Pergolide dosage

Pergolide is usually administered in divided doses 3 times/day. During dosage titration, the dosage of concurrent levodopa/carbidopa may be cautiously decreased. In clinical studies, the mean therapeutic daily dosage of pergolide was 3 mg/day. 

The average concurrent daily dosage of levodopa/carbidopa (expressed as levodopa) was approximately 650 mg/day. The efficacy of pergolide at doses above 5 mg/day has not been systematically evaluated. 

In 41 patients with Parkinson s disease who took pergolide, confusion and hallucinations were the adverse effects that were most likely to result in withdrawal of pergolide (2). Symptoms suggestive of dose-related angina pectoris occurred in four patients in the open phase and two patients in the earlier double-blind phase these symptoms were easily controlled by dosage reduction or withdrawal of pergolide without sequelae. There was leukopenia in one patient. 

Parkinson s disease. In one case the dosage of pergolide was halved and in two others ropinirole or entacapone were used as alternatives, in all cases with reduction of the hypersexual symptoms. The other four patients continued to take pergolide, with persistence of the symptoms, to which they and their partners adjusted. 

Pramipexole is initiated at a dose of 0.125 mg three times a day and increased every 5 to 7 days as tolerated. In a fixed-dose study, daily doses of 3, 4.5, and 6 mg were not more effective than 1.5 mg/day, and the higher doses were associated with a higher frequency of adverse effects. When switching from bromocriptine or pergolide to pramipexole, a 10 1 and 1 1 dosage substitution is recommended, respectively. Ropinirole is initiated at 0.25 mg three times a day and increased by 0.25 mg three times a day on a weekly basis to a maximum of 24 mg/day. The dose of dopaminergic agonists is best determined by slow titration to enhance tolerance and to find the least dose that provides optimal benefit. 

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