{"id":58897,"date":"2024-02-28T05:33:05","date_gmt":"2024-02-28T05:33:05","guid":{"rendered":"https:\/\/medsname.com\/pramirol\/"},"modified":"2026-05-01T10:49:14","modified_gmt":"2026-05-01T10:49:14","slug":"pramirol","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/pramirol\/","title":{"rendered":"Pramirol"},"content":{"rendered":"

<\/p>\n

\n

\u26a1 Rychl\u00e1 odpov\u011b\u010f<\/h3>\n

Pramirol<\/strong> je peror\u00e1ln\u00ed pramipexol<\/strong> (1 mg nebo 1,5 mg) tableta \u2014 neergotov\u00fd dopaminov\u00fd agonista<\/strong> pou\u017e\u00edvan\u00e1 k l\u00e9\u010db\u011b Parkinsonova choroba<\/strong> a st\u0159edn\u011b t\u011b\u017ek\u00fd a\u017e t\u011b\u017ek\u00fd syndrom neklidn\u00fdch nohou (RLS)<\/strong>. P\u0159\u00edmo stimuluje dopaminov\u00e9 receptory D2\/D3 v mozku, \u010d\u00e1ste\u010dn\u011b nahrazuje dopamin, kter\u00fd ji\u017e nen\u00ed produkov\u00e1n. Pramipexol je vylu\u010dov\u00e1n t\u00e9m\u011b\u0159 v\u00fdhradn\u011b v nezm\u011bn\u011bn\u00e9 form\u011b ledvinami \u2014 \u00faprava d\u00e1vkov\u00e1n\u00ed p\u0159i ren\u00e1ln\u00edm posti\u017een\u00ed je nezbytn\u00e1. M\u00e1 nejvy\u0161\u0161\u00ed selektivitu D3:D2 ze v\u0161ech klinicky pou\u017e\u00edvan\u00fdch dopaminov\u00fdch agonist\u016f, co\u017e m\u016f\u017ee vysv\u011btlovat jeho antidepresivn\u00ed \u00fa\u010dinek (FDA schv\u00e1lil pro depresivn\u00ed p\u0159\u00edznaky u Parkinsonovy choroby). Kritick\u00e9 bezpe\u010dnostn\u00ed sign\u00e1ly:<\/strong> poruch impulzivn\u00ed kontroly<\/em> (gambling, hypersexualita, z\u00e1chvatov\u00e9 p\u0159ej\u00edd\u00e1n\u00ed, nutkav\u00e9 nakupov\u00e1n\u00ed), n\u00e1hl\u00fd n\u00e1stup sp\u00e1nku<\/em> (z\u00e1chvaty sp\u00e1nku p\u0159i \u0159\u00edzen\u00ed) a ortostatick\u00e1 hypotenze. D\u00e1vkov\u00e1n\u00ed mus\u00ed b\u00fdt pomalu zvy\u0161ov\u00e1no a postupn\u011b sni\u017eov\u00e1no \u2014 nikdy nesm\u00ed b\u00fdt n\u00e1hle p\u0159eru\u0161eno.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n

Co je Pramirol?<\/h2>\n

Pramirol je peror\u00e1ln\u00ed tableta obsahuj\u00edc\u00ed pramipexol 1 mg nebo 1,5 mg<\/strong>. Pramipexol je neergotov\u00fd agonista dopaminov\u00fdch receptor\u016f D2\/D3<\/strong>, p\u016fvodn\u011b uveden\u00fd jako Mirapex\/Mirapexin\/Sifrol<\/strong>. Pramirol je vyr\u00e1b\u011bn ve v\u00fdrobn\u00edm za\u0159\u00edzen\u00ed certifikovan\u00e9m WHO-GMP a je bioekvivalentn\u00ed s origin\u00e1ln\u00ed zna\u010dkou ve stejn\u00e9 s\u00edle.<\/p>\n

