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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)

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Pramipexole

 

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Summary for Entacapone

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.

Indications for Entacapone

  • Relief of "wearing-off" symptoms in people with Parkinson's disease who are taking carbidopa/levodopa medications (e.g., Sinemet, Rytary)

Pros and Cons for Entacapone

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

Common Side Effects for Entacapone

  • 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%)

Warnings for Entacapone

  • 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

Summary for Mirapex

Prescription only

Pramipexole is used to treat Parkinson's disease (PD) and restless legs syndrome (RLS). It's approved for adults and works as a dopamine agonist to help control movements. For PD, you can take the immediate-release tablets by mouth, usually 3 times a day. There's also an option to take the extended-release tablets just once a day. For RLS, only the immediate-release tablets are available. Side effects include nausea, drowsiness, and dizziness. Pramipexole is a generic medication. The brand name Mirapex is no longer available.

Indications for Mirapex

Pros and Cons for Mirapex

Pros

  • Can help improve movement and shaking
  • Comes as immediate-release (3 times daily) and extended-release (once daily)

Cons

  • Can cause nausea and sleepiness
  • Have to slowly lower the dose to stop the medication to prevent possible withdrawal symptoms

Common Side Effects for Mirapex

Early Parkinson’s disease:

  • Nausea (28%)
  • Dizziness (25%)
  • Sleepiness (22%)
  • Trouble sleeping (17%)
  • Constipation (14%)
  • Weakness (14%)

Restless legs syndrome:

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

Warnings for Mirapex

  • Sleepiness or falling asleep during activities
  • Low blood pressure when standing up
  • Trouble controlling impulsive behavior
  • Hallucinations and changes in behavior and thoughts
  • Trouble controlling body movements
  • Changes in your posture
  • Severe muscle damage (rhabdomyolysis)
  • Possible worsening of RLS symptoms
  • Withdrawal symptoms while lowering the dose or after stopping the medication

Prices with our coupons for Entacapone vs. Mirapex

Price Card Drug Icon
Entacapone360 tablets / 200mg
$98.32$1,339.93
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Pramipexole90 tablets / 0.5mg
$17.13$146.17
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