The problems, known as cardiac valve regurgitation, occur when the heart valves do not seal properly in the reverse-flow direction. This is caused because the drugs interact with heart valve receptors which causes the valves to overgrow and become leaky.The first study, carried out by Italian researchers, found that around one-fourth of patients taking Permax and other Parkinson's drugs had heart valve problems that ranged from moderate to severe. Twenty-three percent of the patients in the study who took Permax had such heart valve problems, compared with none of the patients on other Parkinson's drugs (excluding cabergoline) and less than six percent of the people in the comparison group.
Furthermore, the scientists found that only patients taking Permax or Dostimax showed significant regurgitation in all three heart valves.
The second study, done by German doctors, found that patients taking Permax or Dostinax (sold mainly in Europe) had a risk of leaky heart valves five to seven times higher than patients taking other types of Parkinson's medications. Researchers for this study concluded that patients taking Permax at a daily dose greater than three mg for periods of six months or longer are at a significantly higher risk of heart valve problems.
Both studies found that people who took the highest doses for the longest period of time were at the greatest risk of heart valve problems.
These heart valve problems are similar to the ones caused by the fen-phen diet combination in the late 1990s. Currently, the only way to repair the leaky heart valves is through valve replacement surgery.
Permax (known generically as pergolide) is a medication used to treat symptoms of Parkinson's disease, specifically the stiffness, tremors, and poor muscle control experienced by patients with Parkinson's disease. Permax, often used with other Parkinson's medications, has the same effect on the body as dopamine, which is low in patients with Parkinson's.
Permax has been used to treat Parkinson's since 1989 and is also used to treat restless leg syndrome. The drug was originally manufactured by Eli Lilly and Co.; however Valeant Pharmaceuticals now has the manufacturing rights. Valeant has said that it no longer promotes the use of Permax. In 2003 a black-box warning was added to packaging for Permax warning about the risk of heart-valve problems. However, at the time it was believed the risk of heart-valve problems was low, around five users in 100,000 were believed to be at risk.
Some doctors are now recommending not prescribing Permax for patient use.
Symptoms of valve damage include extreme weakness, shortness of breath, chest pain, swelling of the feet and ankles, palpitations, and difficulty with exertion.
If you are taking Permax and are concerned about adverse reactions, speak to your doctor before discontinuing your prescription. Stopping Permax suddenly may cause serious side effects such as elevated body temperature, altered consciousness, confusion, and other problems.