Pramipexole is a nonergot dopamine agonist indicated for treating Parkinson’s disease (PD) and restless legs syndrome. Pramipexole extended release (ER) is a recently developed once-daily formulation which has demonstrated noninferiority compared with pramipexole immediate release (IR) in the treatment of early  and advanced PD . Compared with the immediate release (IR) formulation, the ER formulation offers some advantages, including the potential for improved compliance owing to its simple once-daily dosing regimen and steadier plasma levels over 24 h . According to data from clinical trials, both formulations have a similar digestive absorption with a bioavailability of more than 90%, and the overnight switch from pramipexole IR three times a day to pramipexole ER once daily at unchanged dosage in PD patients has been shown to be successful in more than 80% of patients, with minor adjustments needed in the other patients . Here we report the case of a patient with mild PD, unsuccessfully treated with pramipexole ER due to lack of digestive absorption of the drug.
Alberto Villarejo, Gema Lizcano, ?lvaro S?nchez-Ferro, Eduardo de Pablo-Fernandez