Dopamine Agonists: Ropinirole, Pramipexole, Rotigotine

(Brand names in India: Pramipex, Pramipex ER, Ropark, Ropark XL)

How do dopamine agonists work?

These chemicals are imitators.

They look just like Dopamine itself. They attach themselves to the same sites that Dopamine usually attaches itself. Therefore, they produce similar effects in the brain as Dopamine and relieve the symptoms of Parkinson’s disease.

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Pramipexole (and Ropinirole) looks like Dopamine.

Use/Advantages:

  1. “Extended-release” / 24-hour preparations: The main advantage is that these medications have “extended-release preparations” that gradually dissolve in the stomach so that they keep gradually entering the blood and then the brain for the entire day. Therefore the effects of a single tablet taken in the morning can last for 24 hours. This infrequent dosing is very convenient! But even more importantly in patients who have Predictable-wearing-OFF or other motor fluctuations with levodopa, these long-acting medications can maintain good movement throughout the day, to “smoothen out the day”.
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    The effect of a single tablet of “Extended Release” Pramipexole (or Ropinirole) can last for 24 hours.
  2. They may produce less dyskinesias than levodopa. They may therefore be used to start treatment in younger patients (e.g. below 45) or may be added to the treatment of a person who cannot tolerate high doses of levodopa due to dyskinesias.

Disadvantages:

  1. These medications are not as strong as levodopa. When given in smaller doses, they may not relieve all the symptoms of Parkinson’s disease.
  2. When given in higher doses, they can produce troublesome side-effects including excessive daytime sleepiness, impulse control problems such as gambling and rarely, sleep disturbances & hallucinations. In particular, the excessive sleepiness during the day often limits their use – restricting their use to smaller doses.
    Gambling
    Rarely, dopamine Imitators can cause Impulse Control Disorders including gambling, excessive spending or excessive eating. But the most common side-effect is sleepiness.

Bottom-line:

While good in theory, it is difficult to use these medications in practice. They are sometimes used for the treatment of very young patients with Parkinson’s disease. Also, the fact that 24 hour preparations are available make these medications useful in certain niche situations such as predictable-wearing OFF.

 

Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

Call 022-4897-1800

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NeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar IconNeuroPlus Epilepsy & Parkinson's Clinic - Dr. Kharkar

near LIC, Dr Balabhai Nanavati hospital, near LIC, Swami Vivekananda Road, LIC Colony, Vile Parle

4.7 57 reviews

  • Avatar JAIKUMAR MANI ★★★★★ in the last week
    My experience with Dr Siddharth Kharkar was really awesome. It’s always great to be in the presence of someone who is a renowned expert in his field & … More it brings peace of mind that the advice will obviously be the correct one. In addition, his ability to convey complex workings of the human brain in such simple terms that a layman like me could easily understand was something I really appreciated. I heartily Thank Dr Kharkar for his astute advice & gladly recommend him to anyone who needs a neurologist.
  • Avatar Rohit shetye ★★★★★ 3 weeks ago
    Best Dr. we have ever meet. Dr. Listened to us patiently and gave us the proper solution. No unnecessary test or didn’t frighten us. Thank you so much … More Dr.
  • Avatar Ashish Patil ★★★★★ 4 weeks ago
    Great doctor!! Really appreciate.The doctor diagnosed me correctly and start treatment that will help me a lots to improve my condition. The doctor is … More really good, calm and his nature is down to earth, gives confidence to patient!!! Thank you!!!
  • Avatar Bianca D'silva ★★★★★ in the last week
    We had been looking for a specialist in parkinsons for a while now, for my father and when we found Dr. Siddharth Kharka's details on Google, we were … More partly relieved. Partly because, we were all very anxious not knowing how would our visit turn out. I appreciate Dr. Kharkar and his team. He was very clear in his explanations, his knowledge about parkinsons. He took the time to answer the questions we had, went over the diagnosis and started necessary treatment immediately. The only drawback we experienced was the waiting time. Overall, we left the clinic satisfied, knowing much more than when we walked in. We would highly recommend him to anyone looking for a specialist.
  • Avatar Neelam Satghare ★★★★★ 4 weeks ago
    I have visited the doctor clinic for the first timeBut he gave good advice and helped me overcomeMy doubts and queries. It was a good experience.I am very … More thankful for cooperation.
  • Avatar Nitin Ghotge ★★★★★ a month ago
    Dr.Sidharth Kharkar is one of the best neurologist i came across ....He is really genuine and focused .....We really satisfied after consultancy...
  • Avatar Krishna kumari Radhakrishnan ★★★★★ 2 months ago
    Hi Sharing my experience with Dr KharkarI had consulted with dr regarding my husband’sProblems of tremors. Dr immediately diagnosed on video consultation … More and could help him to control the tremors s of Parkinson’s disease.I found him genuinely polite and free to talk n patiently listening to the patients problem.Now my husband regained his balance n tremors controlled. Many many thanks to Dr Kharkar
  • Avatar a kumar ★★★★★ a month ago
    Dr kharkar is very nice doctor, sir explained each and every thing very nicely, and i am thankful for Dr kharkar for his treatment .
  • Avatar Nidhi Sonawane ★★★★★ 3 months ago
    I had a positive experience with the doctor. He was very sympathetic. His communication skills were good and listened with patience.
  • Avatar Ujwala Sawant ★★★★★ a month ago
    Because of Dr.kharkar sir my husband got new life. Tnx sir.
  • Avatar Mythili Balasubramanian ★★★★★ 4 months ago
    Consultation with the doctor was a very satisfying experience. Was empathetic in his approach, and responded positively to all the queries we had. Thank … More you doctor!
  • Avatar Govind Patel ★★★★★ 2 months ago
    Doctor explained very Good nice person give length time to check body
  • Avatar Sharmila Kumawat ★★★★★ 6 months ago
    Dr Siddharth is one of the best Dr I have ever met. He is kind, polite, helpful and very selfless person. I have migraine and I am his patient since more … More than 2 years. The staff is always helpful and Dr Siddharth is just beyond words for me. Thank you for ur selfless service and kindness u give to all ur patients.

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India Today Magazine - 2021Noted as one of the Best Neurologists in Mumbai