Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Mirapex (Pramipexole). If you are concerned about side effects, discuss the risks and benefits of Mirapex (Pramipexole) with your doctor.

The following side effects have been reported by at least 1% of people taking Mirapex (Pramipexole). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abnormal dreams
• Constipation
• dizziness
• drowsiness
• Dry Mouth
• headache
• hiccups
• Insomnia
• loss of appetite
• nausea
• tiredness
• weight gain or loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abnormal thinking
• accidental injury
• behavioural changes (compulsive gambling, compulsive shopping)
• delusions (false beliefs)
• difficulty starting movement
• difficulty swallowing
• dizziness, lightheadedness, or fainting, especially when standing up
• double vision or other changes in vision
• falling asleep without warning
• frequent urge to urinate
• hallucinations (seeing, hearing, smelling, tasting, or feeling something that is not there)
• increase in blood cholesterol memory loss
• paranoia (unrealistic and excessive anxiety and worry)
• restlessness or need to keep moving
• shortness of breath
• signs of heart problems (e.g., fast, irregular heartbeat or pulse, chest pain, sudden weight gain, difficulty breathing, leg swelling)
• swelling of arms or legs
• tightness or pain in chest
• trouble sleeping
• twitching, twisting, or other unusual body movements
• unusual tiredness or weakness confusion

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a Anaphylaxis (severe allergic reaction) (Hives; difficulty breathing; swelling of the face, mouth, throat, or tongue)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Mirapex (Pramipexole).

0.125 mg
Each white, round tablet, both faces flat with bevelled edges, one side imprinted with the symbol "P6", the other side imprinted with the Boehringer Ingelheim company symbol, contains 0.125 mg of Mirapex (Pramipexole) dihydrochloride monohydrate. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, magnesium stearate, mannitol, and povidone.

0.25 mg
Each white, oval tablet, both faces flat with bevelled edges, one side with a deep break score and imprinted with the symbol "P7" on either side of the score, the other side also scored and imprinted with the Boehringer Ingelheim company symbol on either side of the score, contains 0.25 mg of Mirapex (Pramipexole) dihydrochloride monohydrate. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, magnesium stearate, mannitol, and povidone.

0.5 mg
Each white, oval tablet, both faces flat with bevelled edges, one side with a deep break score and imprinted with the symbol "P8" on either side of the score, the other side also scored and imprinted with the Boehringer Ingelheim company symbol on either side of the score, contains 0.5 mg of Mirapex (Pramipexole) dihydrochloride monohydrate. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, magnesium stearate, mannitol, and povidone.

1 mg
Each white, round tablet, both faces flat with bevelled edges, one side with a deep break score and imprinted with the symbol "P9" on either side of the score, the other side also scored and imprinted with the Boehringer Ingelheim company symbol on either side of the score, contains 1 mg of Mirapex (Pramipexole) dihydrochloride monohydrate. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, magnesium stearate, mannitol, and povidone.

1.5 mg
Each white, round tablet, both faces flat with bevelled edges, one side with a deep break score and imprinted with the symbol "P11" on either side of the score, the other side also scored and imprinted with the Boehringer Ingelheim company symbol on either side of the score, contains 1.5 mg of Mirapex (Pramipexole) dihydrochloride monohydrate. Nonmedicinal ingredients: colloidal silicon dioxide, cornstarch, magnesium stearate, mannitol, and povidone.

Mirapex (Pramipexole) should not be taken by anyone who is allergic to Mirapex (Pramipexole) or to any of the ingredients of the medication.

There may be an interaction between Mirapex (Pramipexole) and any of the following:

• alcohol
• Aldesleukin
• Aliskiren
• alpha blockers (e.g., Alfuzosin, Doxazosin, Silodosin, Tamsulosin)
• alpha agonists (e.g., Clonidine, methyldopa)
• amantadine
• amifostine
• Amiodarone
• angiotensin converting enzyme inhibitors (ACEIs; Captopril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., candasartan, Irbesartan, Losartan)
• antihistamines (e.g., cetirizine, Chlorpheniramine, Diphenhydramine, doxylamine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• brimonidine
• Bupropion
• Buspirone
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• chloral hydrate
• Cimetidine
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Domperidone
• efavirenz
• Entacapone
• general anesthetics (medications used to put people to sleep before surgery)
• Guanfacine
• Hydralazine
• kava kava
• levodopa
• Methylphenidate
• Metoclopramide
• Minoxidil
• MAO inhibitors (e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• Mirtazapine
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine, Tizanidine)
• narcotic medications (e.g., Codeine, Fentanyl, Hydromorphone, Morphine)
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• Obinutuzumab
• Olopatadine
• Pentoxifylline
• phosphodiesterase 5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• scopolamine
• seizure medications (e.g., Carbamazepine, Clobazam,  Levetiracetam, phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• Tapentadol
• Tramadol
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Mirapex (Pramipexole). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription) and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or illegal drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Mirapex (Pramipexole).

