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Compare Mirapex vs. Duopa

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

Key takeaways

Pramipexole (Mirapex, Mirapex ER) and carbidopa/levodopa (Duopa) are both medications used to treat Parkinson's disease (PD), but they have some differences. Pramipexole is a dopamine agonist, which means it helps increase dopamine levels in the brain to improve movement problems. It's is available in immediate-release tablets and extended-release tablets, and immediate-release pramipexole is also used to treat restless legs syndrome (RLS). Carbidopa/levodopa, on the other hand, is a combination of a dopa decarboxylase inhibitor and dopamine replacement that helps to increase dopamine levels in the brain. Carbidopa/levodopa is administered through a PEG-J tube using an infusion pump. Immediate-release pramipexole is available as a generic, whereas extended-release pramipexole and carbidopa/levodopa only come as a brand. Common side effects of pramipexole include nausea, drowsiness, and dizziness, while Carbidopa/levodopa can cause nausea, constipation, and involuntary muscle movements. Both medications can cause extreme sleepiness, hallucinations, and changes in behavior. Carbidopa/levodopa requires minor surgery for tube placement, which is not needed for pramipexole.

Pramipexole
Duopa (carbidopa / levodopa)
Pramipexole
Duopa (carbidopa / levodopa)
Summary of Mirapex vs. Duopa
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.
Summary for Dopa decarboxylase inhibitor / Dopamine replacement
Prescription only
Duopa is a combination medication that contains carbidopa (a decarboxylase inhibitor) and levodopa (a dopamine replacement). It treats symptoms of advanced Parkinson's disease (PD), particularly movement problems. Duopa (carbidopa / levodopa) comes as a cassette that gets attached to an infusion pump. The infusion pump then sends the medication into the intestines through a feeding tube called a PEG-J tube. Duopa (carbidopa / levodopa) is given over 16 hours out of the day as a morning dose, a continuous dose, and any extra doses. Side effects include nausea, constipation, and involuntary muscle movements.
Indications of Mirapex vs. Duopa
Indications for

•Parkinson's disease

•Moderate-to-severe restless legs syndrome - immediate-release tablets only

Indications for

•Movement problems related to advanced Parkinson's disease (PD)
Pros and Cons of Mirapex vs. Duopa
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.

Pros and Const for Dopa decarboxylase inhibitor / Dopamine replacement
Pros

•Given into your body continuously for 16 hours, so you don't need to remember to take pills

•Comes with extra doses in case you feel like the medication is wearing off

Cons

•Must have a minor procedure done to place the PEG-J tube in your intestines

•Risk of serious stomach problems since the infusion pump sends the medication directly into your gut

•Can cause sleepiness and changes in behavior
Common Side Effects of Mirapex vs. Duopa
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%)

Common Side Effects for

•Issues related to tube placement (57%)

•Nausea (30%)

•Constipation (22%)

•Redness around the area where the tube is placed (19%)

•Involuntary movements (dyskinesia, 14%)

•Depression (11%)

•Discharge after the procedure where the tube is placed (11%)

•Swelling in the legs or feet (8%)

•High blood pressure (8%)

•Upper respiratory tract infection (8%)

•Mouth or throat pain (8%)

•Collapsed lung (8%)
Warnings of Mirapex vs. Duopa
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

Common Side Effects for

•Stomach problems

•Sleepiness or falling asleep during activities

•A drop in blood pressure when standing

•Hallucinations, changes in behavior and thoughts, and confusion

•Difficulty controlling impulsive behavior

•Depression and suicidal thoughts

•High fevers and confusion with treatment changes

•Nerve problems

•Heart problems

•Rise in eye pressure in people with glaucoma
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Compare Mirapex vs. Duopa

Key takeaways

Summary of Mirapex vs. Duopa

Indications of Mirapex vs. Duopa

Pros and Cons of Mirapex vs. Duopa

Common Side Effects of Mirapex vs. Duopa

Warnings of Mirapex vs. Duopa

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