Pramipexole is indicated for the management of Parkinson's disease and symptomatic treatment of moderate to severe primary Restless Legs Syndrome (RLS). Pramipexole likely restores balance to the dopaminergic system, controlling the symptoms of this condition. Restless legs syndrome is thought to occur, in part, through dysfunction of the dopaminergic system, resulting in unpleasant lower extremity symptoms. Pramipexole is considered a non-ergot dopamine agonist that shows specificity and strong activity at the D2 subfamily of dopamine receptors in vitro, binding selectively and dopamine D2 receptors and showing a preference for the dopamine D3 receptor subtype rather than other subtypes. Pramipexole's efficacy in PD is attributed to its D3 selectivity. It binds to presynaptic dopamine autoreceptors exerting negative feedback on endogenous dopamine synthesis. This process leads to a decrease in oxidative stress, which mitigates the damage to the nigrostriatal pathways

Pramipexole Mechanism of Action Pathway References