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Topic: Pergolide

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	CT 11/96 Pergolide:
		Pergolide is one member of a class of potent dopamine receptor agonists used in the treatment of Parkinson's disease (see sidebar).
		The transformations in the conversion of dihydrolysergol to pergolide include replacing the methyl group at N-6 with a propyl and the hydroxymethyl functionality at C-8 with a thiomethyl ether.
		Crude pergolide, as a dried solid or a damp filter cake (no dust), was dissolved in a mobile phase of 17% acetonitrile and pH 3 phosphate buffer and then eluted through a radial flow column (Figure 5); this type of column design allows high capacity and throughput.
	pubs.acs.org /hotartcl/chemtech/96/nov/pergolide.html (2129 words)

	Pergolide (Permax) (Site not responding. Last check: 2007-10-26)
		Pergolide has 10 to 1000 times the potency of bromocriptine on a milligram basis and may be effective in patients who have become tolerant to bromocriptine.
		Pergolide also causes less nausea and orthostatic hypotension than does bromocriptine and may be effective in patients who have become tolerant to bromocriptine.
		Pergolide inhibits the secretion of prolactin in humans and causes transient increases in serum growth hormone and decreases in luteinizing hormone.
	www.rockford.uic.edu /jc/pergolid.htm (220 words)

	FDA Public Health Advisory: Pergolide (marketed as Permax)
		Pergolide is a member of a class of drugs known as dopamine agonists and is used with levodopa and carbidopa to manage the signs and symptoms (tremors and slowness of movement) of Parkinson’s disease.
		Pergolide is marketed by Valeant under the trade name Permax and sold and manufactured as the generic drug pergolide by Par and Teva.
		The FDA is working with the manufacturers of pergolide to determine if it is possible to make the drug available to those few patients who are currently taking pergolide where previous efforts to switch to a different treatment have been unsuccessful, or where efforts subsequent to this advisory to switch therapies are also unsuccessful.
	www.fda.gov /cder/drug/advisory/pergolide.htm (553 words)

	Permax (Pergolide Mesylate) clinical pharmacology - prescription drugs and medications at RxList
		Pergolide mesylate is a potent dopamine receptor agonist.
		Pergolide mesylate inhibits the secretion of prolactin in humans; it causes a transient rise in serum concentrations of growth hormone and a decrease in serum concentrations of luteinizing hormone.
		C radiolabeled pergolide mesylate, approximately 55% of the administered radioactivity can be recovered from the urine and 5% from expired CO, suggesting that a significant fraction is absorbed.
	www.rxlist.com /cgi/generic2/pergol_cp.htm (329 words)

	Pergolide Mesylate Drug Information, Professional
		Pergolide generated a weak mutagenic response in the mammalian cell-point-mutation assay.(in cultured L5178Y cells); other assays, including a DNA repair assay, an Ames bacterial mutation assay, and a hamster bone chromosome alteration determination, generated a mutagenic-negative response.Human-related studies are currently unavailable.
		Pergolide may decrease or inhibit salivary flow, thus contributing to the development of caries, periodontal disease, oral candidiasis, and discomfort.
		Nausea and dizziness associated with initiation of pergolide therapy usually resolve with continued therapy; however, incidence and severity of these side effects may be reduced with a decrease in pergolide dose.
	www.drugs.com /MMX/Pergolide_Mesylate.html (2174 words)

	Pergolide - Patient UK
		Pergolide is used to relieve the symptoms of Parkinson's disease.
		How Parkinson's disease occurs is still unknown, but the result of having it is that there is a reduction in the amount of a chemical messenger in the brain known as dopamine; this lack of dopamine causes the symptoms of parkinsonism such as loss of muscle control and stiffness.
		Pergolide increases the effects of dopamine, relieving these symptoms.
	www.patient.co.uk /showdoc/30002976 (818 words)

	Pergolide Mesylate facts and comparsions at Drugs.com
		Pergolide Mesylate may be taken with or without food.
		Using Pergolide Mesylate alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
		Pergolide Mesylate is to be used only by the patient for whom it is prescribed.
	www.drugs.com /pdr/PERGOLIDE_MESYLATE.html (1091 words)

