Pergolide

Antiparkinsonism Preps · Antiparkinson agent

Indications

As second-line in patients intolerant or refractory to non-ergot compounds as monotherapy, or as adjunct to levodopa, in Parkinson's disease.

Dosage

Adults: Monotherapy: Initially 50 mcg daily taken as a single dose in evening on day 1, then 50 mcg twice daily, on days 2-4, then titrate gradually over the next 25 days, to 1.5 mg daily in three divided doses. Then increase by 250 mcg twice a wk until optimal response is achieved; max 3 mg daily in three divided doses. Adjuvant therapy: Initially 50 mcg daily for 1st two days, increasing gradually by 100-150 mcg daily every 3rd day over next 12 days. Then increase by 250 mcg daily every 3rd day until optimal response is achieved; max 3 mg daily in three divided doses. Reduce levodopa dose cautiously during titrations. Children: Not recommended.

Adverse Effects

Pain, abdominal pain, GI upset, dyskinesias, hallucinations, confusions, somnolence, sometimes with sudden sleep onset, rhinitis, dyspnoea, diplopia, insomnia, dizziness, syncope, abnormal LFTs, hypotension, premature atrial contractions, sinus tachycardia, rash, fever, cardiac fibrosis, other fibrotic and serosal inflammatory conditions, peripheral vasospasm, neuroleptic malignant syndrome, elevated creatinine kinase, reports of pathological gambling and increased libido.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: History of fibrotic disorders, cardiac valvulopathy. Precautions: Cardiac disease, arrhythmias, psychosis. Perform ECG and full cardiovascular assessment before starting therapy. Do not treat if evidence of fibrotic valvular disease. Monitor during treatment for fibrotic reactions, including pleuropulmonary disease, retroperitoneal and cardiac fibrosis; discontinue if appear. Withdraw gradually.

Interactions

Dopamine antagonists, antihypertensives, anticoagulants, drugs that affect protein binding.

Advice to Patient

Take with or without meals. To reduce GI upset, take with meals. Take at the same time each day. Contact prescriber if there is acute headache, unrelieved vomiting or constipation, irregular heartbeat, chest pain, palpitations, loss of memory, ringing in ears, hallucinations, nervousness, seizures, painful or difficult urination, skin rash, increased muscle spasm, rigidity, involuntary movements or if there is worsening of condition. Do not take prescription medications, OTC sedatives, CNS depressants without consulting prescriber. Avoid alcohol during therapy. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Change position slowly from sitting or lying to standing. For runny nose or flu-like symptoms, consult prescriber for relief. Avoid direct sunlight. Use sunscreen, wear proper clothing and eyewear to prevent…

Pharmacokinetics

Absorption: Absorbed from the GI tract. Metabolism: Extensively metabolized into at least 10 metabolites. Excretion: Mainly via urine (approx. 55%). Faeces (40%). Expired CO2 (5%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.