." DuPont Pharmaceuticals, Wilmington, DE.
View all 6 references
Major

Dopamine agonists (applies to Mirapex) 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. Rainer C, Scheinost NA, Lefeber EJ "Neuroleptic malignant syndrome. When levodopa withdrawal is the cause." Postgrad Med 89 (1991): 175-8,
  4. Friedman JH, Feinberg SS, Feldman RG "A neuroleptic malignantlike syndrome due to levodopa therapy withdrawal." JAMA 254 (1985): 2792-5
  5. Genis D "Neuroleptic malignant syndrome: impaired dopaminergic systems?" Neurology 35 (1985): 1806
View all 5 references
Major

Dopaminergic antiparkinson agents (applies to Mirapex) 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

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

Mirapex (pramipexole) drug interactions

There are 230 drug interactions with Mirapex (pramipexole)

Mirapex (pramipexole) alcohol/food interactions

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

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.