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Compare Mirapex vs. Zelapar

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

Key takeaways

Pramipexole (Mirapex, Mirapex ER) and selegiline (Zelapar) are prescription medications used to treat Parkinson's disease (PD), but they have some important differences. Pramipexole is a dopamine agonist, while selegiline is a monoamine oxidase type B (MAO-B) inhibitor. Both medications help increase dopamine activity in the brain, but they do so in different ways. Pramipexole is available in immediate-release tablets and extended-release tablets, and immediate-release pramipexole is also used to treat restless legs syndrome (RLS). Immediate-release pramipexole is typically taken three times a day, while extended-release pramipexole is taken once daily. Selegiline is available as tablets, capsules, and orally disintegrating tablets (ODTs) and is typically taken once or twice daily. Common side effects of pramipexole include nausea, drowsiness, and dizziness, while selegiline can cause nausea, dizziness, and stomach pain. Both medications can cause extreme sleepiness, hallucinations, and changes in behavior.

Pramipexole
Selegiline
Pramipexole
Selegiline
Summary of Mirapex vs. Zelapar
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 MAO-B inhibitor
Prescription only
Selegiline helps relieve symptoms of Parkinson's disease in people who have "off" episodes as their carbidopa/levodopa medication starts to wear off. Selegiline is a type of monoamine oxidase inhibitor (MAOI), which is a drug class that has many drug interactions. Generic selegiline tablets and capsules are taken twice per day; the brand name for the pills, Eldepryl, is no longer available. Selegiline also comes as orally disintegrating tablets (ODTs) under the brand name Zelapar that are dissolved on the tongue once per day. Side effects include changes in blood pressure, nausea, and dizziness.
Indications of Mirapex vs. Zelapar
Indications for

•Parkinson's disease

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

Indications for

•Relief of "off" episodes in people with Parkinson's disease (PD) who are taking a carbidopa/levodopa medication
Pros and Cons of Mirapex vs. Zelapar
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 MAO-B inhibitor
Pros

•Extends the actions of carbidopa/levodopa to relieve PD symptoms

•Comes as tablets, capsules, and ODTs

•Taken once or twice a day, depending on the form of the medication

Cons

•Doesn't work well when you take it by itself; must take in addition to a carbidopa/levodopa medication

•Commonly causes nausea and dizziness
Common Side Effects of Mirapex vs. Zelapar
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
Selegiline tablets and capsules:

•Nausea (20%)

•Dizziness (14%)

•Stomach pain (8%)

•Confusion (6%)

•Hallucinations (6%)

•Dry mouth (6%)

Zelapar (selegiline) ODTs:

•Nausea (11%)

•Dizziness (11%)

•General body pain (8%)

•Headache (7%)

•Trouble sleeping (7%)

•Runny nose (7%)

•Involuntary movements (dyskinesia; 6%)

•Skin irritation (6%)

•Back pain (5%)

•Indigestion (5%)

•Inflamed or sore mouth (5%)

•Other irritation in the mouth (e.g., pain when swallowing, pain in mouth, mouth sores)
Warnings of Mirapex vs. Zelapar
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

•High blood pressure

•Serotonin syndrome

•Extreme sleepiness and falling asleep during activities

•Low blood pressure and risk of falls

•Difficulty controlling body movements

•Hallucinations and behavior changes

•Intense urges

•Caution in people with phenylketonuria (PKU) - Zelapar ODTs only
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Compare Mirapex vs. Zelapar

Key takeaways

Summary of Mirapex vs. Zelapar

Indications of Mirapex vs. Zelapar

Pros and Cons of Mirapex vs. Zelapar

Common Side Effects of Mirapex vs. Zelapar

Warnings of Mirapex vs. Zelapar

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