In this article you will learn all about the Mirapex drug: how to replace this drug, what is its effect, contraindications, side effects, special instructions for its use. These pills can cause abnormal behavior and affect the patient's response. Therefore, before taking the drug "Mirapex" instructions for use should be carefully studied. We will also talk about the compatibility of these tablets with other drugs.
Prolonged "Mirapex": general information about the drug and indications for use
The active substance of the drug "Mirapex" is pramipexole. Auxiliary components of the tablets: povidone, mannitol, starch, aerosil, magnesium stearate.
With the help of this drug, the treatment of idiopathic (independent of other lesions) syndrome of "restless legs" and Parkinson's disease, as well as other specified motor and extrapyramidal disorders.
Release form: tablets "Mirapex PD" 3 mg, 4.5 mg, 1.5 mg, 0.75 mg, 0.375 mg. They are packed in blisters of 10 pieces, and then in cardboard packs.
White pills. They have a beveled edge and a flat shape on both sides, on one of which there is a deep risk.
Tablets should be taken orally, regardless of meals. It is permissible to use the drug at any time. In this case, you need to drink it with water. It is recommended that the daily dose be divided into three doses.
The mechanism of action (pharmacodynamics) of Mirapex tablets
The active substance pramipexole, which contains the drug "Mirapex", specifically and with high selectivity enhances the response of dopamine receptors from the subgroup D2. Thanks to him, the lack of motor activity in the case of Parkinson's disease is compensated. This occurs due to the activation of dopamine receptors in the striatum. In this case, pramipexole prevents the degeneration of their neurons, which occurs due to neurotoxicity or ischemia. It inhibits or reduces the rate of synthesis, metabolism, and dopamine release. Thanks to pramipexole, neurons are protected from the toxic effects of the Levodopa antiparkinsonian drug. Also, due to its effect, prolactin production decreases (dose-dependent).
In the case of prolonged use of Mirapex tablets for the treatment of Parkinson's disease (more than three years) and restless legs syndrome (more than a year), a decrease in the effectiveness of pramipexole was not detected.
Biochemical processes that occur with the drug "Mirapex" in the patient's body (pharmacokinetics)
The active substance of the drug "Mirapex" is completely and rapidly absorbed after oral administration. Its ability to assimilate (bioavailability) is almost absolute - more than 90%. The maximum concentration of the drug in plasma is observed 1-3 hours after its use. With meals, the absorption rate of pramipexole decreases. At the same time, the amount of assimilated food does not change.
Pramipexole binds to proteins slightly (less than 20%). It has a large distribution volume of 400 liters, which means that its concentration in the blood is low. To a small extent, the drug undergoes a metabolic process. Approximately 90% of the dose of Mirapex tablets is excreted by the kidneys, while 80% is unchanged. In feces, pramipexole is found in an amount of less than 2% of the consumed amount of the drug. Tissues and body fluids are cleaned of Mirapex tablets at an average rate of 500 ml / min.
The use of the drug "Mirapex" during pregnancy
Can Mirapex tablets be used during pregnancy? Instructions for use of the drug explains that the effect of the drug on the development of the fetus in the womb and on the lactation process has not been studied.
The possible effects of pramipexole on the systems and organs responsible for the fertilization process were studied in experiments with animals. In this case, violations of the fetal development during pregnancy in rabbits and rats were not manifested.
Excretion of pramipexole with breast milk has not been studied. We can only assume that the substance can suppress lactation, since it inhibits the production of luteotropic hormone. Therefore, it is not recommended to take Mirapex tablets during breastfeeding.
During pregnancy, you should take the drug only when the potential benefit to the expectant mother outweighs the risk to the fetus.
Contraindications to the use of tablets "Mirapex"
The drug "Mirapex" can not be taken in case of hypersensitivity to pramipexole, as well as people under the age of 18 years.
With extreme caution, it is recommended to use tablets with low blood pressure and renal failure.
Side effects of the drug "Mirapex" on the nervous system
The drug "Mirapex" - tablets that can cause the following reactions from the nervous system:
- confusion of consciousness;
- excessive sleepiness or lack thereof;
- hallucinations;
- Amnesia
- asthenia;
- dizziness;
- extrapyramidal syndrome;
- Hypesthesia
- tremor;
- myoclonus;
- dystonia;
- Depression
- rave;
- suicidal tendency;
- hypokinesia;
- ataxia;
- anxiety;
- malignant antipsychotic syndrome.
