Data on the efficacy and tolerability of piribedil in Asians are scarce. Forty-nine Filipino PD patients with motor fluctuations were enrolled in an 8-week trial of piribedil of up to 150 mg/day. Mean improvement was 48% for the motor UPDRS scores (tremor showed greatest change), and 43% for activities of daily living. Mean daily levodopa dose decreased by 17%, and mean duration of effect of levodopa increased by 1.3 h (45%). Most common side effects were hallucinations (20%), dyskinesias (20%), dizziness (8%), and sleepiness (6%). This trial shows that piribedil is effective and well-tolerated by Asian patients with advanced PD at least with short-term use.