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Mirapex Warnings and Precautions

To help ensure a safe, effective treatment process with Mirapex, warnings and precautions for the medication should be fully understood. For example, Mirapex may cause side effects, such as hallucinations; compulsive behaviors; or serious lung, chest, and heart problems. Before taking Mirapex, make sure your healthcare provider is aware of all health conditions you have and any other medications you are taking.

Mirapex: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Mirapex® (pramipexole dihydrochloride) if you have:
  • A sleep disorder other than restless legs syndrome (RLS)
  • Low blood pressure (hypotension)
  • Dyskinesia (a muscle movement disorder)
  • Kidney disease, including kidney failure (renal failure) or milder forms of kidney disease
  • Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about any medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Mirapex Warnings and Precautions

Warnings and precautions to be aware of prior to taking Mirapex include the following:
  • The medication may cause you to fall asleep during the day, sometimes without warning. This can be especially dangerous if you are driving a car or operating heavy machinery. In addition, this can happen long after you start taking Mirapex. Ask your healthcare provider if you should stop driving a car or operating heavy machinery while taking Mirapex.
  • Mirapex can cause low blood pressure, especially when standing or sitting up too quickly. Take your time getting up, and let your healthcare provider know if you experience fainting or frequent dizziness.
  • The medication can cause hallucinations. This side effect is most common in people taking Mirapex for Parkinson's disease and in elderly people. It is not a rare side effect; in some studies, up to 16.5 percent of people taking Mirapex experienced hallucinations. Let your healthcare provider know if you develop hallucinations while taking the drug. Also, let your friends, family, or caretakers know about this potential side effect, as they may be better able to identify the problem.
  • There has been one case of rhabdomyolysis (a breakdown of muscle tissue that can lead to kidney damage) that may have been caused by Mirapex. Make sure to report any severe muscle pain or weakness to your healthcare provider.
  • Mirapex can worsen dyskinesia (a movement disorder that is a common side effect of levodopa, another Parkinson's medication). If you take Mirapex with a medication that contains levodopa (Parcopa®, Sinemet®, Sinemet® CR, Stalevo®), your healthcare provider may need to decrease your levodopa dosage.
  • In animal studies, Mirapex caused damage to the retinas of the eyes in rats. Similar problems have been reported in human studies, but it is unclear if the risks are greater in people taking the drug, compared to the general public.


  • Medications similar to Mirapex can cause serious problems if they are stopped too quickly. Signs of such problems include high fever, stiff muscles, and an altered state of consciousness. Although these problems have not been reported with Mirapex, the possibility cannot be ruled out.
  • The kidneys remove Mirapex from the body. Therefore, if your kidneys are not functioning well, your healthcare provider may recommend a lower Mirapex dosage.
  • Medications similar to Mirapex can cause serious lung, chest, and heart problems as the result of excessive formation of fibrous connective tissue. Rare cases of such problems have been reported with Mirapex, but it is not clear if these problems were caused by the drug or something else.
  • People with Parkinson's disease have a higher risk of melanoma (a type of skin cancer). It is not known if this is due to Parkinson's disease medications or to other factors. Although Mirapex does not seem to increase the risk of melanoma, it cannot be ruled out, and regular skin cancer screenings are recommended.
  • There have been a few reports of unusual compulsive behaviors, such as gambling, binge eating, or hypersexuality, in people taking Mirapex (see Mirapex and Gambling). Let your healthcare provider know if you develop any such behaviors while taking the drug. Also, let your friends, family, or caretakers know about this potential side effect, as they may be better able to identify the problem.
  • Mirapex can potentially interact with several medications (see Mirapex Drug Interactions).
  • Mirapex is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Mirapex and Pregnancy).
  • It is not known whether Mirapex passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Mirapex and Breastfeeding).
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