Importance of the field: Immediate-release pramipexole (P-IR) is indicated three times daily for the symptomatic treatment of early and advanced Parkinson's disease (PD). An extended-release formulation of pramipexole (P-ER) has been developed to allow a once-daily formulation and to provide more stable dopaminergic stimulation.
Areas covered in this review: This review summarizes clinical pharmacology and pharmacokinetics of P-ER for the treatment of early and advanced PD. The advantages and disadvantages of the strategies available at present for achieving continuous dopaminergic stimulation in the treatment of PD are discussed first. The pharmacological properties are then summarized. Finally, the clinical pharmacology and pharmacokinetics of P-ER are described.
What the reader will gain: The reader will gain knowledge of the development of P-ER, its current place in the pharmacotherapy of PD, and future directions.
Take home message: P-ER has been shown to be efficacious in early and advanced PD and it has the same clinical profile when administered once daily as P-IR administered three times daily. An overnight switching of P-IR to dose-equivalent P-ER is successful in 80% of patients with early PD.