What is Mirapex?

Mirapex (pramipexole) is a prescription "dopamine agonist" medicine used to treat Parkinson's disease. Mirapex may be used alone, or in combination with levodopa or other medicines that treat Parkinson's.

Parkinson's disease is a motor system disorder that has four primary symptoms: tremor (trembling), rigidity, slowness of movement, and postural instability (imbalance). Parkinson's disease is caused by the loss of brain cells that produce a chemical called dopamine.

Recently, physicians have also prescribed Mirapex to treat Restless Leg Syndrome (RLS), a condition that causes unpleasant sensations, discomfort, and restlessness in the legs. RLS may be the result of dopamine level changes, but the exact cause is still unknown. Low doses of Mirapex seem to be effective in controlling RLS symptoms in some patients.

Mirapex is manufactured by Pfizer Pharmaceuticals, and is distributed by Boehringer Ingelheim Pharmaceuticals, Inc. Mirapex was first approved by the U.S. Food and Drug Administration (FDA) in 1997.

Mirapex's Suggested Link to Compulsive Behavior

There have been recent reports of Parkinson's disease and RLS patients experiencing out-of-control, compulsive urges while being treated with Mirapex or other dopamine agonist medicines. Among the behaviors that have been reported are cases of pathological gambling, hypersexuality (increased sexual thoughts, feelings, or behavior), and compulsive eating.

Mirapex's prescribing information has been changed to describe these reported cases. Mirapex's prescribing information states that the incidence of compulsive behavior has been low and that they are generally reversible upon dose reduction or treatment discontinuation. The suggested link between Mirapex use and compulsive behavior is still under examination.

Mirapex Precautions

Elderly patients should exercise caution and discuss the risks of Mirapex use with their healthcare professional. Hallucinations (seeing, hearing, or feeling things that are not there) may be especially likely to occur in elderly patients, since they are usually more sensitive than younger adults to the effects of Mirapex.

When taking Mirapex, it is important that your healthcare professional check your progress regularly, to allow for dose adjustments and for the reduction of any unwanted effects.

Do not stop taking Mirapex suddenly without first talking to your healthcare professional. Your healthcare professional may want you to reduce your dose of Mirapex first before stopping it completely.

Because Mirapex may cause drowsiness, dizziness, lightheadedness, vision problems, weakness, or coordination problems, you should make sure you know how you react to Mirapex before you drive, use machines, or perform any activity that requires alertness, good coordination, or the ability to think and see well.

What Should I Tell My Healthcare Professional?

You should tell your healthcare professional if you:

• have or have had any unusual or allergic reaction to Mirapex (pramipexole), or if you are allergic to any other substances (foods, preservatives, or dyes).

• are pregnant, may become pregnant, or are breast-feeding. Although Mirapex has not been studied in pregnant women, animal studies have shown that Mirapex may interfere with pregnancy when the mother is given doses many times higher than the human dose. It is unknown whether Mirapex passes into human breast milk, although there is a possibility of serious unwanted effects in nursing infants.

• have eye problems, especially with the retina.

• experience hallucinations, hypotension (low blood pressure), or postural hypotension (dizziness, lightheadedness, or fainting, especially when getting up from a lying or sitting position).

• have kidney problems.

Mirapex Side Effects

Tell your healthcare professional if any of the following side effects associated with Mirapex use are severe or persistent:

• involuntary movements and motions
• dizziness
• drowsiness
• upset stomach
• heartburn
• constipation
• excessive tiredness
• frequent urination
• dry mouth
• decreased sexual desire or ability

Call your healthcare professional immediately if you experience any of the following side effects of Mirapex use:

• hallucinations
• fainting
• high temperature, rigid muscles, or confusion
• muscle pain
• increased sweating
• falling asleep while eating, having a conversation, or in the middle of another activity

Are There Any Interactions With Drugs or Foods?

Mirapex and certain other medicines can interact with each other. Tell your healthcare professional about all the medicines you take - including prescription and non-prescription medicines - especially:

Carbidopa and levodopa combination (e.g., Sinement)