How do i change from Ropinirole to Pramipexole

[Avosyl]

As the Sinemet were causing more problems than the Ropinirole and i don't see the consultant for a few months yet my GP has agreed to put me on Pramipexole to see how that goes. The augmentation from the Ropinirole was getting worse. My question is can i just stop the one and start the other or do i have to wean off one onto the other. GP said to start replacing one for the other until on the daily dose of 3.3mg or less as and when there is an improvement. This to take place over a period of 3 weeks until i am on1.1mg total per day and only if needed to go farther. Would appreciate any info from those in the know out there lol. Thanks for reading

[Hidden]

i was on 4mgs of ropinerole, and i just swapped

without weaning, what dose are you on with the ropinerole ?

[Hidden]

As Tallula has said you can just switch from one to the other as they are both dopamine agonists. Its usual to start at the lowest dose and work your way up until it reliefs your symptoms. Try to keep the dose as low as you can.

[Avosyl in reply to Hidden]

Will do Elisse and thanks for the advice. Am really determined to find something else. I know the dose i am on is way way too high and only surprised i haven't had augmentation well before now

[lorri214 in reply to Hidden]

That is interesting. I didn't realize if they are both in the same family you could just switch. I get it about working your way slowly up.

[Avosyl]

Lol thats the big problem i am on 3x8mg per day. As it was working for me my consultant let me go that high because its the max for Parkinson and as long as it wasn't causing any harm he felt it was worth it. now i suffer badly from augmentation. Thanks for the answer tallula. Will start the new ones tom and fingers crossed they work for me.

[Hidden]

You are not the only one i have read lately where such a high dose has been used. I dont understand why doctor's or consultant's allow people to go that high, you get augmentation with every dose you go up to, it may not be harming you, but now you have to see if the Pramipexole dose will be enough, as the reduction of the dopamine will probably make your legs go mad. I hope it doesnt and the pramipexole works well for you. I can only say, i wouldnt let your doctor let you go higher than the recommended dose for RLS on the pramipexole. If you have to get off it, it could be a nightmare...

[Avosyl in reply to Hidden]

Since joining this forum i have learned a lot more about RLS from people like yourself. So much so that my GP considers me as an expert compared to him lol. He is willing to learn and i thank fate for him because until him i was fighting all the way. Not sure if the consultant will be happy with what we are doing but hopefully by the time i see him again i will be sorted out with, if not Pramipexole, then with some other tablet. I will keep you updated as to how it goes. I do know i could be in for a hard time of it but with luck not too bad and with the support of you all i will get there. Thanks again Elisse.

[Hidden in reply to Avosyl]

are you on the slow release pramipexole, or the ordinary one, i had the slow release one, and it was great while it worked, around 3 years now i think, but finnaly stopped for me

[Avosyl in reply to Hidden]

It does not actually say on the packet or on the leaflet that was in the box. Is there any way i can find out. They go by the trade name of Glepark (pramipexol) 0.088mg (0.125mg ) tabs

[Hidden in reply to Avosyl]

if it the extended release it should say Pramipexole ER on the pack, if not it most likely the normal one

[Avosyl in reply to Hidden]

Then its the normal one as it does not have ER anywhere. Does that make a big difference ?

[Hidden in reply to Avosyl]

oh yes, with the extended release, you take one a day, with the ordinary one, you have to take them several times a day

[Hidden in reply to Hidden]

i think you would be best to ring your chemist and ask if you have it or not, but im sure they would have told you if they were

[Avosyl in reply to Hidden]

Will do that as they are pretty good there and know me well by now lol They will keep me right on what i take an how thanks again

[Avosyl in reply to Hidden]

Right well i am going to be taking 3 a day so will explain to the doc when i go back for a review on them. Thanks a lot for the info tallula and after reading your blog i hope you find a solution to your probs with the doc you have. keep pushing its worth it even if he thinks your a pest to get somewhere in the end. Good luck

[Hidden in reply to Avosyl]

3 a day, got to be the normal one then

and thanks

[Hidden in reply to Avosyl]

Its your body and your RLS,,,lol. so tough if the consultant doesnt like it. You have to do what is best for you. I am pleased to hear your doctor is at least listening and learning, thats good to hear.

[Avosyl in reply to Hidden]

Lol you are so right and i will remember that if he says anything. My doctor is fantastic but is talking about taking early retirement which i dread because i don't know if there is another one in the practice who would be so receptive to all of this. I stopped seeing one of them because she just wouldn't listen and was very lucky to be able to see the current guy. Fingers crossed he forgets about retirement lol

[Nightingale-5 in reply to Avosyl]

I am delighted to hear of a GP who realises that we know our own bodies and we know when something is not right. Usually the words "persevere with them" are all too familiar when you know the Meds are not right for you. I hope everything goes well for you Agosto.

