Bruce, several days ago you wrote:
>For any of you successfully taking Mirapex, would you please tell me what
>the ultimate dosage, or the one that works for you, is supposed to be?
>I just started.
>Thanks!!
I'm a little late in responding but the following may be of some help to
you. I am one of those PWP who has benefited from Mirapex. It has raised
my spirits, made me more gregarious, lessened my dystonia, improved my gait,
and reduced my tremors. I currently am taking 4 mg of Mirapex daily (1.5 mg
on rising, 1.5 mg at noon, 1 mg at about 4:30 pm). I started Mirapex last
July titrating 'slow and low' for two months before reaching my present
dosage level. At the same time I was able to reduce my Sinemet by some 25%.
As several people have already responded to your question, whatever dosage
works for you at any given time is your ultmate dosage. You have to judge
by titrating your intake of Mirapex as to what constitutes your therapeutic
level. I do, howver, understand
your seeking some guidelines. Perhaps the following will be of some value.
An article entitled "Safety and Efficacy of Pramipexole n Early Parkinson
Disease: A Randomized Dose-Ranging Study" published in JAMA, July 9, 1997,
vol 278, No.2 pp 125-130 tells of a study of PWPs who were NOT taking
levodopa or any other agonist and who were divided into five dosage groups
of 1.5mg/d, 3.0 mg/d, 4.5 mg/d, 6.0 mg/d, and a placebo group. After ten
weeks the study concluded that pramipexole was effective, that it was "safe
and well tolerated." But, the article observes, "pramipexole was not as
well tolerated in the 6.0 mg/d group and some adverse experiences,
particularly somnolence, tended to be reported more frequently in the 6.0
mg/d group" and "the optimal dosage for these subjects with early PD may be
from 1.5 mg/d to 4.5 mg/d."
A companion article, this one published in NEUROLOGY, July 1997, vol 49, pp
162-167 by Abraham Lieberman et. al., is entitled "Clinical Evaluation of
Pramipexole in Advanced Parkinson's Disease: Results of a Double-Blind
Placebo Controlled, Parallel-Group Study." The authors examined the safety,
tolerability and efficacy of pramipexole in a group of PWPs with advanced
cases who were already taking carbidopa/levodopa. All the patients were
given ascending doses of either pramipexole from 0.375 to 4.5 mg daily or a
placebo and were studied over a 32 week period. Following the ascending dose
phase patients went into a maintenance dose phase. The study concluded that
"pramipexole, when administered concurrently with levodopa, improves
patients with advanced PD ... . Compared with placebo, pramipewxole,
administered at a maximal daily dosage of 4.5 mg, improved activities of
daily living of patients with advanced PD ... ."
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Sid Roberts 68/3 <[log in to unmask] > Youngstown, Ohio
