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Permax Side Effects

Generic name: pergolide

Medically reviewed by Last updated on May 6, 2023.

Note: This document contains side effect information about pergolide. Some dosage forms listed on this page may not apply to the brand name Permax.

Applies to pergolide: oral tablet.


Oral route (Tablet)

The use of pergolide has been shown to increase the risk of cardiac valvular disease and is not recommended for use in patients with a history of cardiac valvulopathy. Some patients have required valve replacement, and deaths have been reported. Periodic echocardiograms are recommended during therapy. Pergolide increases the risk of fibrotic complications including pulmonary, pleural, and/or retroperitoneal fibrosis, pericarditis, pleuritis, and pericardial and/or pleural effusions. Pergolide is not recommended for use in patients with a history of fibrotic conditions and patients should be monitored for fibrotic complications during therapy.

Serious side effects of Permax

Along with its needed effects, pergolide (the active ingredient contained in Permax) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking pergolide:


Check with your doctor as soon as possible if any of the following side effects occur while taking pergolide:

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Less common


Other side effects of Permax

Some side effects of pergolide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

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Less common

For Healthcare Professionals

Applies to pergolide: compounding powder, oral tablet.


Gastrointestinal adverse effects are commonly seen during pergolide (the active ingredient contained in Permax) therapy. Nausea occurs in up to 25% of patients treated and may abate with continued therapy. Also, diarrhea, dyspepsia, abdominal pain, vomiting, and constipation are reported less commonly.[Ref]

Nervous system

Nervous system adverse effects are also commonly associated with pergolide (the active ingredient contained in Permax) therapy. Most patients experience an increase in dyskinesias with pergolide. Dizziness and somnolence occurs in approximately 11% of patients treated. Less commonly, insomnia, headache, anxiety, depression, and tremor occur. Hallucinations and confusion have been reported in approximately 14% of patients receiving pergolide and in a few patients following abrupt withdrawal. Two cases of sleep attacks have been reported in patients receiving pergolide. Sleep attacks have also been reported in a number of other patients receiving dopamine agonists.[Ref]

The incidence of hallucinations appears to be dose-related. Patients experiencing hallucinations during pergolide therapy may benefit from a dose reduction, however, often this is at the expense of control of Parkinson's Disease. In some patients, it is possible to increase the dose beyond the originally toxic dose without reoccurrence of hallucinations after a temporary decrease with resolutions of the side effects. Hallucinations following withdrawal of pergolide have been reported to persist for several weeks.[Ref]


Cardiovascular side effects have included rare reports of pleuritis, pleural effusion, pleural fibrosis, pericarditis, pericardial effusion, cardiac valvulopathy involving one or more valves or retroperitoneal fibrosis. The adverse effects reported at an incidence of greater than 1% (n=189) among patients taking pergolide (the active ingredient contained in Permax) when compared to placebo include: postural hypotension, vasodilation, palpitations, orthostatic hypotension, syncope, hypertension, arrhythmia, and myocardial infarction. Peripheral edema is occasionally reported. Angina has been reported in a few patients.[Ref]

Symptomatic postural hypotension is most commonly seen during initial therapy. Most patients become tolerant of this effect if begun on low doses and titrated up gradually over a period of three to four weeks.

Patients who experience angina in clinical trials have responded to a decrease in the dose. A possible association between pergolide and the development of ventricular arrhythmias was seen in a few patients during clinical trials. Although this association has not been verified, caution is recommended when high doses of pergolide are used in patients with cardiac disease.

The valvulopathy reported with pergolide has involved aortic, mitral and tricuspid valves. In some cases this side effect resolved with cessation of pergolide therapy. Valve replacement was required in two patients.

In a letter to the Healthcare Professional issued by Eli Lilly and Company last February 10, 2003, it states that of the estimated 500,000 people who have been treated with pergolide since the drug was launched in the United States in 1989, valvulopathy has been reported in less than 0.005%.[Ref]


Dermatologic abnormalities reported in patients receiving pergolide (the active ingredient contained in Permax) occasionally include erythema of the lower extremities, or erythromelalgia. This erythema may be very warm or painful.[Ref]


Hematologic abnormalities associated with pergolide (the active ingredient contained in Permax) therapy include anemia. Leukopenia has been reported infrequently.[Ref]


Respiratory adverse effects occasionally include dyspnea and nasal congestion.[Ref]


Musculoskeletal adverse effects may rarely include muscle cramps, arthralgia, and myalgias.[Ref]


Ocular adverse effects may include diplopia or vision changes in 2% to 6% of patients treated with pergolide (the active ingredient contained in Permax) [Ref]


Urinary tract infections, urinary frequency, urinary incontinence, and hematuria are reported in approximately 3% of pergolide-treated patients.[Ref]


Other adverse effects of pergolide (the active ingredient contained in Permax) may include flu-like syndrome, and fever.[Ref]


1. Robin DW (1991) "Pergolide in the treatment of Parkinson's disease." Am J Med Sci, 301, p. 277-80

2. Pezzoli G, Martignoni E, Pacchetti C, Angeleri VA, Lamberti P, Muratorio A, Bonuccelli U, Demari M, Foschi N, Cossutta E, Nicolet (1994) "Pergolide compared with bromocriptine in parkinsons disease - a multicenter, crossover, controlled study." Mov Disord, 9, p. 431-6

3. Lamberts SW, Quik RF (1991) "A comparison of the efficacy and safety of pergolide and bromocriptine in the treatment of hyperprolactinemia." J Clin Endocrinol Metab, 72, p. 635-41

4. Ahlskog JE, Muenter MD (1988) "Treatment of Parkinson's disease with pergolide: a double-blind study." Mayo Clin Proc, 63, p. 969-78

5. Olanow CW, Alberts MJ (1987) "Double-blind controlled study of pergolide mesylate in the treatment of Parkinson's disease." Clin Neuropharmacol, 10, p. 178-85

6. (2001) "Product Information. Permax (pergolide)." Athena Neurosciences Inc

7. Ahlskog JE, Muenter MD (1988) "Pergolide: long-term use in Parkinson's disease." Mayo Clin Proc, 63, p. 979-87

8. Stern Y, Mayeux R, Ilson J, Fahn S, Cote L (1984) "Pergolide therapy for Parkinson's disease: neurobehavioral changes." Neurology, 34, p. 201-4

9. McHale DM, Sage JI (1988) "Hallucinations and confusion after pergolide withdrawal." Clin Neuropharmacol, 11, p. 545-8

10. Schapira AHV (2000) "Sleep attacks (Sleep episodes) with pergolide." Lancet, 355, p. 1332-3

11. Ulivelli M, Rossi S, Lombardi C, et al. (2002) "Polysomnographic characterization of pergolide-induced sleep attacks in idiopathic PD." Neurology, 58, p. 462-5

12. Bonuccelli U, Colzi A, Del Dotto P (2002) "Pergolide in the treatment of patients with early and advanced Parkinson's disease." Clin Neuropharmacol, 25, p. 1-10

13. Balachandran KP, Stewart D, Berg GA, Oldroyd KG (2002) "Chronic pericardial constriction linked to the antiparkinsonian dopamine agonist pergolide." Postgrad Med J, 78, p. 49-50

14. Bleumink GS, Van Der Molen-Eijgenraam M, Strijbos JH, Sanwikarja S, Van Puijenbroek EP, Stricker BH (2002) "Pergolide-induced pleuropulmonary fibrosis." Clin Neuropharmacol, 25, p. 290-3

15. Pritchett AM, Morrison JF, Edwards WD, Schaff HV, Connolly HM, Espinosa RE (2002) "Valvular heart disease in patients taking pergolide." Mayo Clin Proc, 77, p. 1280-6

16. Rahimtoola SH (2002) "Drug-related valvular heart disease: here we go again: will we do better this time?" Mayo Clin Proc, 77, p. 1275-7

17. Monk BE, Parkes JD, Du Vivier A (1984) "Erythromelalgia following pergolide administration." Br J Dermatol, 111, p. 97-9

Further information

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

Some side effects may not be reported. You may report them to the FDA.