Pramipexole pat\u0159\u00ed mezi dva nej\u010dast\u011bji pou\u017e\u00edvan\u00e9 neergotn\u00ed dopaminov\u00e9 agonisty (druh\u00fdm je ropinirol). Je vhodn\u00fd jako monoterapie v \u010dasn\u00fdch stadi\u00edch Parkinsonovy choroby \u2013 zejm\u00e9na u mlad\u0161\u00edch pacient\u016f, kde je \u017e\u00e1douc\u00ed odd\u00e1lit pod\u00e1v\u00e1n\u00ed levodopy \u2013 a jako dopl\u0148kov\u00e1 l\u00e9\u010dba v pokro\u010dil\u00fdch stadi\u00edch onemocn\u011bn\u00ed. Na rozd\u00edl od ostatn\u00edch l\u00e9k\u016f na Parkinsonovu chorobu m\u00e1 pramipexole prok\u00e1zan\u00fd antidepresivn\u00ed \u00fa\u010dinek a n\u011bkdy je speci\u00e1ln\u011b vyb\u00edr\u00e1n u pacient\u016f s PD, kte\u0159\u00ed maj\u00ed v\u00fdrazn\u00e9 depresivn\u00ed p\u0159\u00edznaky. Je tak\u00e9 schv\u00e1len pro st\u0159edn\u011b t\u011b\u017ek\u00fd a\u017e t\u011b\u017ek\u00fd syndrom neklidn\u00fdch nohou.<\/p>\n

Jak Pramirol (pramipexole) funguje?<\/h2>\n

Pramipexole p\u0159\u00edmo stimuluje dopaminov\u00e9 receptory D2 a D3, s v\u00fdrazn\u011b vy\u0161\u0161\u00ed afinitou k D3 ne\u017e k D2 \u2013 m\u00e1 nejvy\u0161\u0161\u00ed selektivitu pro D3 ze v\u0161ech klinicky pou\u017e\u00edvan\u00fdch dopaminov\u00fdch agonist\u016f. Receptory D3 jsou koncentrov\u00e1ny v limbick\u00e9m syst\u00e9mu, co\u017e m\u016f\u017ee vysv\u011btlovat prok\u00e1zan\u00fd antidepresivn\u00ed \u00fa\u010dinek pramipexolu, kter\u00fd je u jin\u00fdch agonist\u016f m\u00e9n\u011b v\u00fdrazn\u00fd. Neovliv\u0148uje serotoninov\u00e9 receptory 5-HT2B, tak\u017ee nezp\u016fsobuje fibr\u00f3zu srde\u010dn\u00edch chlopn\u00ed. Vylu\u010dov\u00e1n\u00ed je t\u00e9m\u011b\u0159 v\u00fdhradn\u011b ren\u00e1ln\u00ed \u2013 ledviny vylou\u010d\u00ed >90 % v nezm\u011bn\u011bn\u00e9 form\u011b.<\/p>\n

Pro koho je Pramirol ur\u010den?<\/h2>\n

Pramirol je vhodn\u00fd pro dosp\u011bl\u00e9 s Parkinsonovou chorobou (monoterapie v \u010dasn\u00fdch stadi\u00edch, dopl\u0148kov\u00e1 l\u00e9\u010dba k levodop\u011b v pokro\u010dil\u00fdch stadi\u00edch) a pro st\u0159edn\u011b t\u011b\u017ek\u00fd a\u017e t\u011b\u017ek\u00fd syndrom neklidn\u00fdch nohou, kter\u00fd nereaguje na nefarmakologick\u00e1 opat\u0159en\u00ed a dopln\u011bn\u00ed \u017eeleza. N\u011bkdy je speci\u00e1ln\u011b vyb\u00edr\u00e1n u pacient\u016f s Parkinsonovou chorobou s v\u00fdrazn\u00fdmi depresivn\u00edmi p\u0159\u00edznaky d\u00edky sv\u00e9mu nez\u00e1visl\u00e9mu antidepresivn\u00edmu \u00fa\u010dinku. Mlad\u0161\u00ed pacienti s PD (pod 65 let) \u010dasto profituj\u00ed z po\u010d\u00e1te\u010dn\u00ed l\u00e9\u010dby dopaminov\u00fdm agonistou p\u0159ed nasazen\u00edm levodopy, aby se odd\u00e1lila levodopou indukovan\u00e1 dyskineze.<\/p>\n

