Best time of day to take Mirapex ER?

[shall1019]

[Pete-1]

If the drug were to behave in an ideal way then on a graph the line showing the effect over a 24 hour period would be square or more likely rectangular. But it won't be. It is going to be a curve with a peak. and that peak would serve us best if it coincided with our busiest time of day and it could easily be that the peak time is not at the 12th hour. So to answer the question it is required that that graph is made available so that it would be possible for everyone see how many hours after taking a dose the peak effect would be. Anyone got such a graph or a link to one?

[Silverkins]

I found this when googling " peak plasma concentration of pramipexole PR". The third paragraph says that the peak is 6 hours after administration. I take mine about 7:30-8 am everyday and it works for me - better than the peak when asleep, I figured. There are some practitioners who suggest splitting the dose with a small amount in the evening too. I haven't tried this and wouldn't suggest you do without consulting your neuro first. Best regards.

Absorption

Pramipexole is completely absorbed following oral administration. The absolute bioavailability is greater than 90%.

In a Phase I trial, where pramipexole immediate release and extended-release tablets were assessed in fasted state, the minimum and peak plasma concentration (Cmin, Cmax) and exposure (AUC) of the same daily dose of SIFROL extended-release tablets given once daily and SIFROL tablets given three times a day were equivalent.

The once daily administration of SIFROL extended-release tablets causes less frequent fluctuations in the pramipexole plasma concentration over 24 hours compared to the three times daily administration of pramipexole immediate release tablets.

The maximum plasma concentrations occur at about 6 hours after administration of SIFROL extended-release tablets once daily. Steady state of exposure is reached at the latest after 5 days of continuous dosing.

Concomitant administration with food does generally not affect the bioavailability of pramipexole. Intake of a high fat meal induced an increase in peak concentration (Cmax) of about 24% after a single dose administration and about 20% after multiple dose administrations and a delay of about 2 hours in time to reach peak concentration in healthy volunteers. Total exposure (AUC) was not affected by concomitant food intake. The increase in Cmax is not considered clinically relevant. In the Phase III studies that established safety and efficacy of SIFROL extended-release tablets, patients were instructed to take study medication without regard to food intake.

While body weight has no impact on the AUC, it was found to influence the volume of distribution and therefore the peak concentrations Cmax. A decreased body weight by 30 kg results in an increase in Cmax of 45%. However, in Phase III trials in Parkinson’s disease patients no clinically meaningful influence of body weight on the therapeutic effect and tolerability of SIFROL extended-release tablets was detected.

Pramipexole shows linear kinetics and a small inter-patient variation of plasma levels

[bigmama53]

I take Mirapexin at 7.00am, 12.00 noon and 6.00pm. Depending on what I need to do for the day these times may vary. I usually have a 4-5 hour window when it has kicked in along with Stalevo and I use the opportunity to achieve as much as I can.. I find it best not to let the drug wear off and overlap so that it has continuous effect. Sometimes when I have long days I take an extra stalevo. I usually take my drugs with food like a banana or a piece of toast/rice cake (am also having to watch my weight). It seems to work if I am physically active for eg going to the gym soon after I have taken it. Hope this helps.

[Silverkins]

It sounds like you're on the immediate release rather than the once daily prolonged release mirapexin, bigmmama. Theses work differently and will wear off and give a less continuous action.

[isis6361]

In the uk it's once a day PR. if you can't sleep take it at bed time if you are very active in the day and are slow in the morning take it then

[Bunky]

Please be careful with Mirapex as it has been proven to cause obsessive/compulsive behaviors in some patients. Read the warning label if you haven't already.

[parkinsonspistol in reply to Bunky]

It was a very devastating drug for me.

[Prayingforacure]

After my husband taking MIRAPEX for many years it became necessary to take him off of it due to HORRABLE side effects.

[stanlee in reply to Prayingforacure]

Yes i've had them as well i'ts awful

[Hokuto]

My neuro told me to take two tablets in the morning, so that's what I've been doing. It does seem to work fairly well.

[shall1019]

Thanks for your replies.

[sheshe7755]

My husband was on 3.5 mg once a day, he was always falling asleep. We moved to cyprus and the doctor over here cut his dosage to, 0.7mg x 3 times a day, big improvement. They could'nt understand why he was on such a big dose.

[marthasway]

I was taking Mirapex 1.5 mg. 3X a day in combination with Azilect. The Mirapex was causing edema and sleep attacks (very scary!) I am now taking 1mg Mirapex between 6-7 pm, unless there is unusual stress. Then I take a .5mg "booster around noon; it may be a placebo effect, but it works for me.

[dkleinert]

AM or never. I don't like Mirapex because of its long term (over 5 years taking it).My husband has taken it for 7 years now and is taking a drug to counteract the hallucinations he was having as a side effect from Mirapex. His Neurologist have decreased his dose to 1 1/2 tabs 2 times a day in the morning doses because his dyskinesia was so bad and because of the hallucinations.

[coco71]

Take in morning. Generally between 4 to 6:00 am.