Pramipexole: Side Effects, Uses, Warnings & Interactions


Pramipexole is a medication marketed in the U.S. under the brand names Mirapex and Mirapex ER. Doctors use this medication as a treatment for two conditions: Parkinson’s disease and restless legs syndrome (RLS). Before you can safely take Mirapex, you must understand its uses and potential side effects, as well as its capacity for triggering dangerous drug interactions. In addition, you must understand the warnings that doctors commonly issue for users of the medication.

Medication Uses

Pramipexole belongs to a class of substances called dopamine agonists. This means that the medication increases the levels of a chemical inside your brain called dopamine. You rely on dopamine for several reasons. One of its most important roles is producing the electrochemical responses that make it possible for you to control your muscles. Doctors prescribe Mirapex for people with Parkinson’s disease because this disorder gradually kills off the brain’s dopamine-producing cells. They prescribe it for restless legs syndrome because the normal dopamine production system in people with this disorder is at least partially blocked.

Medication Side Effects

Mirapex can produce a range of side effects that only cause concern when they appear in severe form or linger for long periods of time. The list of effects users may experience includes:

  • Painful joints
  • A confused mental state
  • Memory problems
  • Appetite loss
  • Insomnia
  • Unusual sleepiness
  • General weakness
  • Changes in normal motion or movement
  • Lightheadedness
  • Strange dreams or thought patterns
  • Sexual dysfunction or a lack of interest in sex
  • Nausea
  • Increases in urine output
  • Unusually urgent urination
  • Diarrhea or constipation
  • Heartburn

Use of Mirapex can also lead to the onset of side effects that are medically serious in any form, and require immediate attention. Examples of these problems include:

  • Difficulty catching your breath
  • Pain in your chest
  • Changes in your normal visual field
  • Unusually weak muscles
  • Muscles that are tender, achy or stiff
  • Urine with a red, blackish or dark color

Apart from these mild, moderate and severe side effects, pramipexole can have another unusual impact on your daily function. A small, but significant percentage of users develop a range of compulsive behaviors that they feel unable to control. Examples of reported behaviors include participation in compulsive gambling, participation in compulsive shopping and compulsive sexual activity.

Medication Interactions

Mirapex can cause problems if you use it in combination with any one of a large number of medications. The list of medications you must report to your doctor before receiving a pramipexole prescription includes antidepressants, anti-anxiety drugs, antihistamines and allergy treatments, the Parkinson’s disease treatment levodopa, sedative/tranquilizers, anti-seizure drugs, anti-nausea drugs, certain chest pain and hypertension drugs, and the ulcer/acid reflux treatment cimetidine. You will also need to report your use of any over-the-counter medications or supplements. Depending on your circumstances, your doctor may alter your doses of medications/supplements or check regularly for any harmful effects.


Since Mirapex can produce unusual sleepiness, doctors warn new users not to drive or engage in other potentially dangerous activities until they know how the medication will affect them. Use of the medication can also trigger a range of symptoms, including fainting spells (if you rapidly switch your body position). Breastfeeding women can’t take Mirapex, and your doctor may also suspend its use if you’re pregnant or planning a future pregnancy. In addition, you should not have surgery of any kind without informing your physician about your use of the medication. The U.S. National Library of Medicine, a branch of the National Institutes of Health, maintains a comprehensive list of the guidelines to follow while taking pramipexole/Mirapex.


U.S. National Library of Medicine – MedlinePlus: Pramipexole

Medscape: Pramipexole and Compulsive Gambling – What Are the Odds?

NIH Senior Health: Parkinson’s Disease

Johns Hopkins Medicine: Causes of Restless Legs Syndrome

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