Pergolide mesylate


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Pergolide mesylate
Pergolide mesylate (Permax)
Pergolide mesylate
( PER-go-lyd)
Pregnancy Category: B Permax (Rx)

Classification: Antiparkinson agent

See Also: See also Antiparkinson Agents .

Action/Kinetics: Potent dopamine receptor (both D 1 and D 2& ) agonist. May act by directly stimulating postsynaptic dopamine receptors in the nigrostriatal system, thus relieving symptoms of parkinsonism. Also inhibits prolactin secretion; causes a transient rise in serum levels of growth hormone and a decrease in serum levels of LH. About 90% of the drug is bound to plasma proteins. Metabolized in the liver and excreted through the urine.

Uses: Adjunct with levodopa/carbidopa in Parkinson's disease.

Special Concerns: Use with caution during lactation and in clients prone to cardiac dysrhythmias, preexisting dyskinesia, and preexisting states of confusion or hallucinations. Safety and efficacy have not been determined in children.

Side Effects: The most common side effects are listed. CV: Postural hypotension, palpitation, vasodilation, syncope, hypotension, hypertension, arrhythmias, MI. GI: Nausea (common), vomiting, diarrhea, constipation, dyspepsia, anorexia, dry mouth. CNS: Dyskinesia (common), dizziness, dystonia, hallucinations, confusion, insomnia, somnolence, anxiety, tremor, depression, abnormal dreams, psychosis, personality disorder, extrapyramidal syndrome, akathisia, paresthesia, incoordination, akinesia, neuralgia, hypertonia, speech disorders. Musculoskeletal: Arthralgia, bursitis, twitching, myalgia. Respiratory: Rhinitis, dyspnea, hiccup, epistaxis. Dermatologic: Sweating, rash. Ophthalmologic: Abnormal vision, double vision, eye disorders. GU: UTI, urinary frequency, hematuria. Whole body: Pain in chest, abdomen, neck, or back; headache, asthenia, flu syndrome, chills, facial edema, infection. Miscellaneous: Taste alteration, peripheral edema, anemia, weight gain.

Overdose Management: Symptoms: Include agitation, hypotension, N&V, hallucinations, involuntary movements, palpitations, tingling of arms and legs. Treatment: Activated charcoal (usually recommended instead of or in addition to gastric lavage or induction of vomiting). Maintain BP. An antiarrhythmic drug may be helpful. A phenothiazine or butyrophenone may help any CNS stimulation. Support ventilation.

Drug Interactions: Butyrophenones / Pergolide effect R/T dopamine antagonist effect Metoclopramide / Pergolide effect R/T dopamine antagonist effect Phenothiazines / Pergolide effect R/T dopamine antagonist effect Thioxanthines / Pergolide effect R/T dopamine antagonist effect

How Supplied: Tablet: 0.05 mg, 0.25 mg, 1 mg

Dosage
?Tablets Parkinsonism.
Adults, initial: 0.05 mg/day for the first 2 days; then, increase dose gradually by 0.1 or 0.15 mg/day every third day over the next 12 days. The dosage may then be increased by 0.25 mg/day every third day until the therapeutic dosage level is reached. The mean therapeutic daily dosage is 3 mg used concurrently with levodopa/carbidopa (expressed as levodopa) at a dose of 650 mg/day. The effectiveness of doses of pergolide greater than 5 mg/day has not been evaluated.

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