Mirapex (Generic Pramipexole Dihydrochloride)

Pramipexole Dihydrochloride

Pramipexole dihydrochloride is a dopaminergic agonist used for the treatment of Parkinsonism and Restless Leg Syndrome(RLS). Parkinsonism disease is a progressive movement disorder caused by degeneration of the substantia nigra and pars compacta located in the basal ganglia. Degeneration causes decreased dopamine production. Dopamine receptors located in the striatum are not stimulated leading to overstimulation of the basal ganglia globus pallidus hence inhibition of the thalamus. These decreases signals from the thalamus to the cerebral cortex and spinal cord. Parkinson's present as muscle rigidity, tremors mainly at rest and decreases with movement, posture instability, and bradykinesia. In Parkinson's, there is no weakness.

Restless leg syndrome.

A condition where the is an uncontrolled movement of the legs. Mainly occurs in the evening where the legs start to feel itchy, uncomfortable or feeling of pins and needles deep in the legs.

Mode of action

Pramipexole dihydrochloride binds to D2 (Dopamine) and D3 receptors promoting the activity of dopamine in the substantia nigra and striatum.

Dosage and formulation.

Pramipexole is formulated either as the immediate release or extended-release tablets.

In Parkinsonism, the immediate release or Extended-release tablets are usually prescribed. In Restless Leg Syndrome Pramipexole dihydrochloride immediate-release tablets are used. It is good to let your physician or pharmacist know if you have an allergy to this drug or to its ingredients. The inactive ingredients in this drug have a plausible nature to cause an anaphylactic reaction. Inform your pharmacist or physician about your medical history since it might be vital in your treatment. This includes if you have ever had hypotension or low blood pressures, cardiac issues i.e. palpitations or heart angina or failure, Renal problems such as anuria or dialysis, Irregular levels of consciousness such as confusion, psychosis or hallucinations, mood disorders and sleep disturbances such as narcolepsy. Combining this drug with things such as alcohol can have a synergistic effect of making you feel less active and more sleepy hence you should not drive not move big critical machines when on such a combo.

Dosage strengths

Immediate release tablets.125mg, 0.25mg, 0.5mg, 0.75mg, 1 mg, 1.5mg.

Extended release tablets

0.375 mg, 0.75 mg, 1.5 mg, 2.25 mg, 3 mg, 3.75 mg, 4.5 mg

Parkinsonism dose

Immediate release tablets

Usually taken three times in a day and dosage is increased weekly.In week 1 starting dose is 0.125 mg, Week 2; 0.25 mg Week 3; 0.5 mg Week 4; 0.75 mg Week 5; 1 mg Week 6; 1.25 mg Week 7; 1.5 mg

Extended- release tablets

Starting dose is 0.125 mg where Pramipexole dihydrochloride tablets are taken once a day. The doctor may choose to increase the dose after every 5-7 days. Maximum dose taken is usually 4.5mg also taken once a day.

Restless leg syndrome dosage

The starting dose for Pramipexole dihydrochloride is 0.125 mg which is taken 2-3 hours in the evening before bed. The doctor may choose to increase the dose after every 4-7 days. The maximum dose is 1.5 mg.


Pramipexole dihydrochloride has good oral bioavailability with peak serum concentrations after 2 hours. Its bioavailability is above 95%. Pramipexole dihydrochloride is less protein bound and is excreted unchanged in urine. The half-life is usually around 9 hours.

Side effects

Common side effects include:

  • Nausea
  • Constipation
  • Diarrhea
  • Decreased appetite
  • Dry mouth
  • Constipation
  • Increased urge and frequency of micturition
  • Weakness
  • Confusion
  • Sleep disturbances example insomnia
  • Dizziness

Drowsiness this you should avoid activities that require attention example driving or operation of machinery

Serious Side effects include: 

  • Visual disturbances
  • Hallucinations
  • Depression

Rhabdomylosis which is muscle breakdown leading to muscle weakness and rigidity. You may also see dark color urine due to muscle breakdown.

Different people react differently to different medications hence you should inform your doctor of any untoward effects you may encounter or report to FDA 1-800-FDA-1088.

Drug interaction

Metoclopramide:  Metoclopramide is a dopamine- 2 receptor antagonist used for the treatment of nausea. , therefore, blocks Pramipexole dihydrochloride activity.

Drugs that induce drowsiness example antihistamines and Zolpidem.

Phenothiazines example chlorpromazine, fluphenazine, perphenazine, trifluoperazine, thioridazine which may induce Parkinsonism symptoms.

Muscle relaxants example cyclobenzaprine this is because of uncontrolled involuntary movements.

Narcotic analgesics example codeine, tramadol, morphine.

Methyldopa used in hypertension inhibits the conversion of L- dopa to dopamine hence decreased levels of dopamine.

Drugs that decrease hyperkinesia example valbenazine, tetrabenazine as they decrease dopamine in the storage vesicles.

Alcohol as this may increase drowsiness.

Antihistamines and some narcotic analgesics example codeine, dextromethorphan may be present in some cough, cold or allergic preparations hence you should check their labels and inform your doctor.

You should also inform your doctor of all medication you might be taking examples herbs or supplements.


Do not stop Pramipexole without consulting your doctor as this may increase the severity of withdrawal symptoms.

You should follow the doctor's instructions on the dosage if there is interruption contact your doctor so as to adjust the regimen.

Store the drug in a cool dry place.

Do not crush Pramipexole tablets especially extended-release tablets. If you experience difficulty while swallowing inform your doctor.

In case of a missed dose do not take twice but inform your doctor.

In pregnancy, Pramipexole is classified under Pregnancy Category C which means there are no controlled studies in humans. Pramipexole dihydrochloride should, therefore, be used only when the beneficial effects are greater than the risks.

If you are breastfeeding inform your doctor as the studies are not clear if Pramipexole dihydrochloride is secreted in milk.

Pramipexole dihydrochloride pricing

The price of Pramipexole dihydrochloride is affordable compared to its vast life-saving health benefits. You can purchase/ buy Pramipexole dihydrochloride from accredited online sites such as FairPriceRX.com for fast delivery to your vicinity.

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