From the FDA Drug Label
Doses of pergolide above 5 mg/day are not recommended (seeDOSAGE & ADMINISTRATION) The recommended dosis pargeverina is not to exceed 5 mg/day 1.
- Key points:
- The risk of cardiac valvular disease may be greater with higher doses.
- Patients should undergo periodic echocardiograms to screen for the development of valvulopathy.
From the Research
Pergolide is typically administered at a dose of 3 to 4mg per day, divided into 3 or 4 doses, with a gradual increase from a low initial dosage of 0.05 mg/day to minimize adverse effects. The dosage of pergolide may vary depending on the individual patient's response and tolerance to the medication 2. It is essential to initiate pergolide therapy at a low dose and gradually increase it to achieve the maximum clinical benefit while minimizing adverse effects.
Key Considerations
- Pergolide is a semisynthetic ergoline dopamine agonist used in the treatment of Parkinson's disease, with potent activity at presynaptic dopamine D2 receptors and postsynaptic D2 and dopamine D1 receptors 2.
- The most frequent effective total daily dose of pergolide is 3 to 4mg, administered in divided doses, usually 3 or 4 times per day 2.
- Pergolide has been shown to be effective in reducing the adverse effects of long-term levodopa monotherapy and often enables a reduction in levodopa dosage 2.
- Common adverse effects of pergolide include dyskinesia, nausea, hallucinations, drowsiness, insomnia, nasal congestion, dyspepsia, and dyspnoea 2.
Dosage and Administration
- The initial dosage of pergolide should be 0.05 mg/day for 2 days, with a gradual increase in dose until the maximum clinical benefit is achieved with minimal adverse effects 2.
- The dosage of pergolide may need to be adjusted in patients with concomitant heart disease, and close observation may be necessary to monitor for cardiac adverse events 2.
- Pergolide should be administered with caution in patients with glaucoma, urinary retention, or certain cardiac conditions, and patients should be advised to report any unusual symptoms promptly 2.
Efficacy and Safety
- Pergolide has been shown to be effective in patients with Parkinson's disease, either as monotherapy or in combination with levodopa, with significant improvements in locomotor activity, tremor, gait disturbances, bradykinesia, and rigidity 3.
- The efficacy and safety of pergolide have been evaluated in several trials, including a long-term study that demonstrated maintenance of initial improvement in patients receiving pergolide in combination with levodopa for up to 4 years 3.