Introduction
Parixol 180 is a prescription medicine used in the treatment of Parkinson's disease and restless leg syndrome (an urge to move the legs usually accompanied or caused by uncomfortable and unpleasant leg sensations). It helps to treat excessive shaking by slowing down the body movements.
Parixol 180 should be taken with food. However, take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Take this medicine in the dose and duration as advised by your doctor and if you have missed a dose, take it as soon as you remember it. You should never skip any doses and finish the full course of treatment even if you feel better. It is important that this medication is not stopped suddenly without talking to your doctor.
Some common side effects of this medicine include nausea, dry mouth, fatigue, hallucinations, constipation, and peripheral edema. It also causes dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. Inform your doctor if you develop any unusual changes in mood, an abnormally high sex drive, an urge to gamble or uncontrolled spending as these may prove very harmful.
Uses of Parixol 180
- Parkinson's disease
- Restless leg syndrome
Side effects of Parixol 180
Common
- Dizziness
- Sleepiness
- Nausea
- Dryness in mouth
- Fatigue
- Hallucination
- Constipation
- Peripheral edema
How to use Parixol 180
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Parixol 180 is to be taken with food.
How Parixol 180 works
Parixol 180 works by increasing the action of dopamine, a chemical messenger that is needed to control movement in the brain.
Indication
Parkinson's disease, Restless leg syndrome
Administration
May be taken with or without food. May be taken w/ meals to minimise GI side effects such as nausea.
Adult Dose
Parkinson Disease
Immediate-release: 0.125 mg PO q8hr initially; gradually titrated upward at weekly intervals to target range of 1.5-4.5 mg/day PO divided q8hr
Restless Legs Syndrome
0.125 mg/day PO 2-3 hr before bedtime initially; may be increased every 4-7 days up to 0.5 mg/day (every 14 days if CrCl 20-60 mL/min)
Renal Dose
Parkinson disease
Immediate release
CrCl >50 mL/min: Dosage adjustment not necessary
CrCl 30-50 mL/min: 0.125 mg twice daily initially; not to exceed 0.75 mg TID
CrCl 15-29 mL/min: 0.125 mg qDay; not to exceed 1.5 mg qDay
CrCl <15 mL/min: Dosage adjustment not provided in manufacturer's labeling; not studied
ESRD requiring hemodialysis: Dosage adjustment not provided in manufacturer's labeling; not studied
Restless legs syndrome
Immediate release
CrCl >60 mL/min: Dosasge adjustment not necessary
CrCl 20-60 mL/min: Dosage adjustment not necessary but duration between titration should be increased to 14 days
CrCl<20 mL/min: Dosage adjustment not provided by manufacturer's labeling; not studied
Contraindication
Hypersensitivity. Lactation.
Mode of Action
Pramipexole is a nonergot-derivative dopamine receptor agonist which alleviates Parkinsonian motor deficits by directly stimulating postsynaptic dopamine activity on the striatum and substantia nigra It is used as an adjunct to levodopa for the symptomatic management of parkinsonian syndrome in patients w/ advanced disease. It is also used as monotherapy for the initial symptomatic management of parkinsonian syndrome.
Precaution
Psychotic disorder, severe CV disease, augmentation (earlier onset, increase and spread of symptoms). Risk of neuroleptic malignant syndrome w/ abrupt withdrawal. Taper dose at 750 mcg/day for a wk, then reduce by 375 mcg/day thereafter. Renal impairment. Pregnancy and lactation. Patient Counselling Patients should be informed to refrain from activities involving mental alertness and physical coordination after drug intake. Monitoring Parameters Monitor BP, signs and symptoms of fibrosis and orthostatic hypotension, development of impulse control disorder, behavioural changes. Perform periodic skin examinations. Regular ophthalmological testing due to risk of visual disorders.
Side Effect
>10%
Somnolence,Dyskinesia,Hallucinations,Insomnia,Dizziness,Postural hypotension,Nausea,Constipation
1-10% (partial list)
Abnormal dreams, thoughts, or vision,Amnesia,Confusion,Paranoia or delusion,Akathisia,Asthenia,Dry mouth
Interaction
Inhibits active tubular secretion of basic cationic drugs eg, cimetidine. Reduced clearance w/ drugs eliminated by active renal tubular secretion eg, amantadine. Alcohol & other sedatives.