In this article you will learn everything about Mirapex: how to replace this drug, what is its effect, contraindications for use, side effects, special instructions for its use. These pills can cause abnormal behavior and affect the patient's reactions. Therefore, before taking Mirapeks, the 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 ingredient of Mirapex is pramipexole. Auxiliary components of tablets: povidone, mannitol, starch, aerosil, magnesium stearate.
This drug is used to treat idiopathic (not dependent on other lesions) restless legs syndrome and Parkinson's disease, as well as other specified motor andextrapyramidal disorders.
Release form: Mirapex PD tablets 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.
Pills of white color. They have a bevelled edge and a flat shape on both sides, one of which has a deep notch.
Pills should be taken orally, regardless of meals. It is permissible to use the drug at any time. At the same time, it must be drunk with water. It is recommended to divide the daily dose into three doses.
Mechanism of action (pharmacodynamics) of Mirapex tablets
The active substance pramipexole, which contains Mirapex, specifically and with high selectivity enhances the response of dopamine receptors from the D2 subgroup. Thanks to him, the lack of motor activity in the case of Parkinson's disease is compensated. This happens due to the activation of dopamine receptors in the striatum. At the same time, pramipexole prevents the degeneration of their neurons, which occurs due to neurotoxicity or ischemia. It inhibits or reduces the rate of dopamine synthesis, metabolism, and release. Thanks to pramipexole, neurons are protected from the toxic effects of the anti-Parkinsonian drug Levodopa. Also, due to its effects, the production of prolactin decreases (dose-dependent).
In the case of long-term use of Mirapex tablets for the treatment of Parkinson's disease (more than three years) and restless legs syndrome (more than a year), no decrease in the effectiveness of pramipexole was detected.
Biochemical processes occurring with the drugMirapex in the patient's body (pharmacokinetics)
The active substance of 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 after 1-3 hours after its use. With meals, the rate of absorption of pramipexole decreases. At the same time, the amount of digestible food does not change.
Pramipexole binds slightly to proteins (less than 20%). It has a large volume of distribution - 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 administered amount of the drug. Tissues and body fluids are cleared of Mirapex tablets at an average rate of 500 ml/min.
Using 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 effect of pramipexole on the systems and organs responsible for the process of fertilization was studied in the course of experiments on animals. At the same time, there were no violations of fetal development during pregnancy in rabbits and rats.
No excretion of pramipexole in breast milkhas been studied. It can only be assumed that the substance can suppress lactation, as it inhibits the production of luteotropic hormone. Therefore, it is not recommended to take Mirapex tablets while breastfeeding.
During pregnancy, the drug should be taken only when the potential benefit to the expectant mother outweighs the risk to the fetus.
Contraindications to the use of Mirapex tablets
Mirapex should not be taken in case of hypersensitivity to pramipexole, as well as people under the age of 18.
With extreme caution, it is recommended to use tablets with low blood pressure and kidney failure.
Side effects of Mirapex on the nervous system
Mirapex is a pill that can cause the following reactions from the nervous system:
- confusion;
- excessive sleep cravings or lack thereof;
- hallucinations;
- amnesia;
- asthenia;
- dizziness;
- extrapyramidal syndrome;
- hypesthesia;
- tremor;
- myoclonus;
- dystonia;
- depressed;
- nonsense;
- suicidal tendencies;
- hypokinesia;
- ataxia;
- anxiety;
- Neuroleptic malignant 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 othershuman body systems
The musculoskeletal system may react to the use of Mirapex with the following manifestations:
- muscle hypertonicity, their cramps, twitches;
- appearance of arthritis, myasthenia gravis or bursitis;
- pain in the chest, neck, or spine (lumbosacral).
Digestive system abnormalities may also appear. This results in:
- loss of appetite;
- constipation;
- nausea;
- dyspepsia;
- flatulence;
- diarrhea;
- vomit;
- dry mouth;
- cutting sensations in the stomach.
For the respiratory system, taking Mirapex can result in the development of sinusitis, pharyngitis, rhinitis, and a flu-like syndrome. Shortness of breath, increased coughing, and a change in voice are also possible.
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 Mirapex drug in the genitourinary system, complications such as increased bowel movements and infections may occur. This even suggests a decrease in libido and potency.
In addition, diplopia, cataracts, conjunctivitis, accommodation paralysis, allergies, as well as hearing loss, intraocular pressure may occur.
Other adverse reactionsorganism:
- retroperitoneal fibrosis;
- pleural effusion;
- lung infiltration;
- weight loss;
- peripheral edema.
Method of application and dosage of Mirapex tablets
You need to use the drug inside, 3 times daily. 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 taken every day, in the third - 1.5 mg, during the fourth - 2.25 mg, in the fifth, Mirapex 3 mg should be taken daily, in the sixth - 3.75 mg, seventh - 4.5 mg.
In chronic renal failure, the dosage is adjusted based on the level of creatinine clearance. The doctor should prescribe the exact amount of the drug.
Consequences of an overdose when taking Mirapex tablets
If the dosage was violated when using Mirapex, the following symptoms may presumably occur: hallucinations, hyperkinesia, vomiting, nausea, lowering blood pressure and agitation.