The latter manifests itself in the form of hyperthermia, impaired consciousness and thinking, muscle rigidity, autonomic lability, akathisia.
Side effects of Mirapex tablets on other systems of the human body
The musculoskeletal system can respond to the use of the medicine “Mirapex” with such manifestations:
- muscle hypertonicity, their cramps, twitches;
- the occurrence of arthritis, myasthenia gravis, or bursitis;
- pain in the chest, neck or spine (in the lumbosacral).
Digestive system abnormalities may also occur. When this occurs:
- decreased appetite;
- constipation
- nausea;
- dyspepsia;
- flatulence;
- diarrhea;
- vomiting
- dry mouth
- cutting sensations in the stomach.
For respiratory organs, taking Mirapex may result in the development of sinusitis, pharyngitis, rhinitis, and flu-like syndrome. Also, the onset of shortness of breath, increased coughing and a change in voice are not ruled out.
How do Mirapex tablets affect the cardiovascular system? Instructions for use of the drug informs about the possible development of tachycardia, arrhythmia, angina pectoris, orthostatic hypotension.
Other side effects
When taking the drug “Mirapex” in the genitourinary system, complications such as increased bowel movements and infections can occur. In this case, even a decrease in libido and potency is assumed.
In addition, the occurrence of diplopia, cataracts, conjunctivitis, paralysis of accommodation, allergies, as well as hearing loss, intraocular pressure.
Other adverse reactions of the body:
- retroperitoneal fibrosis;
- pleural effusion;
- pulmonary infiltration;
- weight loss;
- peripheral edema.
Method of application and dosage of Mirapex tablets
You need to use the drug inside, daily 3 times. The initial dose of Mirapex PD tablets is 0.375 mg per day. Gradually, the volume of the drug should be increased (every 7 days) until the desired therapeutic effect is obtained. In the second week of treatment, 0.75 mg should be consumed every day, in the third - 1.5 mg, in the fourth - 2.25 mg, in the fifth it is required to drink 3 mg Mirapex medicines daily, in the sixth - 3.75 mg, and the seventh - 4.5 mg.
In chronic renal failure, the dosage is adjusted based on creatinine clearance levels. The exact amount of the drug should be prescribed by the doctor.
The consequences of an overdose when taking Mirapex tablets
If the dosage was violated when using the Mirapex preparation, the following symptoms are likely to occur: hallucinations, hyperkinesia, vomiting, nausea, low blood pressure and agitation.
For this situation, an antidote has not been established. There have been no cases of overdose with Mirapex. Symptomatic therapy, gastric lavage, and dynamic observation are recommended. If with an overdose there are signs of central nervous system excitation, then antipsychotics should be used.
Interactions of Mirapex tablets with other drugs
Pramipexole binds to plasma proteins to a small extent and undergoes biotransformation. Therefore, its interaction with other drugs that affect these processes is unlikely.
Medicines that inhibit or inhibit the active production of cationic substances or self-eliminating through the renal tubules can react with Mirapex tablets. The instructions for use explain that in this case, a decrease in the rate of cleansing of tissues and biological fluids from either both drugs, or from one of them will manifest itself.
If such drugs are used simultaneously with Mirapex tablets, then you should pay attention to possible hallucinations, dyskinesia, agitation. If such signs appear, then the dosage of the drug must be reduced.
Mirapex tablets compatibility with Amantadine and Levodopa preparations
What happens with the combined use of Levodopa and Selegilin with Mirapex PD tablets? The instruction says that neither the first nor the second affects the pharmacokinetics of the active substance. At the same time, Mirapex tablets are not reflected in the complete assimilation by the body and natural excretion of the Levodopa drug.
The interaction of pramipexole with the drug "Amantadine" has not been studied. But their compatibility is possible in therapy, since they have similar excretion mechanisms.
When the dose of Mirapex increases, the recommended amount of Levodopa is recommended to be reduced. At the same time, the number of other antiparkinsonian drugs must be constantly maintained at the same level.
Features of the compatibility of the drug "Mirapex" with other drugs
Due to the possibility of cumulative effects, it is recommended to use Mirapex tablets in combination with sedatives, alcohol and drugs that increase the concentration of pramipexole in the blood (for example, with Cimetidine) with extreme caution.
