Adult: Monotherapy: 150-250 mg daily given in 3-5 divided doses. In combination with levodopa therapy: 50-150 mg daily. Dose must be achieved gradually, increase by 50 mg every 3 days. Dosing should be reduced gradually until complete discontinuation of therapy. Dosage recommendations may vary between countries (refer to detailed product guidelines).
Should be taken with food. Take at the end of a main meal.
Acute MI, cardiogenic shock. Concurrent use with antiemetic neuroleptics.
Avoid abrupt withdrawal. Elderly. Pregnancy and lactation.
Significant: Neuroleptic malignant syndrome (abrupt discontinuation); impulse control disorders (e.g. pathologic gambling, compulsive buying, binge or compulsive eating, increased libido, hypersexuality, other pathologic urges), abnormal behaviour (e.g. aggression, confusion, agitation), exacerbation of psychotic disorders (e.g. hallucination, delusion, delirium), dyskinesia, peripheral oedema, sleep disorders (e.g. sudden sleep onset or somnolence), orthostatic hypotension, falls (particularly in the elderly). Cardiac disorders: Syncope. Gastrointestinal disorders: Nausea, vomiting, flatulence. General disorders and administration site conditions: Malaise. Nervous system disorders: Dizziness. Vascular disorders: Hypotension.
Patient Counseling Information
This drug may cause somnolence or episodes of sudden sleep onset, if affected, do not drive or operate machinery.
Monitor blood pressure at the start of therapy; onset of impulse control disorders regularly.
Symptoms: Arterial hypotension or hypertension, nausea and vomiting. Management: Symptomatic treatment.
Increased risk of sedation with sedatives. Therapeutic effects of piribedil may be diminished by tetrabenazine. Potentially Fatal: May cause reciprocal antagonism when taken with anti-emetic neuroleptics; use an anti-emetic without extrapyramidal activity.
Enhanced sedative effects with alcohol.
Description: Mechanism of Action: Piribedil is a dopamine agonist that stimulates dopamine D2 and D3 receptors and the cerebral dopamine pathways. Pharmacokinetics: Absorption: Rapidly absorbed from the gastrointestinal tract. Time to peak plasma concentration: 1 hour. Metabolism: Metabolised into hydroxylated and dihydroxylated derivatives. Excretion: Via urine (68% as metabolites); bile (25%). Elimination half-life: 1.7 hours (1st phase); 6.9 hours (2nd phase).