D\u00e1vkov\u00e1n\u00ed a titrace<\/h2>\n

Terapie dopaminov\u00fdmi agonisty mus\u00ed<\/strong> b\u00fdt titrov\u00e1na postupn\u011b po dobu n\u011bkolika t\u00fddn\u016f, aby se p\u0159ede\u0161lo nesnesiteln\u00e9 nevolnosti, ortostatick\u00e9 hypotenzi a ospalosti. N\u00ed\u017ee uveden\u00e9 d\u00e1vkov\u00e1n\u00ed je typick\u00fd v\u00fdchoz\u00ed r\u00e1mec \u2014 v\u00e1\u0161 neurolog jej uprav\u00ed podle va\u0161\u00ed reakce.<\/p>\n\n\n\n\n\n\n\n\n\n
T\u00fdden<\/th>\nD\u00e1vkov\u00e1n\u00ed pramipexolu \u201csoli\u201d pro Parkinsonovu chorobu<\/th>\nPro RLS<\/th>\n<\/tr>\n<\/thead>\n
1<\/td>\n0,125 mg t\u0159ikr\u00e1t denn\u011b (0,375 mg\/den)<\/td>\n0,125 mg 2\u20133 hodiny p\u0159ed span\u00edm<\/td>\n<\/tr>\n
2<\/td>\n0,25 mg t\u0159ikr\u00e1t denn\u011b (0,75 mg\/den)<\/td>\n0,25 mg p\u0159ed span\u00edm<\/td>\n<\/tr>\n
3<\/td>\n0,5 mg t\u0159ikr\u00e1t denn\u011b (1,5 mg\/den)<\/td>\n0,5 mg p\u0159ed span\u00edm<\/td>\n<\/tr>\n
Udr\u017eovac\u00ed d\u00e1vka<\/td>\n1,5\u20134,5 mg\/den ve 3 rozd\u011blen\u00fdch d\u00e1vk\u00e1ch<\/td>\n0,125\u20130,75 mg p\u0159ed span\u00edm<\/td>\n<\/tr>\n
D\u00e1vkov\u00e1n\u00ed p\u0159i ren\u00e1ln\u00edm posti\u017een\u00ed (CrCl 35\u201350)<\/td>\nSni\u017ete frekvenci \u2014 za\u010dn\u011bte s 0,125 mg dvakr\u00e1t denn\u011b<\/td>\nCrCl < 20 ml\/min: vyvarujte se<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Pramipexol je tak\u00e9 dostupn\u00fd jako jednou denn\u011b pod\u00e1van\u00e1 tableta s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm (Mirapex ER) pro Parkinsonovu chorobu \u2014 ne v t\u00e9to prezentaci Pramirolu. Ren\u00e1ln\u00ed funkce siln\u011b ovliv\u0148uje d\u00e1vkov\u00e1n\u00ed: p\u0159i CrCl 35\u201350 ml\/min za\u010dn\u011bte s 0,125 mg dvakr\u00e1t denn\u011b; p\u0159i CrCl 15\u201335 za\u010dn\u011bte s 0,125 mg jednou denn\u011b; p\u0159i CrCl < 15 ml\/min se vyvarujte pod\u00e1v\u00e1n\u00ed.<\/p>\n

