Anti-Parkinson’s Disease Common Drugs Ultimate Review

Anti-Parkinson Disease Common Drugs Ultimate Review

Brand Names: Mirapex
Therapeutic Category: Anti-Parkinson Agent, Dopamine Agonist
Dosage Forms: Tablet, oral
Use:
Labeled Indications: Parkinson disease: Treatment of Parkinson disease
Restless legs syndrome
(immediate release only): Treatment of moderate to severe primary restless legs syndrome (RLS)
Off-Label: Bipolar depression/ Fibromyalgia

Dosing for Anti-Parkinson:
Immediate release: Initial: 0.125 mg 3 times daily, increase gradually every 5 to 7 days; maintenance (usual): 0.5 to 1.5 mg 3 times daily
Bipolar depression (off-label use): Oral: Immediate release: Initial: 0.125 mg given 2 to 3 times daily; increase gradually by 0.125 to 0.25 mg daily every 3 to 7 days to a target range of 1 to 3 mg/day given in 2 to 3 divided doses
Dose Adjustments for Anti-Parkinson
Renal Impairment:. CrCl 30 to 50 mL/minute: Initial: 0.125 mg twice daily (maximum: 0.75 mg 3 times daily)
CrCl 15 to 29 mL/minute: Initial: 0.125 mg once daily (maximum: 1.5 mg once daily)
Hepatic Impairment: No dosage adjustment necessary
Adverse Drug Interaction:
Orthostatic hypotension/ Drowsiness/ insomnia/ dizziness
Pharmacodynamics/Kinetics:
Bioavailability: Immediate release: >90%
Half-life elimination: 8.5 hours
Time to peak: Immediate release: 2 hours
Important Notes:
Use with caution in patients with preexisting dyskinesias
Impulse control disorders: Has been associated with compulsive behaviours and/or loss of impulse control.
Use with caution in patients at risk of hypotension (such as those receiving antihypertensive drugs)
. Pregnancy & Lactation: Pregnancy category C/ not known if present in breast milk
Medication Safety Issues: Mirapex may be confused with Hiprex, Mifeprex, MiraLax

Brand Names: Requip
Therapeutic Category: Anti-Parkinson Agent, Dopamine Agonist
Dosage Forms: Oral/ Tablet
Use:
Labeled Indications: Parkinson disease: Treatment of Parkinson disease
Restless legs syndrome (immediate release only): Treatment of moderate to severe primary restless legs syndrome (RLS)
Dosing : Parkinson disease: Oral:
Immediate-release tablet: The dosage should be increased to achieve a maximum therapeutic effect
Week 1: 0.25 mg 3 times daily; total daily dose: 0.75 mg
Week 2: 0.5 mg 3 times daily; total daily dose: 1.5 mg
Week 3: 0.75 mg 3 times daily; total daily dose: 2.25 mg
Week 4: 1 mg 3 times daily; total daily dose: 3 mg
Note: After week 4, if necessary, daily dosage may be increased by 1.5 mg/day on a weekly basis up to a dose of 9 mg/day, and then by up to 3 mg/day weekly to a total of 24 mg/day

Dose Adjustments for Anti-Parkinson
Renal Impairment:. No dosage adjustment necessary.
Hepatic Impairment: No dosage adjustment necessary
Adverse Drug Interaction:
Increased heart rate/ Headache/ Nausea/ diarrhea/ vomiting
Pharmacodynamics/Kinetics:
Bioavailability: Absolute: 45% to 55%
Half-life elimination: 6 hours
Time to peak: Immediate release: 1-2 hours
Important Notes:
Dyskinesias: May cause and/or exacerbate dyskinesias. Use with caution in patients with preexisting dyskinesias
Impulse control disorders: Has been associated with compulsive behaviors and/or loss of impulse control.
. Pregnancy & Lactation: Pregnancy category C/ not known if present in breast milk
Medication Safety Issues:
Requip may be confused with Reglan
ROPINIRole may be confused with RisperDAL, risperiDONE, ropivacaine