RE: Mirapex Problems

February 18, 2002

Hi Jim & Peg:

Fred's been on Mirapex for sometime now, He doesn't have any problems with it. I've put in the report on what the sides affect are so you can read it. I hope this will help you.

Take Care

Vera

Brand name:

Mirapex

Pronounced: MERE-a-pecks

Generic name: Pramipexole dihydrochloride

Why is this drug prescribed?

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Although it is not a cure, Mirapex eases the symptoms of Parkinson's disease--a progressive disorder marked by muscle rigidity, weakness, shaking, tremor, and eventually difficulty with walking and talking. Parkinson's disease results from a shortage of the chemical messenger dopamine in certain areas of the brain. Mirapex is believed to work by boosting the action of whatever dopamine is available. The drug can be used with other Parkinson's medications such as Eldepryl, Sinemet, and Larodopa.

Most important fact about this drug

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If you are taking Sinemet or Larodopa, Mirapex may allow a reduction in your dosage. And if you suffer from the "on-off" effect that often develops during Parkinson's therapy (symptom-free periods alternating with severe attacks), Mirapex may extend the good "on" times and shorten your "off" periods.

How should you take this medication?

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Take Mirapex exactly as prescribed. If it makes you nauseous, try taking it with food.When discontinuing Mirapex therapy, it's best to do it gradually. Your doctor will tell you how to taper your dose over a week's time.--If you miss a dose...Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at the same time.--Storage instructions...Store at room temperature; protect from light.

What side effects may occur?

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Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Mirapex.

More common side effects may include:

Abnormal dreams, arthritis, chest pain, confusion, constipation, decreased sensitivity to touch, difficulty breathing, difficulty walking, dizziness, dizziness upon standing, drowsiness, dry mouth, hallucinations, increased muscle tone, increased urination, insomnia, involuntary movement (jerky motions), lack of appetite, memory loss, nasal inflammation, nausea, swelling, urinary tract infections, vision abnormalities, weakness

Less common side effects may include:

Decreased sex drive, delusions, difficulty swallowing, fever, general feeling of illness, impotence, inability to hold urine, muscle spasms or twitching, pneumonia, skin disorders, thinking abnormalities, uncontrollable restlessness, unfounded suspicions, weight loss

Rare side effects may include:

Abnormal ejaculation, abnormal heartbeat, agitation, blood clots, blood in urine, blood circulation problems, convulsions, difficult or painful urination, enlarged abdomen, eye disorders, heart attack, heart problems, joint problems, lung problems, mental illness, muscular problems, prostate problems, severe chest pain (angina), thirst

Why should this drug not be prescribed?

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If Mirapex gives you an allergic reaction, you'll be unable to use it.

Special warnings about this medication

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Mirapex can cause your blood pressure to drop when you first stand up, resulting in symptoms such as dizziness, nausea, fainting, blackouts, and, sometimes, sweating. To avoid or reduce these symptoms, try to stand up slowly, especially at the beginning of treatment with Mirapex.Mirapex can cause drowsiness and may trigger hallucinations, especially if you are over 65 or have an advanced case of Parkinson's. You may even fall asleep--without warning and without feeling drowsy--while performing everyday activities. Check with your doctor immediately if you find that you're getting drowsy or falling asleep while eating, talking, or watching television. Do not drive a car or undertake other dangerous activities until you've spoken with the doctor. Be especially cautious when taking other drugs that cause sleepiness.If you have a kidney condition, make sure the doctor is aware of it. You'll probably need regular blood tests to check your kidney function, and your dosage of Mirapex may have to be reduced.In very rare cases, Mirapex may cause muscle wasting. If you develop muscle aches or soreness after you start Mirapex, be sure to tell your doctor. Also alert your doctor if you notice any changes in your eyesight.

Possible food and drug interactions when taking this medication

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If Mirapex is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Mirapex with the following:

Carbidopa/Levodopa (Sinemet)

Sedatives and tranquilizers such as chloral hydrate, codeine products, Dalmane, Halcion, and phenobarbital

Cimetidine (Tagamet)

Diltiazem (Cardizem, Dilacor XR)

Major tranquilizers such as Compazine, Haldol, Mellaril, Navane, Prolixin, Stelazine, and Thorazine

Metoclopramide (Reglan)

Quinidine (Quinidex, Quinaglute)

Quinine

Ranitidine (Zantac)

Triamterene (Dyrenium)

Verapamil (Calan, Isoptin)Combining Mirapex with Sinemet or Larodopa sometimes triggers twitching and jerky movements. If this happens, tell your doctor. A reduction in your dose of Sinemet or Larodopa may solve the problem.

Special information if you are pregnant or breastfeeding

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The effects of Mirapex during pregnancy have not been adequately studied, so it's best to avoid it if you're expecting. If you are pregnant or plan to become pregnant, inform your doctor immediately.It is not known whether Mirapex appears in breast milk. If the drug is considered essential to your health, your doctor may advise you to stop breastfeeding while taking the medication.

Recommended dosage

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ADULTS The usual starting dose is 0.125 milligrams 3 times a day. If necessary, your doctor may increase the dose every 5 to 7 days until the maximum dose of 4.5 milligrams a day is reached. Dosage is usually increased gradually to minimize the drug's potential side effects. If you have kidney disease, the doctor will keep the dosage quite low.CHILDREN The safety and effectiveness of this drug in children have not been established.

Overdosage

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Although there is no information on Mirapex overdose, any medication taken in excess can have dangerous consequences. If you suspect an overdose, seek medical attention immediately.Return to top

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Subject: Mirapex Problems

Barbara has reported that her husband Ken had problems when he started

using Mirapex. Has anyone else shown problems when using Mirapex? I am

especially interested in information about the effect of Mirapex on mental

cognition.

Thanks for your assistance.

Peg and Jim from Guam

February 18, 2002

My husband was put on Mirapex about a year ago and he experienced

lethargy and was very " heavy " to move - it felt like he weighed 400

lb. when I tried to transfer him from bed to chair, etc. We had to

discontinue it as it seemed to provide no benefit.

Hope this helps.

Marie Fox

February 18, 2002

I started to take it. I was on it about 3 weeks when I started having

visual problems. I don't think I was having problems thinking per se. I do

think I was having trouble deciding which things I had dreamt and which were

real. Things as weird as thinking there was a large moth in the bedroom, to

thinking I had taken certain clothes to the cleaners and had not. The

visual things were usually in low light. If I blinked it seemd to cause a

strobe effect. I think the second week I was seeing pin wheels with my eyes

closed. The Parkinson's doc is taking me off of the Mirapex. I am down to

..5 mg per day. This will be my last week on it. I started taking sinemet

last week.

Mirapex Problems

Barbara has reported that her husband Ken had problems when he started

using Mirapex. Has anyone else shown problems when using Mirapex? I am

especially interested in information about the effect of Mirapex on mental

cognition.

Thanks for your assistance.

Peg and Jim from Guam

********************************

*** Peg & Jim

*** # 29 Cruz Heights

*** Ipan-Talofofo, Guam 96930-4736

*** USA

***

*** Note: Guam is 15 hours ahead of

*** Eastern Standard Time (EST).

*** 14 ahead of EDT.

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February 18, 2002