Pramipexole (Mirapex®)
This nonergot, benzothiazole derivative is an excellent medication for early PD and has a broader range of indication than bromocriptine and pergolide for the treatment of the sign and symptoms of PD. Its role in advanced PD is similar to that of other dopamine agonists.
Indicated both as a single agent and adjuvant to levodopa. Dose should be gradually increased to achieve maximum therapeutic effects balanced against the major side effects, i.e., motor disturbances, hallucinations, somnolence and dry mouth. Patients with renal impairment need dose reduction and the drug should be given less frequently.
Side effects
Orthostatic hypotension is rare.