Pergolide

Trade names

• PERMAX
• PRASCEND

Actions

• Agonist of D1 and D2 dopamine receptors and may act as an agonist in other dopamine receptor subtypes.
• Agonist of serotonin 5-HT1A, 5-HT1B, 5-HT2A, 5-HT2B, and 5-HT2C receptors.

Route of Administration

Oral

Bioavailability

Not known, probably high

Plasma protein binding

90%

Half-life

27 hours

Metabolism

Hepatic

Elimination

Renal

Important side-effects

Cardiac Valvulopathy. All patients should undergo a cardiovascular evaluation, including echocardiogram to assess the potential presence of valvular disease. If valvular disease is detected, the patient should not be treated with pergolide. Pergolide should be discontinued if an echocardiogram reveals new valvular regurgitation, valvular restriction or valve leaflet thickening. The risk of developing valvular disease is dose dependent.

Extracardiac Fibrotic Reactions.

• Pleuro-pulmonary disease
• Renal insufficiency or ureteral/abdominal vascular obstruction.
• Pericardial fibrosis.

Nausea, vomiting.

Somnolence, depression.

Orthostatism.

Recommended dose

Start with 0.05 mg / day divided in 3 doses for the first 2 days.

Gradually increase by increments of 0.1-0.15 mg/day every third day over the next 12 days.

The dosage may then be increased by 0.25 mg/day every third day until optimal dose is reached.

The mean therapeutic daily dosage of Permax is 3 mg/day divided in 3 doses.

Doses of pergolide above 5 mg/day are not recommended.

Renal impairment

Limited data exist on the safety of pergolide in patients with impaired renal function.

Hepatic impairment

Limited data exist on the safety of pergolide in patients with impaired hepatic function.