Pergolide Side Effects

Medically reviewed by Drugs.com. Last updated on May 6, 2023.

Applies to pergolide: oral tablet.

Important warnings This medicine can cause some serious health issues

Oral route (tablet)

The use of pergolide has been shown to increase the risk of cardiac valvular disease and is not recommended for use in patients with a history of cardiac valvulopathy.

Some patients have required valve replacement, and deaths have been reported.

Periodic echocardiograms are recommended during therapy.

Pergolide increases the risk of fibrotic complications including pulmonary, pleural, and/or retroperitoneal fibrosis, pericarditis, pleuritis, and pericardial and/or pleural effusions.

Pergolide is not recommended for use in patients with a history of fibrotic conditions and patients should be monitored for fibrotic complications during therapy.

Serious side effects of pergolide

Along with its needed effects, pergolide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking pergolide:

Rare side effects

• chest pain (severe)
• convulsions (seizures)
• difficulty in breathing
• fainting
• fast heartbeat or irregular pulse
• headache (severe or continuing)
• high fever
• high or low (irregular) blood pressure
• increased sweating
• loss of bladder control
• nausea and vomiting (continuing or severe)
• nervousness
• severe muscle stiffness
• sudden weakness
• unexplained shortness of breath
• unusual tiredness or weakness
• unusually pale skin
• vision changes, such as blurred vision or temporary blindness
• abdominal pain or pressure
• chills
• cough
• decreased flow of urine
• fever
• pain in side or lower back

Check with your doctor as soon as possible if any of the following side effects occur while taking pergolide:

More common side effects

• anxiety
• bloody or cloudy urine
• confusion
• difficult or painful urination
• frequent urge to urinate
• hallucinations (seeing, hearing, or feeling things that are not there)
• uncontrolled movements of the body, such as the face, tongue, arms, hands, head, and upper body

Less common side effects

• Dizziness
• headache
• swelling in hands and legs

Other side effects of pergolide

Some side effects of pergolide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

• chest congestion
• constipation
• dizziness or lightheadedness, especially when getting up from a lying or sitting position
• drowsiness
• heartburn
• lower back pain
• muscle pain
• nausea
• runny or stuffy nose
• trouble in sleeping
• weakness

Less common side effects

• diarrhea
• dryness of mouth
• loss of appetite
• swelling of the face
• vomiting

For healthcare professionals

Applies to pergolide: compounding powder, oral tablet.

Gastrointestinal adverse events

Gastrointestinal adverse effects are commonly seen during pergolide therapy. Nausea occurs in up to 25% of patients treated and may abate with continued therapy. Also, diarrhea, dyspepsia, abdominal pain, vomiting, and constipation are reported less commonly.^[Ref]

Nervous system

Nervous system adverse effects are also commonly associated with pergolide therapy. Most patients experience an increase in dyskinesias with pergolide. Dizziness and somnolence occurs in approximately 11% of patients treated. Less commonly, insomnia, headache, anxiety, depression, and tremor occur. Hallucinations and confusion have been reported in approximately 14% of patients receiving pergolide and in a few patients following abrupt withdrawal. Two cases of sleep attacks have been reported in patients receiving pergolide. Sleep attacks have also been reported in a number of other patients receiving dopamine agonists.^[Ref]

The incidence of hallucinations appears to be dose-related. Patients experiencing hallucinations during pergolide therapy may benefit from a dose reduction, however, often this is at the expense of control of Parkinson's Disease. In some patients, it is possible to increase the dose beyond the originally toxic dose without reoccurrence of hallucinations after a temporary decrease with resolutions of the side effects. Hallucinations following withdrawal of pergolide have been reported to persist for several weeks.^[Ref]

Cardiovascular

Cardiovascular side effects have included rare reports of pleuritis, pleural effusion, pleural fibrosis, pericarditis, pericardial effusion, cardiac valvulopathy involving one or more valves or retroperitoneal fibrosis. The adverse effects reported at an incidence of greater than 1% (n=189) among patients taking pergolide when compared to placebo include: postural hypotension, vasodilation, palpitations, orthostatic hypotension, syncope, hypertension, arrhythmia, and myocardial infarction. Peripheral edema is occasionally reported. Angina has been reported in a few patients.^[Ref]

Symptomatic postural hypotension is most commonly seen during initial therapy. Most patients become tolerant of this effect if begun on low doses and titrated up gradually over a period of three to four weeks.

Patients who experience angina in clinical trials have responded to a decrease in the dose. A possible association between pergolide and the development of ventricular arrhythmias was seen in a few patients during clinical trials. Although this association has not been verified, caution is recommended when high doses of pergolide are used in patients with cardiac disease.

The valvulopathy reported with pergolide has involved aortic, mitral and tricuspid valves. In some cases this side effect resolved with cessation of pergolide therapy. Valve replacement was required in two patients.

In a letter to the Healthcare Professional issued by Eli Lilly and Company last February 10, 2003, it states that of the estimated 500,000 people who have been treated with pergolide since the drug was launched in the United States in 1989, valvulopathy has been reported in less than 0.005%.^[Ref]

Dermatologic

Dermatologic abnormalities reported in patients receiving pergolide occasionally include erythema of the lower extremities, or erythromelalgia. This erythema may be very warm or painful.^[Ref]

Hematologic

Hematologic abnormalities associated with pergolide therapy include anemia. Leukopenia has been reported infrequently.^[Ref]

Respiratory

Respiratory adverse effects occasionally include dyspnea and nasal congestion.^[Ref]

Musculoskeletal

Musculoskeletal adverse effects may rarely include muscle cramps, arthralgia, and myalgias.^[Ref]

Ocular

Ocular adverse effects may include diplopia or vision changes in 2% to 6% of patients treated with pergolide.^[Ref]

Renal

Urinary tract infections, urinary frequency, urinary incontinence, and hematuria are reported in approximately 3% of pergolide-treated patients.^[Ref]

Other

Other adverse effects of pergolide may include flu-like syndrome, and fever.^[Ref]

Further information

Pergolide side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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