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Mirapex vs. Neupro

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

Key takeaways

Pramipexole (Mirapex, Mirapex ER) and rotigotine (Neupro) are both dopamine agonists used to treat Parkinson's disease (PD) and moderate-to-severe restless legs syndrome (RLS), but they have some key differences. Pramipexole is available in both immediate-release and extended-release tablets, while rotigotine is available only as a transdermal patch. This means you take pramipexole orally, whereas you apply rotigotine to your skin. Rotigotine's patch form might be more convenient if you have trouble swallowing pills.Pramipexole is available in a lower-cost generic form, but rotigotine is only available as the brand name Neupro, which can be more expensive. Pramipexole can cause extreme sleepiness and requires careful monitoring of blood pressure, while rotigotine can cause skin irritation at the application site and may not be suitable for those with sulfite allergies. Both medications can cause compulsive behaviors and hallucinations and should not be stopped suddenly.

Pramipexole

 

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Neupro

(rotigotine)

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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

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 Neupro

Prescription only

Neupro (rotigotine) is a dopamine agonist used to treat adults with Parkinson's disease (PD) and restless legs syndrome (RLS). It helps manage symptoms such as tremors, stiffness, and uncontrollable leg movements. The medication comes as a patch that you apply to your skin once a day. Neupro (rotigotine) is only available as a brand-name medication, with no generic version. Common side effects include nausea, vomiting, and sleepiness.

Indications for Neupro

Pros and Cons for Neupro

Pros

  • Approved to treat both PD and RLS
  • Patch is applied to the skin once a day
  • Good option for people who don't want to take pills

Cons

  • Can't stop suddenly; must wean off the medication
  • Not suitable for people with sulfite allergies
  • Can cause serious side effects, like impulsive behavior and hallucinations

Common Side Effects for Neupro

Parkinson's disease

  • Nausea (28-48%)
  • Application site reaction (19-46%)
  • Sleepiness (12-32%)
  • Dizziness (14-23%)
  • Vomiting (8-20%)
  • Tiredness (6-18%)
  • Uncontrolled muscle movements (14-17%)
  • Trouble sleeping (6-14%)
  • Swelling in the arms and legs (2-14%)
  • Hallucinations (0-13%)
  • Joint pain (8-11%)
  • Excessive sweating (1-11%)
  • Headache (8-10%)

Restless leg syndrome

  • Application site reactions (23–43%)
  • Nausea (15–23%)
  • Headache (15–21%)
  • Fatigue and weakness (7-14%)
  • Sleepiness (5-10%)
  • Trouble sleeping (3-10%)

Warnings for Neupro

  • Serious allergic reactions
  • Extreme sleepiness
  • Hallucinations and mental health changes
  • Low blood pressure and fainting
  • Impulsive behavior
  • High blood pressure and heart rate
  • Weight gain and swelling
  • Uncontrolled muscle movements
  • Skin reactions
  • Worsening symptoms of RLS
  • High fevers and confusion
  • Withdrawal symptoms

Prices with our coupons for Mirapex vs. Neupro

Price Card Drug Icon
Pramipexole90 tablets / 0.5mg
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Neupro30 patches / 2mg
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