Special instructions for the use of tablets "Mirapex"
The drug described by us is categorically not recommended to be taken simultaneously with antipsychotic drugs.
When treating with dopamine agonists, known side effects are confusion and hallucinations. In cases where Mirapex tablets were used in combination with Levodopa, such deviations were observed more often in the late stages of the disease than in the early ones with monotherapy.
The doctor must inform patients about the possible occurrence of visual hallucinations. This side effect affects the ability to drive vehicles and make responsible decisions.
With a sharp cessation of pills in the case of Parkinson's disease, a symptom complex was identified that resembles a neuroleptic malignant syndrome.
Abnormal behavior when using the drug "Mirapex"
Patients and those who care about them need to know that taking dopaminergic drugs, in particular Mirapex tablets (reviews confirm this), often cause abnormal behavior of the patient. Hyperphagia (a tendency to overeating), pathological shopping (obsessive desire to make many purchases), an irresistible craving for gambling and hypersexuality are possible. In such cases, it is necessary to reduce the dosage of the drug or gradually stop taking it.
Caution with the use of tablets "Mirapex"
The medicine "Mirapex" should be used with caution in patients with severe diseases of the cardiovascular system. When conducting therapy with dopaminergic drugs, there is a risk of developing orthostatic hypotension. Therefore, control of blood pressure is required, especially at the initial stage of treatment.
In case of impaired vision, it is necessary to regularly check it immediately after prescribing Mirapex tablets and then at specified intervals.
Patients should take into account the fact that the drug may have a sedative effect. There are known cases of sudden falling asleep and excessive drowsiness in the process of daily activities. Including this can happen at any time when driving complex mechanisms or when driving vehicles.
The possibility of developing melanoma
Epidemiological studies have revealed that patients with Parkinson's disease are at risk for melanoma. Whether this ailment or other factors, for example, the use of the Mirapex drug, is its cause, is not established.
Strengthening the "restless legs" syndrome
How does Mirapex affect the restless legs syndrome? Patient reviews suggest that dopaminergic drugs can enhance it. This manifests itself in the form of an earlier onset of symptoms of the syndrome in the evening, and sometimes in the afternoon. In this case, the symptoms spread to other limbs. In a clinical controlled trial over 26 weeks, which was planned to study this effect, no significant difference between the pramipexole and placebo groups in enhancing the symptoms of the syndrome was detected.
Storage conditions and shelf life
Mirapex tablets belong to the preparations from the list B. They must be stored in a dark place. In this case, the room temperature must not exceed 30 ° C.
The shelf life of the drug is 36 months (3 years) from the date of manufacture.
The use of Mirapex tablets in childhood and the conditions for their purchase
The drug is contraindicated for use in childhood. Pills are allowed for people who have reached 18 years of age. Mirapex medicine is dispensed in pharmacies upon presentation of a prescription.
Analogues of the drug "Mirapex"
Can you for any reason buy exactly Mirapex tablets? How to replace the drug, you should tell the pharmacist or doctor. And we offer the following analogues.
- Tablets "Motopram". Indications: Parkinson's disease. You can conduct monotherapy or combine the drug with the drug "Levodopa". It is also used for severe idiopathic or moderate form of restless legs syndrome.
- Tablets "Oprimeya." Appointment: antiparkinsonian therapeutic agent-stimulator of dopaminergic transmission to the central nervous system.
- Pramipexole tablets. A therapeutic agent used in Parkinson's disease. It is believed that the mechanism of its action is directly related to the ability of the substance pramipexole to stimulate the dopamine receptors of the striatum.
Mirapex tablets - analogues or the original? No self-medication!
The list above lists drugs that are analogues of Mirapex tablets. They have the same unique, non-proprietary international name (or ATC code) as recommended by WHO (World Health Organization).
If you need to undergo treatment with Mirapex tablets, analogues can also be a great alternative. But before replacing the therapy prescribed for you, be sure to consult with a specialist. Do not self-medicate under any circumstances! This can cause irreversible negative effects on your health.
Attention! This article with the description of the drug "Mirapex" is a supplemented and simplified version of the official instructions for use. Information about the medicine is provided for informational purposes. Never use it as a guide for self-medication.