Neurologic Drugs : Parkinsonism
OMIRA2 “Mirapex PR tablet” 0.375 mg/tab
適應症：治療自發性帕金森氏症的徵候及症狀、治療原發性腿部躁動症（Primary restless legs syndrome）的症狀。
Usual dose:
Parkinson’s disease: initial, 0.125 mg tid, slow upward titration q5-7d for 6 or 7 wks to achieve optimal response; typical ascending dosage schedule: wk 1, 0.375 mg/day; wk 2, 0.75 mg/day; wk 3, 1.5 mg/day; wk 4, 2.25 mg/day; wk 5, 3 mg/day; wk 6, 3.75 mg/day; wk 7, 4.5 mg/day.
Restless legs syndrome (moderate to severe), primary: initial, 0.125 mg qd taken 2-3 h hs; may increase by doubling dose q4-7day if needed; max. 0.5 mg/day.
Dose adjustment:
Renal impairment:
|
Parkinson’s disease |
|
|
CrCl (ml/min) |
suggested dosage |
|
> 60 |
starting dose 0.125 mg tid, max. 1.5 mg tid. |
|
35-59 |
starting dose 0.125 mg bid, max. 1.5 mg bid. |
|
15-34 |
starting dose 0.125 mg qd, max. 1.5 mg qd. |
|
Restless legs syndrome |
|
|
20-60 |
up-titration every 14 days if needed. |
Precaution: falling asleep during activities of daily living.
Adverse effect:
Common: constipation, nausea, amnesia, asthenia, confusion, dizziness, dream disorder, extrapyramidal movements, insomnia, somnolence, hallucinations.
Serious: orthostatic hypotension, dyskinesia, p’ts with advanced disease.
健保使用規範：
1.治療自發性帕金森氏症的徵候及症狀，同amantadine。(91/11/1、93/2/1、95/9/1、96/9/1、97/7/1、100/6/1、101/6/1)
2.用於治療原發性腿部躁動症時需先排除腎衰竭、鐵缺乏症及多發性神經病變，且不得與dopamine agonist及levodopa併用。（96/9/1、97/7/1）每日最大劑量為0.75mg。（96/9/1）