Mirapex vs. Carbidopa for Parkinson's Disease: Important Differences and Potential Risks.

Key takeaways

Pramipexole (Mirapex, Mirapex ER) and carbidopa (Lodosyn) are both prescription medications used to treat Parkinson's disease (PD), but they have some important differences. Pramipexole is a dopamine agonist, while carbidopa is a decarboxylase inhibitor. Pramipexole is available in immediate-release tablets and extended-release tablets, and immediate-release pramipexole is also used to treat restless legs syndrome (RLS). Carbidopa helps more levodopa reach the brain, so must be taken with levodopa or Sinemet (carbidopa/levodopa) to be effective. Carbidopa is available as a generic and is typically taken multiple times a day. Common side effects of pramipexole include nausea, drowsiness, and dizziness, while carbidopa can cause involuntary movements and nausea. Both medications can cause impulsive behaviors as well as hallucinations and extreme sleepiness.

Pramipexole

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Carbidopa

(Lodosyn)

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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

Parkinson's disease (PD)
Moderate-to-severe restless legs syndrome - immediate-release tablets only

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

Summary for Carbidopa

Prescription only

Carbidopa (Lodosyn) is taken with Sinemet (carbidopa / levodopa) or levodopa alone to treat adults with symptoms of Parkinson's disease (PD), like shakiness and slowed movement. The medication belongs to the decarboxylase inhibitor class and it works by helping levodopa better travel into your brain so it can relieve your symptoms. This might allow some people to take a lower dose of levodopa, which can lower some of its side effects. Side effects include fatigue, a drop in blood pressure, changes in urination, and weight changes.

Indications for Carbidopa

When taken together with levodopa or Sinemet (carbidopa / levodopa):

Pros and Cons for Carbidopa

Pros

Helps levodopa relieve your Parkinson's symptoms
Might allow some people to take a lower dose of levodopa, which can ease side effects like nausea and vomiting
Can split the tablet in half as needed
Available in a lower-cost generic form