Initially 0.375 mg/day, then increased every 5-7 days. Dose may be further increased by 0.75 mg wkly up to a max of 4.5 mg/day. Patient w/ CrCl 30-50 mL/min Initially 0.375 mg every other day. Dose may be increased by 0.375 mg wkly up to a max of 2.25 mg/day, if necessary.
Risk of hallucinations; dyskinesia; somnolence & episodes of sudden sleep onset; impulse control disorders (eg, pathological gambling, increased libido, hypersexuality, compulsive spending, buying or eating, & binge eating); mania & delirium. Reports of dystonia. Reports of neuroleptic malignant syndrome upon abrupt treatment w/drawal. Patients w/ psychotic disorders. Ophth monitoring is recommended at regular intervals or in case of vision abnormalities. Monitor BP especially at start of treatment in patients w/ severe CV disease due to risk of postural hypotension. Dopamine agonist w/drawal syndrome. Major influence on the ability to drive & use machines. Patients w/ renal or hepatic impairment. Should not be used during breast-feeding. Pregnancy.
Reduced renal clearance w/ medicinal products that are inhibitors of active renal elimination pathway or are eliminated by this pathway eg, cimetidine, amantadine, mexiletine, zidovudine, cisplatin, quinine, & procainamide. Possible additive effects w/ other sedating medicinal products or alcohol. Avoid co-administration w/ antipsychotic medicinal products eg, if antagonistic effects can be expected. When co-administered w/ levodopa, it is recommended that the dose of levodopa is reduced & the dose of other anti-parkinsonian medicinal products is kept constant while increasing the dose of Mirapex ER.
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