Behaviour changes: People taking Mirapex (Pramipexole) have experienced abnormal behaviour such as compulsive gambling, compulsive shopping, hypersexuality, and binge eating. If you experience these symptoms or any other behaviour change while taking Mirapex (Pramipexole), contact your doctor immediately.

Blood pressure: Mirapex (Pramipexole) can lower blood pressure for some people. People taking Mirapex (Pramipexole) may feel dizzy or lightheaded when rising from a sitting or lying position. Make sure to tell your doctor if you experience this effect. If you have severe heart disease, discuss with your doctor how Mirapex (Pramipexole) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Mirapex (Pramipexole), and whether any special monitoring is needed.

Drowsiness/sudden onset of sleep: Mirapex (Pramipexole) and similar mediations can cause drowsiness and sudden onset of sleep or sleep attacks. Sudden onset of sleep can occur without warning or drowsiness. People taking Mirapex (Pramipexole) should avoid driving or operating heavy machinery. If you experience any daytime drowsiness or sudden onset of sleep while taking Mirapex (Pramipexole), contact your doctor immediately.

Hallucinations: People taking Mirapex (Pramipexole) should be aware that hallucinations (mainly seeing things that are not really there) can occur and may affect their ability to drive and perform other daily activities. Make sure to tell your doctor if you experience this effect.

Kidney function: Decreased kidney function or Kidney Disease can cause Mirapex (Pramipexole) to build up in the body, causing side effects. People with reduced kidney function should discuss with their doctor how Mirapex (Pramipexole) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Mirapex (Pramipexole), and whether any special monitoring is needed. Mirapex (Pramipexole) is not recommended for people with end-stage renal disease.

Melanoma: People with Parkinson's disease may be at increased risk of developing melanoma (a type of Skin Cancer). It is not known if this increased risk is due to Parkinson's disease or to the medications used to treat Parkinson's disease. Your doctor will monitor you for skin cancer while you are taking Mirapex (Pramipexole). Talk to your doctor if you have any concerns.

Neuroleptic malignant syndrome (NMS): As with other medications that have an effect on movement disorders, Mirapex (Pramipexole) can trigger a potentially fatal set of symptoms known as neuroleptic malignant syndrome (NMS). If you experience symptoms of NMS, such as high Fever; muscle stiffness; confusion or loss of consciousness; sweating; or rapid or irregular heartbeat, seek immediate medical attention.

This is more likely to occur if Mirapex (Pramipexole) is stopped suddenly or the dose is decreased rapidly. If you are considering stopping Mirapex (Pramipexole), talk with your doctor about the appropriate way to reduce Mirapex (Pramipexole).

Restless leg syndrome: When Mirapex (Pramipexole) is used to treat the symptoms of restless leg syndrome, it may cause a worsening of symptoms in the early morning hours. It may also cause earlier onset of symptoms in the evening or an increase in symptoms. If you experience this, let your doctor know.

Stopping treatment: Do not stop taking Mirapex (Pramipexole) without consulting with your doctor. Stopping this mediation suddenly can cause symptoms such as fever, rigid muscles, and blood pressure changes. If you and your doctor decide that stopping Mirapex (Pramipexole) is best for you, your doctor will gradually reduce your dose over a week.

Suicidal or agitated behaviour: People with Parkinson's disease are at risk of experiencing thoughts and intent of self-harm or suicide. These feelings may not pass when the symptoms of PD are relieved. If you have Depression or bipolar disorder, you may be at an increased risk of feeling agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or wanting to hurt themselves or others. If you experience these side effects or notice them in a family member who is taking Mirapex (Pramipexole), contact your doctor immediately.

Pregnancy: Mirapex (Pramipexole) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Mirapex (Pramipexole), contact your doctor immediately.

Breast-feeding: It is not known if Mirapex (Pramipexole) passes into breast milk. Since the medication reduces the amount of breast milk produced, women who are breast-feeding should not take Mirapex (Pramipexole).

Children: The safety and effectiveness of using Mirapex (Pramipexole) has not been established for children.

Seniors: Seniors may be more likely to experience hallucinations (hearing, seeing or feeling things that are not there) while taking Mirapex (Pramipexole).