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Indications and Dosage
Oral
Parkinson's disease 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).
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Administration
Should be taken with food. Take at the end of a main meal.
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Contraindications
Acute MI, cardiogenic shock. Concurrent use with antiemetic neuroleptics.
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Special Precautions
Avoid abrupt withdrawal. Elderly. Pregnancy and lactation.
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Adverse Reactions
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. |
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Patient Counseling Information
This drug may cause somnolence or episodes of sudden sleep onset, if affected, do not drive or operate machinery.
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Monitoring Parameters
Monitor blood pressure at the start of therapy; onset of impulse control disorders regularly.
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Overdosage
Symptoms: Arterial hypotension or hypertension, nausea and vomiting. Management: Symptomatic treatment.
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Drug Interactions
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. |
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Food Interaction
Enhanced sedative effects with alcohol.
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Action
Description: 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). |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4850, Piribedil. https://pubchem.ncbi.nlm.nih.gov/compound/Piribedil. Accessed July 27, 2021. |
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Storage
Store below 30°C.
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MIMS Class
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ATC Classification
N04BC08 - piribedil ; Belongs to the class of dopamine agonists. Used in the management of Parkinson's disease.
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References
Anon. Piribedil. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/07/2021. Buckingham R (ed). Piribedil. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/07/2021. Trivastal Retard 50 (Servier Philippines, Inc). MIMS Philippines. http://www.mims.com/philippines. Accessed 05/07/2021. Trivastal Retard 50 mg Sustained-Release Coated Tablets (Servier Malaysia Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 05/07/2021.
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