Active Ingredients

Pramipexole – Effect, Application & Risks


Pramipexole is one of the dopamine antagonists . The drug is used to treat Parkinson’s disease.

What is Pramipexole?

Pramipexole is a drug from the group of dopamine antagonists. This means that the substance mimics the effects of natural dopamine . The drug is used to treat Parkinson’s disease. So pramipexole is considered the standard preparation for people under 70 years of age with this disease.

A positive property of pramipexole is that its use allows the use of the drug levodopa to be postponed in the early stages of Parkinson’s disease. This is considered an advantage as levodopa has significant side effects .

Pramipexole primarily combats the tremors that are considered typical of Parkinson’s disease. Regardless of its dosage, pramipexole is always subject to prescription. In Germany, pramipexole was put into circulation in 1997 by the drug company Boehringer. Patent protection expired in 2009, allowing several generics containing pramipexole as the active ingredient to enter the market.

Pharmacological action

In the context of Parkinson’s disease, the people affected suffer from the loss of nerve cells that release the messenger substance dopamine for reasons that have not yet been fully clarified. However, humans cannot do without dopamine because they need it for their movement processes. Due to the affected nerve cells (neurons) in the substantia nigra , Parkinson’s patients suffer from typical symptoms such as tremors, movement disorders and muscle rigidity . As the disease progresses, Parkinson’s disease progresses continuously.

Pramipexole is used to treat the symptoms, which is administered either alone or together with levodopa. Pramipexole makes it possible to effectively combat the patients’ tremors. The dopamine antagonist is mainly bound to D3 dopamine receptors, which are located on the brain cells. The binding process means that the stimuli within the brain can be better transmitted from the neurons to each other. This gives the patient the opportunity to coordinate and implement their movements more effectively.

If the Parkinson’s disease is still in its early stages, the effect of pramipexole is based on its effect on the closed- loop self-regulation. The active ingredient pretends that there is enough dopamine. As a result, the nerve cells no longer overwork themselves by constantly producing dopamine.

By late-stage Parkinson’s disease, most of the dopamine-secreting neurons within the substantia nigra have died. The pramipexole then unfolds its effect directly on the nerve cells of the striatum .

It is believed that the binding of pramipexole to the D3 dopamine receptors also has a positive effect on restless legs syndrome . According to recent studies, there is also a positive influence of the drug on bipolar disorders and depression .

The absorption of pramipexole into the bloodstream of the human body takes place via the intestine . After one to three hours, the active ingredient reaches its maximum amount there. The pramipexole is passed on to the brain via the blood-brain barrier . There is no significant degradation of the dopamine antagonist within the body. Around 50 percent of the drug is passed out of the body via the urine without any changes.

Medical Application & Use

Pramipexole is used in all stages of Parkinson’s disease. The agent can be administered alone or in combination with levodopa. It is important that the drug is administered continuously and over a longer period of time.

Another indication for pramipexole is restless legs syndrome. The drug is given to the patient for treatment in moderate and severe cases of the disease. In restless legs syndrome, there are nervous sensations in the legs . These are even worse when at rest, which means that the legs have to move constantly. To treat restless legs syndrome, pramipexole is given on its own.

Pramipexole is taken in pill form. The patient initially starts with a low dose. In the further course, the dosage increases to the optimal level. The tablets are taken three times a day. The recommended dose is 3.3 milligrams. If levodopa is used at the same time, the pramipexole dose will be lower. Retard tablets only need to be taken once a day, because the active ingredient can be released from these preparations throughout the day.

Risks & side effects

Taking pramipexole can be associated with bothersome side effects. Not all patients experience annoying side effects, since each patient reacts differently. In most cases, affected individuals experience involuntary facial movements, low blood pressure , dizziness , nausea , and drowsiness . Other possible side effects include confusion , abnormal behavior , headache , memory problems , blurred vision , restlessness , problems sleeping , tiredness,Weight loss , edema in the limbs, constipation and vomiting .

Rarely, disorders of the libido , sudden falling asleep, breathing difficulties , skin rashes , itching and delusions appear . Since sleep attacks can occur when taking pramipexole, driving and risky work activities are not recommended.

There is a risk of interactions when pramipexole is administered at the same time as the Parkinson’s drug amatadine and the gastric drug cimetidine . Thus, these drugs impede the excretion of the dopamine antagonist through the kidneys . For this reason, a reduction in the pramipexole dosage is considered sensible.

Pregnant and breastfeeding women should not take pramipexole as the effects on them and the child are unknown. Other contraindications are hypersensitivity to the active substance and carrying out a blood wash . Serious heart and vascular diseases, delusions and psychotic disorders are also classified as alarming . If the kidney function is impaired, the doctor must adjust the pramipexole dose accordingly.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.