sifrol

[kaysar]

Hi All
Can anyone give me their experiences with Siferol please. My Hubby went to a new Dr and he took him off Madopar rapid and put him on ordiary Madopar and 125 mg Siferol 3 times a day. I have been clued up on the side effects so will have to see hoe he goes, this drug is new in Australia but has been used o/s for aquite a few years. Would appreciate any feedback. My Hubby only newly diagnosed last June and in early stages ie, right hand shakey. xx Kaysar

[Rikki]

Hi,
My Neurologist switched me to Sifrol (the new wonder drug) six months ago. We went through all the reported side effects, including the bizarre tendency for the drug to promote obsessive behaviour in some people (eg: gambling, sex, cleaning, etc.).

Initially I responded well to the initial dose and it was smoothing out my bodies take up of the levadopa well, with no adverse reaction. Then we increased the dose. First my ankles blew up like balloons and my GP had me off for chest x-rays and evryone was looking for a heart condition. Then I began to itch severely in the extremities - lower arms and legs. This soon became red and hyper sensitive (almost like a sunburn), but then the blisters began to appear and my skin became inflamed. Now this was extremely uncomfortable - not to mention I began to feel like Elephant Man. My GP quickly worked through the range of Cortisone creams until I was using the strongest they had plus Aloe Vera and anything that would give me some relief (even an ice bath).

Finally I saw a skin specialist. She took two skin core samples and the biopsy confirmed a reaction to pharmeceutical compound. Between her and my Neurologist they agreed that it was the Sifrol and a report is now being writen up for the pharmaceutical company (my Neurologist had another patient on Sifrol with the same rash). I did a crash withdrawl over two weeks that wasn't a lot of fun, but the rash is clearing quickly now and the wounds from the skin cores are healing well.

Having said all this I have to say that I really miss the effect of the Sifrol on my levadopa uptake. I now take extra Stalevo (levadopa) and I am experiencing distinct 'on' and 'off' periods. I don't have any advise as such, just watch for the signs and get treatment quickly -you don't want to go through what I did.

Cheers,
Rikki

[kaysar]

Thanks Rikki for the info, so far my hubby is having positive effects with the use of this drug and we are cautiously optimistic that he will be able to tolerate it for a while.
Wishing you well...Kaysar

[smurf122]

I was on Caaser until it was removed from PBS, it worked well for me.

Sifrol has been linked to a friend who PD as well, he fell asleep while driving

[zzagz]

I've jsut been put on Sifrol and am struggling with the nausea big time. I am frightened of other side effects too. *blah*

[Mike]

The Dr put me on Sifrol recently 500mg X 3 a day but I cant notice anything. Does anybody know what its suppose to do. I didnt asdk my Dr & I dont see him for 2 months. I am also on Magopar

[ltd-addition]

Mike
and everyone else who hasn't had a reply

I'm sorry i thought I couldn't reply until I realised it is what I take but under a different name..

1. What Sifrol is used
4b) Things to be careful of
Do not drive a car, operatemachinery, or do anything else that could be dangerous (after taking Sifrol) until you know how Sifrol affects you.
Sifrol may cause drowsiness,hallucinations and episodes of sudden onset of sleep, in some people.
Make sure you know how you react to Sifrol before you engage in any activities where impaired alertness may put yourself or others at risk of serious injury.
If you experience excessive drowsiness or an episode of sudden onset of sleep (while performing daily activities), do not drive or perform any potentially dangerous activities, and contact your doctor.
Be careful when drinking alcohol while taking Sifrol. Combining Sifrol and alcohol can make you more drowsy or sleepy.
Be careful getting up from a sitting or lying position. You may feel dizzy or lightheaded while taking Sifrol, especially during the first few weeks of treatment. If
you wish to stand up, you should do so slowly.
Patients with Parkinson's Disease may have an increased risk of developing melanoma. You should monitor your skin and see your doctor in case of any concerns.
5. Side effects
You should be aware that all prescription medicines carry some risks and that all possible risks may not be known at this stage despite thorough testing.
Your doctor has weighed the risks of your taking Sifrol against the expected benefits.
Ask for the advice of your doctor or pharmacist if you have any concerns about the effects of taking
Sifrol.
The most common side effects of Sifrol include nausea, constipation, drowsiness, hallucinations, confusion, dizziness and swelling of hands, ankles or feet (peripheral oedema). In patients also taking other medicines to treat Parkinson's disease, abnormal uncontrolled movements can occur.
These side effects tend to appear at the start of treatment and lessen or disappear with time.
Sudden onset of sleep episodes (while engaged in daily activities) have been reported with/without prior warning signs, such as excessive drowsiness.
Other reported side effects include hypersensitivity, diarrhoea, dry mouth, fatigue, visual disturbance
including blurred vision and reduced visual acuity, vomiting, headache, lightheadedness or low blood
pressure (hypotension), trouble sleeping (insomnia), amnesia, restlessness, dream abnormalities, delusion, paranoia, weight gain, weight decrease.
Compulsive behaviour such as gambling, hypersexuality, shopping, eating, medication use and repetitive purposeless activities have been
reported in patients taking dopamine agonists for the treatment of Parkinson's disease, especially at high doses.
If you or your family notice an increase in compulsive behaviour, seek immediate medical advice. Your doctor may consider reducing or ceasing your
treatment. Tell your doctor as soon as possible if you experience any side effects during or after taking Sifrol, so that these effects may be properly treated.
Other side effects not yet known or listed above, may also occur in some for Sifrol is used in the treatment of Parkinson's disease.Parkinson's disease is a disease of the brain that affects body movement.
The symptoms of Parkinson's disease are caused by a lack of dopamine, a naturally occurring chemical produced by certain brain cells.
Dopamine relays messages in the part of the brain that controls movement. When too little dopamine is produced, this results in Parkinson's disease. Sifrol works by having a similar effect as dopamine
in the brain. Sifrol is also used in the treatment of Restless Legs Syndrome (RLS).
RLS is a neurological disorder characterised by unpleasant sensations in the legs and the compelling need to move the legs (in an effort to relieve these feelings).
The sensations range in severity from uncomfortable to irritating to painful and typically occur when sitting or lying down - which often leads to problems falling or staying asleep.
Occasionally the arms may also be affected. Current evidence suggests that RLS may be due to impaired transmission of dopamine signals in
certain area(s) of the brain. Sifrol works by having a similar effect as dopamine in the brain.
Sifrol contains the active ingredient Pramipexole hydrochloride.
Pramipexole hydrochloride belongs to a group of medicines known as "dopamine agonists".
Ask your doctor if you have any questions about why Sifrol has been prescribed for you.
Your doctor may have prescribed Sifrol for another reason.