	Pergolide , Pergolide Side Effects, Pergolide Information
		PERMAX (Pergolide mesilate) is indicated as monotherapy, or as adjunctive treatment to levodopa, in the management of the signs and symptoms of Parkinson's disease.
		In clinical trials of pergolide as monotherapy, the overall reported incidence of nausea was higher than was reported in trials of pergolide as adjunctive therapy.
		Pergolide has been associated with somnolence and episodes of sudden sleep onset, particularly in patients with Parkinson's disease.
	www.medisave.ca /DrugMoreInfo1839.aspx (765 words)

	Celance 50, 250, 1000 microgram tablets. , SPC from the eMC
		The incidence of valvulopathy with pergolide is not known; however based on recent studies of the prevalence of valvular regurgitation (the most sensitive echocardiographic marker for restrictive valvulopathy), the prevalence of regurgitation (virtually all cases asymptomatic) potentially attributable to pergolide may be in range of 20 percent or greater.
		Pergolide mesilate inhibits the secretion of prolactin in humans and lowers serum prolactin concentrations; it causes a transient rise in serum concentrations of growth hormone and a decrease in serum concentrations of luteinizing hormone.
		C radiolabelled pergolide mesilate to healthy subjects, approximately 55 percent of the administered radioactivity can be recovered as pergolide metabolites from the urine, 40 percent from the faeces, and 5 percent from expired CO, suggesting that a significant fraction is absorbed.
	emc.medicines.org.uk /emc/assets/c/html/displaydoc.asp?documentid=589 (2686 words)

	Medical Alerts
		Pergolide is in a class of medications called dopamine agonists and is used with levodopa and carbidopa to manage the symptoms (tremors and slowness of movement) of Parkinson's disease.
		Pergolide (a dopamine-receptor agonist) is a drug that mimics the effects of a chemical in the body that helps to regulate movement-dopamine-and is approved by the US Food and Drug Administration for the treatment of Parkinson's disease.
		Six patients stopped taking pergolide after they were found to have restrictive valvular heart disease; two of these six had less stiffening of their valves when they were reexamined six months later.
	www.grassrootsconnection.com /medalerts.htm (1607 words)

	Pergolide, Permax For Veterinary Use
		Pergolide is a human drug used in the treatment of Parkinson's disease.
		Pergolide is the drug of choice for the treatment of pituitary pars intermedia hyperplasia or Equine Cushing's Syndrome (ECS) in horses.
		Pergolide should only be used in pregnant or lactating animals if the benefits outweigh the risks.
	www.wedgewoodpharmacy.com /monographs/pergolide.asp (814 words)

PDtrials.org -

Site News

Pergolide is a member of a class of drugs known as dopamine agonists and is used with levodopa and carbidopa to manage the signs and symptoms (tremors and slowness of movement) of Parkinson’s disease.

Pergolide is marketed by Valeant under the trade name Permax and sold and manufactured as the generic drug pergolide by Par and Teva.

The FDA is working with the manufacturers of pergolide to determine if it is possible to make the drug available to those few patients who are currently taking pergolide where previous efforts to switch to a different treatment have been unsuccessful, or where efforts subsequent to this advisory to switch therapies are also unsuccessful.

www.pdtrials.org /front/pressrelease.php?id=165 (570 words)

	Parkinsn's List Drug DataBase pergolide / Permax
		Gastrointestinal complaints with pergolide were frequently reported in clinical trials, usually at a rate about twice that for placebo.
		Pergolide will not cure Parkinson's disease, but will help to control the symptoms and slow down the progression of the disease.
		Pergolide tablets are taken together with other tablets that control parkinsonian symptoms.
	www.parkinsons-information-exchange-network-online.com /drugdb/099.html (1077 words)

	pergolide - Drug Finder - MSN Health & Fitness (Site not responding. Last check: 2007-10-26)
		Pergolide is used to treat the stiffness, tremors, spasms, and poor muscle control of Parkinson's disease.
		Pergolide is often used in conjunction with other medicines in the treatment of Parkinson's disease.
		Pergolide is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby.
	health.msn.com /drugfinder/articlepage.aspx?cp-documentid=100060147 (1310 words)

	Permax - Permax Side Effects - Permax Information - Canada Pharmacy - Drugs from Canada
		Pergolide is approximately 90% bound to plasma proteins.
		Pergolide may be used both as early therapy, without concomitant levodopa, and as an adjunct to levodopa (usually with a peripheral decarboxylase inhibitor).
		In clinical trials for pergolide early therapy, the overall reported incidence of nausea was higher than that reported in trials for adjunctive therapy (38.0% vs 24.3%, respectively); this nausea rate occurred despite a mandatory regimen of the antiemetic domperidone during the initial 3- or 8-week up-titration period, for all patients in early therapy clinical trials.
	www.rxcarecanada.com /PERMAX.asp?currency=CAD&page=/PERMAX.asp&q=prodid=PERMAX (1939 words)

	Drugs and Treatments - Pergolide Oral - Patient Handout from RxList
		Pergolide is an ergot medication that works by helping to restore the balance of a certain natural substance (dopamine) in the brain.
		To decrease the risk of side effects (e.g., drowsiness, low blood pressure) when you first start taking pergolide, your doctor will slowly increase your dosage until the best dose for you is reached.
		Before taking pergolide, tell your doctor or pharmacist if you are allergic to it; or to other ergot medications (e.g., bromocriptine); or if you have any other allergies.
	www.rxlist.com /drugs/search.aspx?query=PERGOLIDE (1395 words)

	DG DISPATCH - AAN: Pergolide improves restless legs symptoms (Site not responding. Last check: 2007-10-26)
		SAN DIEGO, CA -- May 2, 2000 -- Pergolide decreases limb movements and improves sleep in restless legs syndrome (RLS), according to a study presented Monday (May 1) at the 52nd Annual Meeting of the American Academy of Neurology, in San Diego, CA.
		Pergolide, a long-acting D1 and D2 dopamine receptor agonist, has been shown to be effective for RLS in short-term, double-blind trials.
		The study, titled, "Long-term effect of pergolide in the treatment of restless legs syndrome," was supported by Lilly Deutschland.
	www.pslgroup.com /dg/1cf5ae.htm (366 words)

	Pergolide for RLS
		Doses of pergolide were generally in the range 0.25 to 0.75 mg daily, with individual patient titration of dose to effect.
		The relative benefit was 4.3 (2.8 to 6.6), and the number needed to treat with pergolide for 4-6 weeks compared with placebo for one additional patient to benefit was 1.7 (1.4 to 2.1).
		There is limited data, but pergolide for RLS appears to be a potentially useful therapy.
	www.jr2.ox.ac.uk /bandolier/booth/RLS/perg.html (610 words)

	TheHorse.com: Your Online Guide to Equine Health Care
		More than a month after pergolide mesylate, a drug commonly used to treat pituitary pars intermedia dysfunction (PPID), also known as equine Cushing's disease, was withdrawn for human use, the FDA has yet to make an announcement on whether it will allow bulk shipments of the drug to be imported for veterinary use.
		To ensure an uninterrupted supply of pergolide, the FDA would need to publish a specific exception for the importation of pergolide for veterinary use, and also a specific exception to the prohibition of use of bulk drugs in veterinary compounding.
		Pergolide, a dopamine agonist formerly used to treat Parkinson's disease, was withdrawn for human use March 29 because of a risk of damage to patients' heart valves.
	www.thehorse.com /ViewArticle.aspx?ID=9526&nID=7 (533 words)

	Pergolide by Ray Sahelian, M.D. (Site not responding. Last check: 2007-10-26)
		Pergolide by Ray Sahelian, M.D. Pergolide by Ray Sahelian, M.D. Pergolide is a dopamine agonist.
		Pergolide works by acting in place of dopamine, a natural substance in the brain that is needed to control movement.
		Case reports and echocardiographic studies suggest that the ergot-derived dopamine agonist pergolide, used in the treatment of Parkinson's disease and restless legs syndrome, may increase the risk of cardiac-valve regurgitation.
	www.raysahelian.com /pergolide.html (295 words)

	Pergolide (Permax) Withdrawn Over Heart Valvulopathies - CME Teaching Brief® - MedPage Today
		The FDA has known about the link between pergolide and valve disease since 2002 and in 2003 a warning about valvulopathy was added to the drug's label and a "Dear Healthcare Provider" letter was sent to clinicians by Lilly, which then marketed Permax.
		If treatment with a dopamine agonist is to be discontinued, pergolide should not be stopped abruptly, because rapid discontinuation of all dopamine agonist therapies can be dangerous.
		Patients who will be taken off pergolide should be told that other effective options for treatment exist, including three other dopamine agonists that are not associated with damage to heart valves.
	www.medpagetoday.com /ProductAlert/Prescriptions/tb1/5357 (654 words)

