1 What is Mirapex?

Brand: Mirapex, Mirapex ER

Generic: Pramipexole

Mirapex is a dopamine agonist that is used as a treatment for Parkinson’s disease. Used alone or with other medicines like levodopa, Mirapex alleviates the symptoms of the disease by working on the nervous system.

This prescription drug is also used as a treatment for RLS or Restless Legs Syndrome, a neurological disorder that makes legs feel uncomfortable when not moving, causing the affected person to want to move the legs constantly to make them feel comfortable.

2 What to Know Before Using

Before using Mirapex, you must know all about the risks and complications associated with it. Taking this drug is a decision you make with your doctor.

The following things must be considered before using this drug:


If you have any unusual reaction to any medicine, be sure to tell your doctor about it. Additionally, disclose other types of allergies - foods, preservatives, animals, or dyes, if there are any. Read the package ingredients carefully and make sure you are not allergic to any of its ingredients.


There are no appropriate studies performed to establish safety and efficacy of pramipexole use in children.


While there is no appropriate study done to point out the relationship of old age to the effects of this drug, no geriatric-related problems are given to date. Nonetheless, utmost caution must be considered when giving this medicine to the elderly, since they are likely to have hallucinations, which can be a red flag for patients taking it.


It is not sure if there are adequate studies done in pregnant women or if animal studies showing adverse effects are available.


Although there are no adequate studies in lactating mothers that determine potential risk in an infant when breastfeeding, the benefits should be weighed against the risks before taking this medication.

Drug Interactions.

Some drugs have adverse effects when used together. Make sure to inform your doctor about other drugs you are taking, so that alterations and precautions will be made if necessary. Before using pramipexole, talk to your doctor about possible interactions if you are taking other medications.

It is also important to inform your doctor if you are smoking tobacco or drinking alcohol since these may interact with the drug’s effectiveness. Tell your doctor about any drug you are using.

Prescription or nonprescription, and even vitamin and herbal supplements. Cimetidine and Kava are known to interact with pramipexole, so if you are taking them, make sure to inform your doctor.

Other medical problems.

If you have other health problems, the use of this medicine may be affected. Certain medical problems like:

  • Dyskinesia
  • Hallucinations
  • Hypotension
  • Postural hypotension

May stop you from using this drug since pramipexole may make these conditions worse.

If you have kidney disease, the drug may have an increased effect on you since the condition can slow down the removal of the medicine from your system.

3 Proper Usage

To use Mirapex properly, you must follow all instructions given by your doctor. The dose of pramipexole depends on the patient's age, weight, and symptoms, as well as the strength of the medicine. Do not change the dosage the doctor indicated unless he or she told you otherwise.

The number of doses and the number of hours between doses generally depend on the reason why you are taking this drug. Do not break, crush, or chew the extended-release tablet; swallow it whole and with water.

Generally, dosage will be as follows:

  • For adults with Parkinson’s disease, 0.125 mg three times a day is initially given. If you are using extended-release tablets, 0.375 milligrams of extended-release tablet once a day is initially given. Dosage may be adjusted by your doctor as needed, but may not exceed 4.5 mg a day.
  • For adults with RLS or Restless Legs Syndrome, 0.125 milligrams once a day to be taken 2-3 hours before bedtime. Dosage may be adjusted by your doctor as needed, but may not exceed 0.5 mg a day. Dosage for children is determined by the doctor.

Missed dose:

Take the missed dose as soon as possible. In case it is almost time for the next dose, skip the missed one and follow your regular dosing schedule. Never take double doses.


Keep the medicine in an airtight container at normal room temperature. Keep it away from direct light, heat, and moisture. Do not let it freeze. Keep the medicine out of children’s reach. Throw away any outdated medicine or medicine that are not in use.

4 Precautions to Take

Before using Mirapex, there are some precautions you must take. To check your progress, allow for changes in medicine dosage, or check for any unwanted effects, visit your doctor regularly.

Do not stop intake of this medicine without your doctor’s advice, regardless if the symptoms are gone. Gradual reduction of dosage prior to stopping completely may be necessary.

People using this medicine have a tendency to fall asleep without warning during daily activities, including driving. This can result in accidents.

Make sure you are familiar with how your body reacts to pramipexole before driving, using machines, or doing anything that can be hazardous if you are not alert enough. This medicine interacts with alcohol and CNS depressants.

In some patients, hallucinations may occur, especially in elderly patients. A hallucination is seeing, hearing, or feeling things that are not there.

If you have a fever, muscle cramps, and stiffness, unusual weakness or tiredness, or dark-colored urine, call your doctor immediately. These signs may mean you have rhabdomyolysis.

Some Mirapex users may experience unusual behavioral changes, such as:

  • Compulsive eating
  • Increased sex drive
  • Even problems with gambling

Do not take other medications, including prescription or nonprescription drugs, vitamins, and herbal supplements without discussing first with your doctor.

5 Potential Side Effects

While not all people taking Mirapex may suffer from these side effects, you may need to call your doctor if any of these are present:

  • Dizziness
  • Lightheadedness or Fainting
  • Drowsiness
  • Hallucinations
  • Nausea
  • Twitching, Twisting, or Other unusual body movements
  • Trouble sleeping
  • Double vision
  • Cough
  • Unusual tiredness or weakness
  • Confusion
  • Difficulty with swallowing
  • Swelling of the body
  • Mental changes, such as sudden fearfulness or suspiciousness
  • Falling asleep without warning
  • Muscle weakness
  • Fever
  • Memory loss
  • Frequent urination
  • Muscle or Joint pain
  • Restlessness or Need to keep moving
  • Tightness in the chest
  • Breathing difficulty
  • Unusual body movements like writhing
  • Anxiety
  • Abnormal thinking
  • Bloody or Cloudy urine
  • Difficult urination that may feel painful
  • Frequent urge to urinate chest pain
  • Dizziness
  • Loss of bladder control
  • Swollen arms or legs

Some patients may experience side effects not listed above. If you want to report side effects, you may do so by calling the FDA at 1-800-FDA-1088.

6 Related Clinical Trials