\u26a0 Poruchy impulzivn\u00ed kontroly \u2014 varov\u00e1n\u00ed, kter\u00e9 by m\u011bl sly\u0161et ka\u017ed\u00fd pacient (i partner)<\/strong> A\u017e 14\u201317 %<\/strong> pacient\u016f u\u017e\u00edvaj\u00edc\u00edch dopaminov\u00e9 agonisty vyvine jeden nebo v\u00edce poruch impulzivn\u00ed kontroly<\/em>: patologick\u00e9 hr\u00e1\u010dstv\u00ed, nutkav\u00e9 nakupov\u00e1n\u00ed, hypersexualita, z\u00e1chvatov\u00e9 p\u0159ej\u00edd\u00e1n\u00ed nebo punding (opakovan\u00e9 bez\u00fa\u010deln\u00e9 chov\u00e1n\u00ed). Riziko je z\u00e1visl\u00e9 na d\u00e1vce a nejvy\u0161\u0161\u00ed je u neergotn\u00edch agonist\u016f. Pacienti si zm\u011bny \u010dasto neuv\u011bdomuj\u00ed \u2014 jako prvn\u00ed ji mohou zaznamenat partne\u0159i nebo rodinn\u00ed p\u0159\u00edslu\u0161n\u00edci. Pokud vy nebo n\u011bkdo z va\u0161eho okol\u00ed pozoruje jak\u00e9koli nov\u00e9 nutkav\u00e9 chov\u00e1n\u00ed, neprodlen\u011b kontaktujte sv\u00e9ho neurologa.<\/strong> Sn\u00ed\u017een\u00ed d\u00e1vky nebo vysazen\u00ed obvykle chov\u00e1n\u00ed normalizuje b\u011bhem n\u011bkolika t\u00fddn\u016f.<\/div>\n
\u26a0 N\u00e1hl\u00e9 usnut\u00ed (\u201csp\u00e1nkov\u00e9 ataky\u201d)<\/strong> V\u0161echny neergotn\u00ed dopaminov\u00e9 agonisty mohou zp\u016fsobit n\u00e1hl\u00e9, neovladateln\u00e9 epizody sp\u00e1nku bez varov\u00e1n\u00ed \u2014 v\u010detn\u011b b\u011bhem \u0159\u00edzen\u00ed, j\u00eddla nebo rozhovoru. Tento jev je \u010dast\u011bj\u0161\u00ed v prvn\u00edch m\u011bs\u00edc\u00edch l\u00e9\u010dby, p\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch a v kombinaci s levodopou. Dokud nebudete alespo\u0148 2 t\u00fddny na stabiln\u00ed d\u00e1vce a nebudete v\u011bd\u011bt, jak na l\u00e9k reagujete, ne\u0159i\u010fte, neobsluhujte stroje ani se nev\u011bnujte \u010dinnostem, p\u0159i nich\u017e by usnut\u00ed mohlo b\u00fdt nebezpe\u010dn\u00e9.<\/strong><\/div>\n

B\u011b\u017en\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky<\/h2>\n

\u010cast\u00e9 (>10%):<\/strong> nevolnost, z\u00e1vrat\u011b, ospalost, ortostatick\u00e1 hypotenze, perifern\u00ed ed\u00e9my (otoky kotn\u00edk\u016f), z\u00e1cpa, halucinace (\u010dast\u011bji vizu\u00e1ln\u00ed ne\u017e sluchov\u00e9), dyskineze (v kombinaci s levodopou).<\/p>\n

M\u00e9n\u011b \u010dast\u00e9, ale z\u00e1va\u017en\u00e9:<\/strong> n\u00e1hl\u00e9 usnut\u00ed, poruchy impulzivn\u00ed kontroly, livedo reticularis (mramorovan\u00e1 k\u016f\u017ee), \u017eiv\u00e9 sny, otoky nohou, synkopa, dyskineze, halucinace, paranoia.<\/p>\n

Vz\u00e1cn\u00e9:<\/strong> syndrom z vysazen\u00ed dopaminov\u00fdch agonist\u016f (DAWS) p\u0159i rychl\u00e9m sni\u017eov\u00e1n\u00ed d\u00e1vek \u2014 deprese, \u00fazkost, panika, \u00fanava, ba\u017een\u00ed po l\u00e9ku, autonomn\u00ed nestabilita. Z tohoto d\u016fvodu je nutn\u00e9 agonisty vysazovat postupn\u011b.<\/p>\n

Interakce s l\u00e9\u010divy<\/h2>\n