	Patent 6,001,390
		Composition of matter for application to a body surface or membrane to administer pergolide by permeation through the body surface or membrane, the composition comprising pergolide to be administered, at a therapeutically effective rate, alone or in combination with a permeation enhancer or mixture.
		It is unexpected that pergolide would be delivered through the skin at meaningful therapeutic rates either as a base or salt because, as its chemical name 8-[(methylthiolmethyl]-6-propylergoline monomethanesulfonate)] indicates, it has a complex chemical structure which does not lend itself to readily permeate through biological membranes such as the skin.
		In addition, the present invention provides methods for the transdermal delivery of pergolide and delivery systems for effecting the same, which are suitable for the administration of pergolide continuously through a body surface or membrane to achieve and maintain therapeutic blood plasma levels of pergolide in an individual.
	www.pharmcast.com /Patents/121499OG/6001390_transderm121499.htm (1005 words)

	Mayo Clinic - Pergolide and Heart Valve Problems: Could there be a Link?
		Until now, the drug pergolide, which is prescribed for Parkinson’s disease, restless legs syndrome and occasionally prescribed for other conditions, has not been linked to heart valve problems.
		This is the first report of heart valve problems occurring among people taking pergolide, which has been available for prescription use since 1989.
		More studies are needed to determine the incidence of valvular disease and the spectrum of abnormalities seen with pergolide treatment.
	www.mayoclinic.org /news2003-rst/1617.html (542 words)

	Pergolide
		Symptomatic hypotension occurs in 10% of patients; use with caution in patients with a history of cardiac arrhythmias, hallucinations, or mental illness.
		Pergolide is a semisynthetic ergot alkaloid similar to bromocriptine but stated to be more potent (10-1000 times) and longer-acting; it is a centrally-active dopamine agonist stimulating both D1 and D2 receptors.
		When adding pergolide to levodopa/carbidopa, the dose of the latter can usually and should be decreased.
	www.umm.edu /altmed/drugs/pergolide-098800.htm (1325 words)

	Australian Adverse Drug Reactions Bulletin, Volume 23, Number 4, August 2004
		Pergolide (Permax) is a dopamine agonist and ergot derivative indicated for the adjunctive treatment of Parkinson's disease.
		Pergolide was discontinued in only six of the patients with restrictive valvular heart disease and improvement had occurred in two of them six months after discontinuation of pergolide.
		Before pergolide is prescribed, patients should be advised of the risk of valvulopathy.
	www.tga.health.gov.au /adr/aadrb/aadr0408.htm (1669 words)

	MedlinePlus Drug Information: Pergolide
		Pergolide is no longer available in the U.S. If you are currently taking pergolide, you should call your doctor to discuss switching to another treatment.
		Pergolide is used with another medication to treat the symptoms of Parkinson's disease (a disorder of the nervous system that causes difficulties with movement, muscle control, and balance).
		Like all medications, pergolide was studied in a limited number of patients before it was approved for sale to the public.
	www.nlm.nih.gov /medlineplus/druginfo/medmaster/a601093.html (1213 words)

	WE MOVE: Pergolide and Valvular Disease
		Use of pergolide may be associated with a high risk for restrictive valvular heart disease, according to this study.
		Pergolide treatment was stopped in 6 patients, 2 of whom showed improvement following drug cessation.
		The authors conclude, “Although pergolide remains a good treatment for the symptoms of Parkinson’s disease, our findings underline the necessity to inform patients of the possible risk of inducing restrictive valvular heart disease and pulmonary hypertension.
	www.imakenews.com /wemove/e_article000251234.cfm (240 words)

	FDA Announces Voluntary Withdrawal of Pergolide Products
		Pergolide is in a class of medications called dopamine agonists and is used with levodopa and carbidopa to manage the symptoms (tremors and slowness of movement) of Parkinson’s disease.
		The removal of pergolide products is not expected to adversely affect patient care because of the alternative therapies available.
		FDA is working with the manufacturers of pergolide to determine if it might be possible, once the drug is withdrawn from the market, to make the drug available under an Investigational New Drug Application (IND) for those few patients who are currently receiving pergolide and who cannot be successfully converted to other available treatments.
	www.fda.gov /bbs/topics/NEWS/2007/NEW01596.html (582 words)

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