pramipexole
Brand names: Mirapex
Pramipexole extended-release tablets help treat Parkinson's disease. It belongs to a class of drugs called dopamine agonists.
Drug Pricing (NADAC)
Generic Price
$0.04/unit
Generic Available
Yes (13 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
This medicine treats Parkinson's disease.
Common side effects
Feeling sleepy, Feeling sick to your stomach, Constipation
Key warnings
Pramipexole can make you fall asleep suddenly, even during normal daily activities.
How It Works
Pramipexole works by acting like dopamine in the brain. Dopamine is a chemical that helps control movement. By mimicking dopamine, this medicine helps reduce Parkinson's symptoms.
How to Take It
Take pramipexole extended-release tablets once a day. You can take it with or without food. Swallow the tablet whole; do not chew, crush, or divide it. Your doctor may change your dose over time.
Pregnancy & Breastfeeding
This medicine may harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if this medicine passes into breast milk. Pramipexole may also reduce breast milk production.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store at room temperature (68° to 77°F) and keep away from high humidity. Keep out of reach of children.
Side Effects (from patient reports)
Based on 8,808 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 14,399 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
14,399
Death-Related Reports
1,206
Hospitalization Reports
5,034
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DRUG INEFFECTIVE | 1,349 |
| 2 | FALL | 1,066 |
| 3 | FATIGUE | 1,043 |
| 4 | NAUSEA | 832 |
| 5 | PAIN | 795 |
| 6 | CONDITION AGGRAVATED | 788 |
| 7 | HALLUCINATION | 754 |
| 8 | OFF LABEL USE | 737 |
| 9 | DIZZINESS | 734 |
| 10 | DYSPNOEA | 710 |
| 11 | DYSKINESIA | 643 |
| 12 | GAIT DISTURBANCE | 642 |
| 13 | HEADACHE | 593 |
| 14 | TREMOR | 576 |
| 15 | DEATH | 565 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Pramipexole can make you fall asleep suddenly, even during normal daily activities. Tell your doctor if this happens. Pramipexole can also cause compulsive behaviors like gambling or overeating. Watch for these changes and tell your doctor if they occur.
Known Drug Interactions
7 DRUG INTERACTIONS Dopamine antagonists: May diminish the effectiveness of pramipexole (7.1). 7.1 Dopamine Antagonists Since pramipexole is a dopamine agonist, it is possible that dopamine antagonists, such as the neuroleptics (phenothiazines, butyrophenones, thioxanthenes) or metoclopramide, may diminish the effectiveness of pramipexole dihydrochloride extended-release tablets.
Mechanism: Pramipexole works by acting like dopamine in the brain, while dopamine antagonists block those same spots. Because they work against each other, the antagonist can stop pramipexole from working correctly.
What to do: Your doctor may need to avoid using these drugs together or adjust your treatment because they can cancel each other out.
7.1 Dopamine Antagonists Since pramipexole is a dopamine agonist, it is possible that dopamine antagonists, such as the neuroleptics (phenothiazines, butyrophenones, thioxanthenes) or metoclopramide, may diminish the effectiveness of pramipexole dihydrochloride extended-release tablets.
Mechanism: Metoclopramide blocks the same receptors that pramipexole is trying to activate. This prevents pramipexole from doing its job effectively.
What to do: Talk to your doctor before taking these together, as metoclopramide may make your pramipexole treatment less effective.
Common Questions
Can I cut the tablet in half?
What should I do if I feel dizzy?
Can I drink alcohol while taking this medicine?
How long does it take for this medicine to work?
What if I start having hallucinations?
Can I drive while taking this medicine?
What should I do if I develop new or worsening uncontrolled movements?
Is it okay to suddenly stop taking this medicine?
What if I have kidney problems?
Can this medicine affect my blood pressure?
What are the common side effects of pramipexole?
Does pramipexole interact with other medications?
What drug class is pramipexole?
Is pramipexole safe during pregnancy?
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What the FDA Data Shows for pramipexole
The FDA label for pramipexole (sold under brand names such as Mirapex) classifies it as a prescription-only medication in the Dopamine Agonist class. This medicine treats Parkinson's disease. Official labeling lists 12 commonly reported side effects, including Feeling sleepy, Feeling sick to your stomach, Constipation.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 8,808 voluntary reports. The database also lists 2 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $0.04.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: August 31, 2021
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages