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Pramipexole (Mirapex)

Dopaminergicprescriptionoral · inferred

Non-ergot dopamine D2/D3 receptor agonist (D3-preferring); approved for Parkinson's disease (IR and ER) and restless legs syndrome. Parkinson's IR: titrated from 0.125 mg TID up to 1.5 mg TID; RLS: 0.125-0.5 mg QHS. Plasma half-life ~8h. Very high oral bioavailability (>90%). Minimal metabolism, >90% excreted unchanged renally; reduce dose in renal impairment. Notable impulse-control disorders (pathological gambling, hypersexuality) and sudden-onset sleep attacks.

Projected serum levels — 0.50 mg, once daily

Pramipexole (Mirapex)
Pramipexole (Mirapex) modeled serum levels, 0.50 mg once daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 1 days. 0 0.25 0.50 0.75 1 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 1

Maintenance schedule: 0.50 mg once daily (oral).

Modeled steady state after ~1 days: peak ≈ 0.45 mg, trough ≈ 0.078 mg body load. Population-based estimate over 15 days for a 0.50 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Dopaminergic
Route modeled
Oral
Model confidence
inferred
Half-life
8.5 h
Common dose
0.50 mg
Suggested maximum
4.5 mg/day
Reference dose range
0.25–4.5 mg (single dose)
Suggested cadence
once daily
Validated against
0.50 mg oral — Cmax 0.001 mg/L at 2 h

Documented interactions

  • danger
    Ropinirole (Requip) + Pramipexole (Mirapex) Stacked effects

    Pramipexole (Mirapex) and Ropinirole (Requip) both push the dopamine D2, dopamine D3, and dopamine D4 in the same direction.

  • moderate
    Aripiprazole (Abilify) + Pramipexole (Mirapex) Stacked effects

    Aripiprazole (Abilify) and Pramipexole (Mirapex) both push the dopamine D2 and dopamine D3 in the same direction.

  • moderate
    Brexpiprazole (Rexulti) + Pramipexole (Mirapex) Stacked effects

    Brexpiprazole (Rexulti) and Pramipexole (Mirapex) both push the dopamine D2 and dopamine D3 in the same direction.

  • moderate
    Cariprazine (Vraylar) + Pramipexole (Mirapex) Stacked effects

    Cariprazine (Vraylar) and Pramipexole (Mirapex) both push the dopamine D2 and dopamine D3 in the same direction.

  • moderate
    Dolutegravir (DTG / Tivicay) + Pramipexole (Mirapex) Transporter inhibition

    Dolutegravir (DTG / Tivicay) inhibitor of OCT2 may alter Pramipexole (Mirapex) absorption / distribution

  • moderate
    Trimethoprim/Sulfamethoxazole (Bactrim) + Pramipexole (Mirapex) Transporter inhibition

    Trimethoprim/Sulfamethoxazole (Bactrim) inhibitor of OCT2 may alter Pramipexole (Mirapex) absorption / distribution

Serum checks 15 modeled interaction pairings for pramipexole (mirapex) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Clinical pharmacokinetics of pramipexole Wright CE et al. · Clinical Pharmacokinetics, 1997 DOI

    Seminal PK review: F >90%, minimal metabolism, ~8h half-life, renal elimination, linear dose-proportional PK.

  2. Pramipexole vs levodopa as initial treatment for Parkinson disease: a 4-year randomized controlled trial Parkinson Study Group (Holloway RG et al.) · Archives of Neurology, 2004 DOI

    Landmark 4-year RCT comparing pramipexole vs levodopa monotherapy initiation in early PD, characterizing long-term motor and AE profiles.

2 published studies referenced in the app, each with a plain-language summary.