Reactions 898 - 20 Apr 2002

★Pramipexole/ropinirole

First report of alopecia in elderly patients: 2 casereports

Two women, aged 66 and 68 years, developed alopecia afterreceiving pramipexole for Parkinson’s disease. Alopeciacontinued in the second woman after pramipexole wasreplaced with ropinirole.

The first woman received pramipexole adjusted to amaintenance dosage of 1.5 mg/day; she was also receivingamantadine. After < 2 months’ treatment, she noticed hairloss, which worsened over the following weeks. Pramipexolewas replaced with ropinirole adjusted to a maintenancedosage of 12 mg/day, and her hair loss stopped within 2weeks. One month later, new hair had grown. The alopecia didnot recur during the following 12 months while she continuedropinirole therapy.

The second woman started pramipexole with the dosageincreased to 3.5 mg/day approximately 11 months later; shewas also receiving amantadine and selegiline. One month afterher pramipexole dosage increase, she noticed some hair loss,which worsened during the following weeks. Her pramipexoledosage was reduced to 3 mg/day, but the alopecia persisted.Pramipexole was replaced with ropinirole 21 mg/day;however, her hair loss continued. Ropinirole was thenreplaced with carbidopa/levodopa and, within 1 week, heralopecia stopped. During the next 6 months, she experiencedsome hair regrowth, but complete reversal of the alopecia didnot eventuate.

Author comment: ‘It is possible that hair loss developed as aconsequence of the interaction between amantadine and thedopamine agonists.’Tabamo RE, et al. Alopecia induced by dopamine agonists. Neurology 58:829-830, 12 Mar 2002 - USA 800903667

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of alopecia withpramipexole or ropinirole. The WHO Adverse Drug Reactionsdatabase contained 4 and 6 reports of alopecia associated withpramipexole and ropinirole, respectively.

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Reactions 20 Apr 2002 No. 8980114-9954/10/0898-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved