Mirapex ER has some of the same effects as a chemical called dopamine, which occurs naturally in your body. Low levels of dopamine in the brain are associated with Parkinson's disease.

Mirapex ER is used to treat symptoms of Parkinson's disease (stiffness, tremors, muscle spasms, and poor muscle control). This medicine is also used to treat restless legs syndrome (RLS).

Only immediate-release Mirapex ER (Mirapex) is approved to treat either Parkinson symptoms or RLS. Extended-release this medicine (Mirapex ER) is approved only to treat Parkinson symptoms.

Parkinson's and RLS are two separate disorders. Having one of these conditions will not cause you to have the other condition.

Mirapex ER may also be used for purposes not listed in this medication guide.

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

If you are taking immediate-release Mirapex ER (Mirapex) you should not take extended-release this medicine (Mirapex ER) at the same time.

The dose and timing of pramipexole in treating Parkinson's disease is different from the dose and timing in treating RLS. Follow the directions on your prescription label. Ask your pharmacist if you have any questions about the kind of pramipexole you receive at the pharmacy.

Mirapex ER can be taken with or without food. Take the medication with food if it upsets your stomach.

Do not crush, chew, or break an extended-release tablet (Mirapex ER). Swallow it whole.

If you are taking this medication for RLS, tell your doctor if your symptoms get worse, if they occur in the morning or earlier than usual in the evening, or if you feel restless symptoms in your hands or arms.

Do not stop using Mirapex ER suddenly, or you could have unpleasant withdrawal symptoms. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture, heat, and light.

You should not use Mirapex ER if you are allergic to it.

Tell your doctor if you have ever had:

• low blood pressure;

• dizziness after getting up too fast;

• daytime drowsiness;

• kidney disease; or

• problems controlling your muscle movements.

People with Parkinson's disease may have a higher risk of skin cancer (melanoma). Talk to your doctor about this risk and what skin symptoms to watch for.

It is not known whether Mirapex ER will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using Mirapex ER.

It is not known whether pramipexole passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Do not drink alcohol. Dangerous side effects can occur when alcohol is combined with Mirapex ER.

Avoid driving or hazardous activity until you know how Mirapex ER will affect you. Your reactions could be impaired. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Some people taking Mirapex ER have fallen asleep during normal daytime activities such as working, talking, eating, or driving. Tell your doctor if you have any problems with daytime sleepiness or drowsiness.

Mirapex ER may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• hallucinations (seeing or hearing things that are not real);

• extreme drowsiness, falling asleep suddenly, even after feeling alert;

• tremors, twitching or uncontrollable muscle movements;

• unexplained muscle pain, tenderness, or weakness;

• vision problems; or

• posture changes you cannot control, such as involuntary bending forward of your neck, bending forward at the waist, or tilting sideways when you sit, stand, or walk.

Side effects such as confusion or hallucinations may be more likely in older adults.

You may have increased sexual urges, unusual urges to gamble, or other intense urges while taking Mirapex ER. Talk with your doctor if this occurs.

Common side effects of Mirapex ER may include:

• muscle spasm or muscle weakness;

• drowsiness, dizziness, weakness;

• confusion, memory problems;

• dry mouth;

• nausea, constipation;

• increased urination; or

• sleep problems (insomnia), unusual dreams.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Using Mirapex ER with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your other medicines, especially:

• cimetidine;

• metoclopramide; or

• medicine to treat mental illness, such as chlorpromazine, droperidol, fluphenazine, haloperidol, perphenazine, prochlorperazine, thioridazine, and others.

This list is not complete. Other drugs may affect Mirapex ER, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.