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Compare Entacapone vs. Mirapex

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Entacapone (Comtan) and pramipexole (Mirapex, Mirapex ER) are both used to treat Parkinson's disease (PD), but they work differently and have different uses. Entacapone is a COMT inhibitor that helps carbidopa/levodopa work better by preventing its breakdown, and it must be taken with each dose of carbidopa/levodopa. Pramipexole, on the other hand, is a dopamine agonist that can be used alone and is also used to treat restless legs syndrome (RLS). Pramipexole is available in both immediate-release and extended-release forms, while entacapone is only available in one form. Common side effects of entacapone include involuntary movements and muscle spasms, whereas pramipexole can cause swelling, dry mouth, and dizziness. Both medications can cause serious side effects like hallucinations and muscle damage, but pramipexole also has a risk of compulsive behaviors and worsening RLS symptoms.

  • Entacapone (Comtan)
    Pramipexole
  • Entacapone (Comtan)
    Pramipexole

  • Summary of Entacapone vs. Mirapex

    Summary for COMT inhibitor
    Prescription only

    Entacapone (Comtan) is used for Parkinson's disease (PD) and helps relieve symptoms like shakiness and slowed movement. It's used along with the combination medication carbidopa/levodopa. Entacapone (Comtan) is a good option for people whose levodopa wears off before their next dose ("wearing-off" periods). But, this medication has to be taken every time you take carbidopa/levodopa for it to work properly. Some side effects include involuntary movements (dyskinesia) and nausea. Entacapone (Comtan) is available as a brand-name and generic medication.

    Summary for Dopamine agonist
    Prescription only

    Pramipexole is used to treat Parkinson's disease (PD) and restless legs syndrome (RLS). The dosage depends on what form you’re taking: the immediate-release tablet is taken 3 times per day and the extended-release tablet is taken once per day. The immediate-release is only available as a lower-cost generic (the brand name Mirapex has been discontinued in the US). The extended-release version of this medication is available as brand (Mirapex ER) and generic. Side effects include nausea, drowsiness, dizziness, and tiredness.

  • Indications of Entacapone vs. Mirapex

    Indications for
    •Relief of "wearing-off" symptoms in people with Parkinson's disease who are taking carbidopa/levodopa medications (e.g., Sinemet, Rytary)
    Indications for
    •Parkinson's disease
    •Moderate-to-severe restless legs syndrome - immediate-release tablets only

  • Pros and Cons of Entacapone vs. Mirapex

    Pros and Const for COMT inhibitor
    Pros
    •Helps carbidopa/levodopa relieve your PD symptoms better
    •Can be useful for people with advanced PD or people who experience "wearing-off" periods with their carbidopa/levodopa
    •Can take with or without food
    Cons
    •Must take with every dose of carbidopa/levodopa to see an effect on PD symptoms; it has no effect when it's taken alone
    •Can cause involuntary movements or other movement problems
    •Can cause nausea, especially when you first start taking the medication
    Pros and Const for Dopamine agonist
    Pros
    •Works well to control movement problems
    •Available in a lower-cost generic version
    •Extended-release tablet can be taken once daily
    Cons
    •Only available as a tablet
    •Can cause extreme sleepiness
    •Immediate-release tablets need to be taken 3 times per day.

  • Common Side Effects of Entacapone vs. Mirapex

    Common Side Effects for
    •Involuntary movements (dyskinesia, 25%)
    •Nausea (14%)
    •Muscle spasms (hyperkinesia, 10%)
    •Changes in the color of your urine (10%)
    •Diarrhea (10%)
    •Slowed muscle movements (hypokinesia, 9%)
    •Stomach pain (8%)
    •Dizziness (8%)
    Common Side Effects for

    Early Parkinson’s disease (PD)

    •Sleepiness (33-36%)
    •Nausea (22-24%)
    •Constipation (12-14%)
    •Dizziness (12%)
    •Swelling in arms or legs (5-8%)
    •Fatigue (6%)
    •Hallucinations (5-6%)
    •Dry mouth (4-5%)

    Restless legs syndrome

    •Nausea (16%)
    •Headache (16%)
    •Fatigue (9%)
    •Sleepiness (6%)
    •Constipation (4%)

  • Warnings of Entacapone vs. Mirapex

    Common Side Effects for
    •Sleepiness or falling asleep while doing daily activities
    •Low blood pressure and fainting
    •Hallucinations and changes in behavior and thoughts
    •Difficulty controlling impulsive behavior
    •Diarrhea and inflamed colon (colitis)
    •Muscle damage (rhabdomyolysis)
    •High fevers and confusion
    •Interactions with other medications
    Common Side Effects for
    •Extreme sleepiness
    •Changes in blood pressure and higher risk of falls
    •Intense urges
    •Hallucinations and behavior changes
    •Difficulty controlling body movements
    •Changes to your posture
    •Severe muscle damage (rhabdomyolysis)
    •Worsening symptoms of RLS

  • Prices with our coupons for Entacapone vs. Mirapex

    Learn more about Entacapone
    Learn more about Pramipexole

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