An antidote has not been established for this situation. Cases of overdose with Mirapeks have not been recorded. Symptomatic therapy, gastric lavage and dynamic observation are recommended. If signs of excitation of the central nervous system occur during an overdose, then antipsychotic drugs should be used.
Interactions of Mirapex tablets withother 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.
Medications that inhibit or suppress the active production of cationic substances or self-excreted through the renal tubules may react with Mirapex tablets. Instructions for use explains that in this case, there will be a decrease in the rate of purification of tissues and biological fluids, either from both drugs, or from one of them.
If such drugs are used simultaneously with Mirapex tablets, then you should pay attention to possible hallucinations, dyskinesia, arousal. If such signs appear, then the dosage of the medicine must be reduced.
Compatibility of Mirapex tablets with Amantadine and Levodopa
What happens when Levodopa and Selegiline are taken together with Mirapex PD tablets? The instruction states that neither the first nor the second affects the pharmacokinetics of the active substance. At the same time, Mirapex tablets do not affect the complete assimilation by the body and the elimination of Levodopa in a natural way.
The interaction of pramipexole with the drug "Amantadine" has not been studied. But their compatibility is possible in therapy, as they have similar excretion mechanisms.
When the dose of Mirapex is increased, the amount of Levodopa used is recommendedreduce. At the same time, the number of other anti-Parkinsonian drugs must be constantly maintained at the same level.
Features of the compatibility of Mirapex with other drugs
Due to the possibility of cumulative effects, it is recommended to use Mirapex tablets with extreme caution in combination with sedatives, alcohol and drugs that increase the concentration of pramipexole in the blood (for example, with the drug Cimetidine).
Special instructions for using Mirapex tablets
The drug described by us is strongly not recommended to be taken simultaneously with antipsychotics.
With dopamine agonist treatment, known side effects are confusion and hallucinations. In cases of using Mirapex tablets in combination with Levodopa, such deviations were observed more often in the later stages of the disease than in the early stages 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.
After abrupt discontinuation of pills in the case of Parkinson's disease, the onset of a symptom complex that resembles neuroleptic malignant syndrome was revealed.
Abnormal behavior when using Mirapex
Patients and their caregivers need to be aware that taking dopaminergic drugs, in particular pills"Mirapex" (reviews confirm this), often causes abnormal behavior of the patient. Hyperphagia (a tendency to overeat), pathological shopping (an obsessive desire to make a lot of purchases), an irresistible attraction to gambling and hypersexuality may occur. In such cases, it is necessary to reduce the dosage of the drug or gradually stop taking it.
Caution when using Mirapex tablets
Mirapex medicine should be used with caution by 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 check it regularly immediately after the appointment of Mirapex tablets and then at certain intervals.
Patients should be aware that the drug may have a sedative effect. Cases of sudden falling asleep and excessive sleepiness in the course of daily activities are known. Including this can happen at any time when operating complex mechanisms or driving vehicles.
Possibility of developing melanoma
As a result of epidemiological studies, it was found that patients with Parkinson's disease are at risk of developing melanoma. Is it caused by this disease or other factors, such as the use of a drugMirapex, not established.
Increase in restless legs syndrome
How does Mirapex affect Restless Leg Syndrome? Patient feedback suggests that dopaminergic drugs can enhance it. This manifests itself in the form of an earlier onset of the symptoms of the syndrome in the evening, and sometimes in the afternoon. The symptoms also spread to other limbs. In a 26-week clinical controlled trial that was designed to investigate this effect, there was no significant difference between the pramipexole and placebo groups in worsening the symptoms of the syndrome.
Storage conditions and expiration date
Mirapex tablets are drugs from list B. They must be stored in a dark place. In this case, the temperature in the room should not exceed 30 °C.
The shelf life of the drug is 36 months (3 years) from the date of production.
The use of Mirapex tablets in childhood and the conditions for their purchase
The drug is contraindicated for use in childhood. It is allowed to take pills to persons who have reached 18 years of age. Mirapex is available in pharmacies upon presentation of a prescription.
Analogues of Mirapex
Can't buy Mirapex tablets for any reason? How to replace the drug, you should be prompted by a pharmacist or doctor. And we offer the following analogues.
- Motopram tablets. Indications for use: Parkinson's disease. Can be used as monotherapy or combined with a drug"Levodopa". Also used for severe idiopathic or moderate restless legs syndrome.
- Oprimea tablets. Purpose: antiparkinsonian drug-stimulant of dopaminergic transmission to the central nervous system.
- Pramipexole tablets. The therapeutic agent is used in Parkinson's disease. It is generally accepted that the mechanism of its action is directly related to the ability of the substance pramipexole to stimulate dopamine receptors in the striatum.
Tablets "Mirapex" - analogues or original? No self-treatment
The list above lists drugs that are analogues of Mirapex tablets. They have the same unique, nonproprietary international name (or ATC code) as recommended by the WHO (World He alth Organization).
If you need to undergo treatment with Mirapex tablets, analogues can also be a great alternative. But before replacing the prescribed therapy, be sure to consult a specialist. Under no circumstances self-medicate! This can cause irreversible negative effects on your he alth.
Attention! This article describing the Mirapeks preparation is an augmented and simplified version of the official instructions for use. Information about the drug is presented for the purpose of familiarization. Do not under any circumstances use it as a guide for self-medication.
