I noticed that of those on this website who use one of these two meds, most use requip. I have been on mirapex (pramipexole) and would like to ask if there is reason to prefer requip as I will see a new neurologist tomorrow and could ask to change to requip if there is benefit. I did read that studies show there is more possibility of requip being neuroprotective and if that is true it would make sense to switch over. Thank so much for any information or thoughts anyone may share!

I can only speak for myself, but I've been on Mirapex for the past 12 years. In addition to Mirapex I also take Artane. I think my insurance won't cover the cost for new patients but did agree to keep me on it since it works so well. My neuro wrote my insurance company a letter and the jest of it is "You don't mess with something that works."

Those two drugs combined kept me literally symptom free ... so much so that my family honestly didn't think I even had Parkinson's! They thought I was misdiagnosed or something. 12 years later my symptoms flared up and reared its ugly head so I began taking Levadopa/Carbidopa but I'm not a fan of it and want to get off of it by (hopefully) trying medical marijuana. I've only been on Levadopa for six months or so and already am exhibiting dyskinesia. My mouth is also really dry, something that I never experienced with Mirapex.

Let me know what your neuro says. I wish you the best! If you have any questions, feel free to contact me.

It's important to drink LOTS of water when you're using Sinemet. It should help with your dry mouth. I had every bad possibility with Mirapex and no trouble with Requip. Go figure.

Thanks for the tip ... Parkinson's sure if fickle and what works for one person doesn't mean it works for you! I count myself "lucky" that I don't have a different neurological condition, especially Huntington's Disease which my best friend has. If you have Huntington's, you eventually lose your ability to walk, to talk, and to reason. It's the reasoning part that gets to me the most.

Have a great weekend everyone!

over the years i've been reading this board, it seems more people in the u.s. use regular generic mirapex whereas in britain more generic requip xl is used. i've read posts from posters in the U.S. stating brand name REQUIP XL works much better than generic and i don't know what generic brand is used in britain.
i wasn't under the impression requip is currently thought to be neuroprotective, this was speculated when the agonists first came out as for almost every "new" pd drug including l-dopa but has never been proven.

Good point Soccertese. I have a strong reaction of nausea with generic Requip and no negative reactions at all to the non-generic Requip, except of course, the reaction to the difference in price!

back in 2004 i was in a clinical trial for a new agonist called SUMANIROLE and in the first phase of the trial you received either REQUIP or SUMANIROLE, in the second phase it turned into an open lable trial and everyone got SUMANIROLE. In both phases you dosed up to an effective dose. I think i dosed up to 6mg and could tolerate both drugs just fine, at the time there was no generic requip. The trial was shutdown when PFIZER, which made REQUIP, bought PHARMACIA, which made sumanirole. There were only 3 people in the trial at my location!! But one advanced pd'er did much better on sumanirole. After the trial i went on mirapex, can't remember why, then tried requip and finally just sinemet. Last year i tried generic requip and couldn't tolerate .125mg. so stopped there and didn't try the brand because of cost. I guess my point here is i think how well someone does on requip vs mirapex might also depend on which generic you get. So someone might want to try the brand name. Might be opening a can of worms especially since it takes weeks to dose up, even though i think you should be able to switch back and forth between generic and brand and even requip and mirapex.

Thanks to all who replied! Thank you Terri for sharing your experience on Mirapex. The doctor today said Requip and Mirapex are similar drugs and in the same family so they have equal chance of being neuroprotective. He did not seem optimistic that either is. Soccertese, I appreciate your observation about US and UK, and your advice about generics. I am grateful to you all for helping me to prepare for this appointment.

I started on Permax, an older agonist. I was nauseous for most of the year my MDS kept me on it and lost a lot of weight. He was convinced that there was no difference between Permax, Mirapex and Requip. I finally got my family doctor to switch me to Mirapex and the nausea was rapidly gone. I managed my PD for years with tiny increases in Mirapex. Now I've been decreasing it a tiny bit (1.5 mg three times a day to as little as 0.75 mg in the evening as my dyskinesia gets worse. I'm not sure if it 's worse because that's what happens with the passage of time or because my high cadence cycling is making me better and I don't need so much medication. I'll find out if other symptoms improve even more.

By the way, Permax isn't around anymore, they discovered it could damage heart valves.

Mary, the early research showed "some" evidence that agonists might be neuroprotective. Today, there isn't much credence given to those early studies. Improvements shown for agonists in those studies is now attributed strictly to the drug's symptomatic effects, not interventional. You should take them (whichever works best) if they are helping you symptomatically. However, I personally wouldn't make the decision based on potential for neuroprotection.