Pramipexole

CLINICAL USE

Parkinson’s disease Symptomatic treatment of restless legs

DOSE IN NORMAL RENAL FUNCTION

Parkinson’s disease: 88 – 1100 mcg 3 times a dayRestless legs: 88–540 mcg taken 2–3 hours before bedtime

PHARMACOKINETICS

Molecular weight :302.3 (as hydrochloride)

%Protein binding :<20

%Excreted unchanged in urine : <90

Volume of distribution (L/kg) :400–500 litres

half-life – normal/ESRD (hrs) :8–14/36

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Initially 88 mcg twice daily and titrate slowly

10 to 20 : Initially 88 mcg once daily and titrate slowly

<10 : Initially 88 mcg once daily and titrate slowly

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR <10 mL/min

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Not dialysed. Dose as in GFR=10–20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAvoid concomitant use with antipsychotics

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

88 mcg of base ≡ 125 mcg of salt, 180 mcg ≡ 250 mcg, 350 mcg ≡ 500 mcg, 700 mcg ≡ 1 mg, 1.1 mg ≡ 1.5 mgLess than 9% of dose is removed by haemodialysisDrowsiness is a common side effect especially at higher dosesFor restless legs, dose as in normal renal function.

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