Pramipexole primarily leaves the body through the kidneys. About 90% of an administered dose is excreted unchanged in the urine within 24 hours. This means most of the medication is filtered by the kidneys and removed from the bloodstream directly.
A small portion (approximately 10%) undergoes metabolism, primarily by the liver, via glucuronidation. This process modifies the drug’s chemical structure, producing metabolites with minimal pharmacological activity. These metabolites are then also eliminated through the kidneys.
The elimination half-life, representing the time it takes for the body to eliminate half of the drug, is approximately 8 hours. However, this can vary depending on factors such as age, kidney function, and liver function. Individuals with impaired renal function will experience a prolonged elimination half-life, necessitating dose adjustments to prevent accumulation.
Monitoring kidney function is crucial for patients taking pramipexole, especially in those with pre-existing kidney disease. Regular blood tests assessing creatinine clearance can help healthcare providers tailor the dosage to ensure safety and efficacy.
Liver function is also a consideration, although less critical than kidney function due to the limited hepatic metabolism of pramipexole. Individuals with severe liver impairment may still require careful monitoring and potential dose modifications.
