Perkirol0.25 mg

Perkirol 0.25 mg is indicated for the treatment of the signs and symptoms of idiopathic Parkinson's disease. It is also indicated for the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS).

Antiparkinson drugs

Perkirol 0.25 mg binds the dopamine receptors D3 and D2. Although the precise mechanism of action of Perkirol 0.25 mg as a treatment for Parkinson's disease is unknown, it is believed to be related to its ability to stimulate these receptors in the striatum. This conclusion is supported by electrophysiologic studies in animals that have demonstrated that Perkirol 0.25 mg influences striatal neuronal firing rates via activation of dopamine receptors in the striatum and the substantia nigra, the site of neurons that send projections to the striatum.

In all clinical studies, dosage was initiated at a sub therapeutic level and gradually titrated to therapeutic response. The dosage should be increased to achieve a maximum therapeutic effect, balanced against the principal side effects of nausea, dizziness, somnolence and dyskinesia.The recommended starting dose is 0.25 mg three times daily with or without food. Based on individual patient response, dosage should then be titrated with weekly increments as described in the table below. After week 4, if necessary, daily dosage may be increased by 1.5 mg per day on a weekly basis up to a dose of 9 mg per day, and then by up to 3 mg per day weekly to a total dose of 24 mg per day.Ascending-Dose Schedule of Perkirol 0.25 mg: First week: 0.25 mg three times daily. Total Daily Dose: 0.75 mg  Second week: 0.5 mg three times daily. Total Daily Dose: 1.5 mg Third week: 0.75 mg three times daily. Total Daily Dose: 2.25 mg Fourth week: 1.0 mg three times daily. Total Daily Dose: 3.0 mg Dosage greater than 24 mg/day have not been tested in clinical trials. Perkirol 0.25 mg should be discontinued gradually over a 7 day period. The frequency of administration should be reduced from three times daily to twice daily for 4 days. For the remaining 3 days, the frequency should be reduced to once daily prior to complete withdrawal of Perkirol 0.25 mg.

Dosing for Parkinson's disease: The recommended starting dose for Parkinson's disease is 0.25 mg three times daily. Based on individual patient therapeutic response and tolerability, if necessary, the dose should then be titrated with weekly increments as described below. Maximum recommended total daily dose of 24 mg (8 mg three times daily). Week 1: 0.25 mg 3 times daily. Total Daily Dose 0.75 mg Week 2: 0.5 mg 3 times daily. Total Daily Dose 1.50 mg Week 3: 0.75 mg 3 times daily. Total Daily Dose 2.25 mg Week 4: 1 mg 3 times daily. Total Daily Dose 3 mg Dosing for Restless Legs Syndrome: The recommended adult starting dose for RLS is 0.25 mg once daily 1 to 3 hours before bedtime. After 2 days, if necessary, the dose can be increased to 0.5 mg once daily, and to 1 mg once daily at the end of the first week of dosing, then as shown below as needed to achieve efficacy. Titration should be based on individual patient therapeutic response and tolerability, up to a maximum recommended dose of 4 mg daily. Days 1 and 2: 0.25 mg, 1 to 3 hours before bedtime, to be taken once daily Days 3-7: 0.5 mg, 1 to 3 hours before bedtime, to be taken once daily Days 2: 1 mg, 1 to 3 hours before bedtime, to be taken once daily Days 3: 1.5 mg, 1 to 3 hours before bedtime, to be taken once daily Days 4: 2 mg, 1 to 3 hours before bedtime, to be taken once daily Days 5: 2.5 mg, 1 to 3 hours before bedtime, to be taken once daily Days 6: 3 mg, 1 to 3 hours before bedtime, to be taken once daily Days 7: 4 mg, 1 to 3 hours before bedtime, to be taken once daily

Because Perkirol 0.25 mg is a dopamine agonist, it is possible that dopamine antagonists such as neuroleptics (phenothiazines, butyrophenones, thioxanthenes) or metodopramide may reduce the efficacy of Perkirol 0.25 mg.

It is contraindicated in patients known to have a hypersensitivity to Perkirol 0.25 mg.

The most common side effects of Perkirol 0.25 mg include fainting, drowsiness, hallucinations, dizziness, nausea or vomiting, uncontrolled sudden movements, leg swelling, fatigue, confusion, headache, upset stomach, abdominal pain or discomfort, increased sweating etc.

Pregnancy: Pregnancy category C. There are no adequate and well-controlled studies using Perkirol 0.25 mg in pregnant women. Perkirol 0.25 mg should be used during pregnancy only if the potential benefit outweighs the potential risk of the fetus.Nursing Mothers: Perkirol 0.25 mg inhibits prolactin secretion in humans and could potentially inhibit lactation. Because of the potential for serious adverse reactions in nursing infants from Perkirol 0.25 mg, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother

Patients treated with Perkirol 0.25 mg have reported falling asleep while engaged in activities of daily living. Dopamine agonists in clinical trials and clinical experience appear to impair the systemic regulation of blood pressure, with resulting orthostatic hypotension.

Symptoms include nausea, vomiting, visual hallucinations, hyperhidrosis, asthenia and nightmares. General supportive measures and monitoring of vital signs are recommended. May consider gastric lavage.

Protect from light and moisture, store below 25°C. Keep out of the reach of children.

Pediatric Use: Safety and effectiveness of Perkirol 0.25 mg in the pediatric population have not been established.

Antiparkinson drugs

Perkirol 0.25 mg is a non-ergoline dopamine agonist. Perkirol 0.25 mg has the highest affinity at the D3 receptors, which are concentrated in the limbic areas of the brain and may be responsible for some of the neuropsychiatric effects. The exact mechanism of action of Perkirol 0.25 mg as a treatment for Parkinson’s disease is unknown, however, it is believed to be related to its ability to selectively stimulate dopamine D2 receptors within the caudate-putamen system in the brain. This system affects body movement. Negligible affinity is seen for Perkirol 0.25 mg at α2 adrenoreceptors in the periphery and 5HT-1 receptor. Perkirol 0.25 mg has no affinity at the D1-like receptors, benzodiazepine or GABA receptors. The precise mechanism of action of Perkirol 0.25 mg as a treatment for Restless Legs Syndrome is unknown, however, it is believed to be related to its ability to stimulate dopamine receptors.

Pregnancy category C. There is no adequate and well-controlled studies in pregnant women. It should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Perkirol 0.25 mg inhibits prolactin secretion in human and could potentially inhibit lactation.