[Mike]

Thanks that was very helpful

[ltd-addition]

Dopamine agonists

Dopamine agonist drugs are one of the main ways to treat the symptoms of Parkinson's
Dopamine agonists directly stimulate the parts of the brain where dopamine works and mimic its function.
Dopamine is a neurotransmitter (chemical) that influences both the movement and thinking areas of the brain.
The loss of dopamine-producing cells in the brain leads to the appearance of Parkinson's symptoms.

The generic drug names and brand names are:

• pramipexole dihydrochloride (Mirapexin®)
• ropinirole hydrochloride (ReQuip®)
• pergolide mesilate (Celance®)
• bromocriptine mesylate (Parlodel®)
• cabergoline (Cabaser®, Dostinex®)
• rotigotine (Neupro®)
• apomorphine hydrochloride (APO-go®)

When dopamine agonists are used alone, they can be less effective than levodopa at controlling the motor symptoms of Parkinson's.
Dopamine agonists need to be carefully introduced to minimise their side effects. Agonists are therefore started at a low dose and increased gradually until the best benefits are achieved.
However, they are mostly used with levodopa to ease the control of symptoms in people whose response to treatment is beginning to fluctuate.
If you have any form of heart or lung disease, or symptoms that might be related to a problem with the heart or lungs, be sure to inform your medical team if you are considering taking one of the dopamine agonist drugs.
Taking dopamine agonists

Dopamine agonists should be introduced gradually. At first it may feel like they have little effect and for a brief time symptoms may feel worse.
Benefits begin to appear as dosage is increased and can prevent side effects such as uncontrolled movements (dyskinesias) and 'on/off' fluctuations.
Most dopamine agonists are taken by mouth as tablets or capsules up to several times a day.
There is also a patch for rotigotine that is applied once daily onto the skin.
Apomorphine is available as a single injection or as a continuous infusion under the skin.
Side effects and problems of dopamine agonists


Common side effects of dopamine agonists include:

• nausea and vomiting
• drowsiness and sudden 'attacks' of sleepiness
• dizziness or fainting due to low blood pressure
• hallucinations and confusion
• existing dyskinesias (uncontrolled movements) may initially become more troublesome

Compulsive behaviour

There is growing evidence that suggests a link between certain dopamine agonists and compulsive behaviour.

Read more on compulsive behaviour:

• Parkinson's drugs and compulsive behaviour
• Compulsive behaviour and Parkinson's information sheet

More information

Read our drug treatment of Parkinson's booklet

Or visit the Medicine Guides website for independent, up to date information about these medicines:

• Mirapexin Medicine Guide
• ReQuip Medicine Guide
• Celance Medicine Guide
• Bromocriptine mesylate (Parlodel) Medicine Guide
• Cabaser Medicine Guide
• Rotigotine (Neupro) Medicine Guide
• Apomorphine (APO-go) Medicine Guide

More drug treatments of Parkinson's

• Levodopa
• Dopamine agonists
• Apomorphine
• Amantadine
• Anticholinergics
• COMT inhibitors
• MAO-B inhibitors
• Parkinson's drugs and compulsive behaviour

Return to the drug treatment of Parkinson's main page
Direct and confidential help and support

• Call our confidential helpline 0808 800 0303 begin_of_the_skype_highlighting 0808 800 0303 end_of_the_skype_highlighting (Calls are free from UK landlines and most mobile networks.)
• Or email enquiries@parkinsons.org.uk