Pramipexole

Increase in blood pressure has been reported in patients taking pramipexole. In controlled clinical trials in patients with idiopathic Parkinson’s disease, the mean change from baseline in systolic blood pressure was +4.4 mm Hg for the 0.25 mg dose, +4.9 mm Hg for the 0.5 mg dose, and +6.0 mm Hg for the 0.75 mg dose. In the same trials, the mean change from baseline in diastolic blood pressure was +2.0 mm Hg, +2.1 mm Hg and +2.5 mm Hg, respectively. In addition, in controlled clinical trials in patients with restless legs syndrome, the mean change from baseline in systolic blood pressure was +2.2 mm Hg for the 0.25 mg dose and +0.5 mm Hg for the 0.5 mg dose. In the same trials, the mean change from baseline in diastolic blood pressure was +1.3 mm Hg and +0.5 mm Hg, respectively. It is unknown whether these findings are related to pramipexole or other factors. In Parkinson’s disease patients, treatment with pramipexole should be started at a dose of 0.25 mg/day and should be increased gradually until optimal response is achieved. The maximum recommended dose is 1.5 mg/day. In patients with restless legs syndrome, treatment with pramipexole should be started at a dose of 0.5 mg/day. This dose should be increased gradually until optimal response is achieved. The maximum recommended dose is 1.5 mg/day. In both Parkinson’s disease and restless legs syndrome, changes in blood pressure should be monitored at each visit, and the pramipexole dose should be adjusted accordingly.