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piribedil

N04BC08

Forms & Strengths

Sustained-release tablets: 50 mg
Conventional coated tablets: 20 mg

Adult Dosing

Parkinson's disease (monotherapy): 150 mg per day divided into 3 to 5 doses
Parkinson's disease (adjunct to levodopa): 50 mg to 150 mg per day divided into 2 to 3 doses
Sustained-release formulation: 50 mg to 150 mg once daily with meals

Pediatric Dosing

Safety and efficacy in pediatric patients have not been established

Indications

Treatment of Parkinson's disease, either as monotherapy or in combination with levodopa
Management of symptomatic peripheral vascular disease of the lower limbs
Treatment of pathological cognitive deficits in the elderly (excluding Alzheimer's disease)

Mechanism of Action

Direct dopamine agonist with preferential affinity for D2 and D3 receptors in the striatum and limbic system
Stimulates dopaminergic pathways in the central nervous system to improve motor function
Exerts weak alpha-2 adrenergic antagonistic properties, contributing to peripheral vasodilation

Contraindications

Hypersensitivity to piribedil or any of its excipients
Acute cardiovascular collapse or shock
Recent myocardial infarction
Concurrent use with major neuroleptic dopamine antagonists

Adverse Reactions

Nausea, vomiting, dyspepsia, and gastrointestinal disturbances
Somnolence, sudden sleep onset, confusion, and hallucinations
Orthostatic hypotension and dizziness
Dyskinesias and abnormal involuntary movements when combined with levodopa
Impulse control disorders (e.g., pathological gambling, hypersexuality)

Drug Interactions

Major neuroleptic antipsychotics antagonize the therapeutic effects of dopaminergic agonists
Antihypertensive agents may exhibit additive hypotensive effects, particularly orthostatic hypotension
Central nervous system depressants and alcohol may potentiate sedation and somnolence
Metoclopramide acts as a functional antagonist and reduces efficacy

Curated Content: Needs Vetting Before Put to Clinical Use