Pramipexol

A large number of molecules have provided experimental evidence of neuroprotection in in vitro and in vivo models of Parkinson s disease and many of these putative neuroprotective substances are now the objects of clinical trials. Recently, a team of experts has identified potential neuroprotective agents to be tested in pilot studies [4]. Twelve compounds have been considered for clinical trials caffeine, coenzyme Q 10, creatine, estrogen, GPI1485, GM-1 ganglioside, minocycline, nicotine, pramipexole, ropinirol, rasagiline, and selegiline (for individual discussion see [4]). 

The dopamine receptor agonists, such as pramipexole (Mirapex) and ropinirole (Requip), are used for die treatment of die signs and symptoms of Parkinson s disease... 

The most common adverse reactions seen with pramipexole and ropinirole include nausea, dizziness, postural hypotension, hallucinations, somnolence, vomiting, confusion, visual disturbances, abnormal involuntary movements, and headache... 

The phenotiiiazines may decrease the effectiveness of tiie dopamine receptor agonists. When pramipexole is administered concurrently witii cimetidine, ranitidine, verapamil, and quinidine, there is an increased effect of pramipexole When ropinirole is administered with the estrogens, particularly estradiol, there may be an increased effect of ropinirole... 

Cj H403 85-44-9) sec Anisindione Chlortalidone Cilazapril Deptropine Fluorescein Hydralazine Indobufen Indoprofen Melphalan Phenolphthalein Phthalylsulfathiazole Pizotifen Pramipexole hydrochloride Saquinavir Sulfaloxic acid Thalidomide Tilisolol hydrochloride phthalide... 

C14H13NO3 104618-32-8) see Pramipexole hydrochloride 6-(phthalimidomethyl)-llff-dibenz[h,e]azepine (C23Hi(jN202 74860-00-7) - see Epinastine hydrochloride 6-(phthalimidomethyl)-6,ll-dihydro-Sff-dibenz[6,e]aze-pine... 

CjHoO 123-38-6) see . Amorolfine Anethole Ethiazide Pramipexole hydrochloride Proligesione Retinol propionaldehyde thiosemicarbazone (C4H9N3S 22042-87-1) see Sulfaethidole propionic acid... 

Amantidine, bromocriptine, mazindol, pergolide, cabergoline, L-dopa/carbidopa, pramipexole, ABT-431, catecholamine metabolism inhibitors (disulfiram, phenelzine, selegiline), amineptine Methylphenidate, /-amphetamine, tropanes, GBR-12909 (partial agonist that may also act as antagonist), modafinil, coca tea... 

Opioids, benzodiazepines, barbiturates, corticosteroids, dopamine agonists (e.g., amantadine, bromocriptine, levodopa, pergolide, pramipexole, ropinirole), H2-receptor antagonists, anticholinergics (e.g., diphenhydramine, trihexylphenidyl), P-adrenergic blockers, clonidine, methyldopa, carbamazepine, phenytoin, baclofen, cyclobenzaprine, lithium, antidepressants (e.g., tricyclic antidepressants, selective serotonin reuptake inhibitors), and interleukin-2... 

Pramipexole (Mirapex ) Activate postsynaptic D2 DA receptors Start with 0.125 mg three times daily increase about weekly by 0.375-0.75 mg/day to a MD of 0.5-1.5 mg three times daily dosage reduction needed in patients with creatinine clearance less than 60 mL/minute... 

Common side effects include nausea, vomiting, sedation (highest with apomorphine), pedal edema, orthostatic hypotension (highest with pramipexole and cabergoline), and... 

Maggio R, Scarselli M, Novi F, Millan MJ, Corsini GU. Potent activation of dopamine D3/D2 heterodimers by the antiparkinsonian agents, S32504, pramipexole and ropinirole. J Neurochem 2003 87 631-641. 

Lagos P., Scorza C., Monti J. M. et al. (1998). Effects of the D3 preferring dopamine agonist pramipexole on sleep and waking, locomotor activity and striatal dopamine release in rats. Eur. Neuropsychopharmacol. 8(2), 113-20. 

Streeter C.C., Hennen J., Ke Y. et al. Prefrontal GABA levels in cocaine-dependent subjects increase with pramipexole and venlafaxine treatment. Psychopharmacology (Berlin). 1, 2005. 

The most important alternatives to levodopa therapy are direct-acting dopamine receptor agonists, such as ropinirole,pramipexole, or pergolide (Fig. 46-5). A number of studies have shown that use of these agents may help to delay the need for use of levodopa/carbidopa. This has... 

Zarate, C. A., Payne, I. L., Singh, J. et al. Pramipexole for bipolar II depression a placebo-con trolled proof of concept study. Biol Psych. 56 54-60, 2004. 

Pramipexole is initiated at a dose of 0.125 mg three times daily and increased every 5 to 7 days as tolerated. It is primarily renally excreted, and the initial dose must be adjusted in renal insufficiency. 

---