[Nightingale-5 in reply to Nightingale-5]

Avosyl, forgot to check the spellcheck!

[Stephenr]

please read rls.org for advise on augmentation with dopamine agonists

The doctor is of the opinion that once augmentation sets in it is best to stop with dopamine agonists and switch to another class of drugs e.g. Anti-convulsants, opiods,

The withdrawal from dopamine agonists is horrible. Took me 3 months before finding relief with combination of Lyrica/tramadol

I hope that you may be an exception to augmentation with Mirapex

[Hidden in reply to Stephenr]

my doctor doesnt say this, and i switched from requip to mirapexin ER with no problem at all, we all react different with meds, also Tramadol is a meds i cannot tolerate at all, plus the mirapexin has just stopped wiorking for me, i dont have augmentation

[Avosyl]

Hi again Stephenr thanks for the input. You seem to have a complete aversion to anyone using a dopamine agonist but as tallula says there was no problem for her. If like me you go through this site you will see a lot of us can only take that type of med whereas others can only take the opiods etc. I tried Tramadol years ago and it did not help me in any shape or form. I think with RLS you have to follow your instincts and try everything and anything possible which is what i and most of us on here do.

[wibblewobble]

Whenever I have had to switch medication, I have had to reduce my medication over about a week before going on another medication. i.e. from Ropinarole to Sinemet to Pramipexole to Clonazepam which I have just started taking, and the horrible thing is whilst doing this I haven't slept properly over this last week whilst reducing dose, and I am now on 72 hours with no sleep..................please Clonazepam work soon................

[Hidden in reply to wibblewobble]

When switching from one dopamine agonist to another then weaning off isnt really necessary. Sorry you are having such a bad time, its because you have dropped the pramipexole dose so your body doesnt like the dopamine withdrawal, it may take a while for your system to adjust to not having the dopamine. Thats what is so hard when getting off the dopamine meds,

[wibblewobble in reply to Hidden]

Thanks for your comment, however on all occasions whilst switching meds I was advised by my GP to reduce the dose gradually,unless I have been led up the garden path, it would have made my life so much easier, as I have had really two bouts of not sleeping for 48 hours, and two bouts of not sleeping for 72 hours, alongside of this I have fallen over a number of time whilst being so tired, and walked into walls, cabinets etc.

[Avosyl]

Hi just wanted to update you on the change from Ropinirole to the Pramipexole. It took a bit of sorting out because i had a severe asthma attack and could not concentrate on sorting out the change over. I am now taking the minimum maintenance dose, 2x 0.18mg tablets three times a day and have stopped the Ropinirole altogether. It seems to be working well i am glad to say. The only time i seem to have a problem is when its wet weather. That has always affected me and have always been able to tell when its going to rain because my legs would start. Handy when thinking of putting a washing out lol. I am hoping that things will stay this way for a while. Did as Talula said and just stopped one to go on the other. Have to say i was worried this might cause problems but it didn't. The only thing at the moment is that i do feel tired a lot but Doc says this could just be my body recovering from the asthma attack. Thank you all for the support and advice. Fingers crossed this tablet lasts a while but meantime I have gained a better knowledge of what the limits are and what signs to look out for if it stops working or starts causing augmentation. I hope all of you find something that helps soon.

[lorri214]

I would never stop taking a med cold turkey, especially if you have RLS. Ask your dr. I have always gradually weaned off one and slowly onto a new med.

[Lindy14]

Hi Avosyl,

I asked the neurologist how to change over and she said she was putting me on a dose of Prampexole that was the equivalent of the 2mg Ropinirole I've been taking. She had to look it up and was going to put it in the letter sent to my GP so I won't know until I manage to get an appointment with him. It sounds as though they are working on individual cases. I also asked if there would need to be a gradual introduction to the Prampexole, but she said that as I was going tonto the equivalent dose that wouldn't be necessary. I'm as confused as ever.

Please let us know how you get on.

Nurse-14

[Avosyl]

Hi Nurse-14 Thanks for your reply. I weaned myself off one and onto the until i read what Elisse said then just went onto the Pramipexole. However since then i have had big problems with falling asleep anywhere and everywhere and it was becoming dangerous. I contacted Dr B in California and after explaining everything to him he advised i come off Pramipexole altogether as i was having severe augmentation. I am in the process of doing that now and so far i have only had a couple of bad times with it. I am down to 2 x 180 tablets a day. My GP being a great guy took Dr B's advice and prescribed me some Zomorph 10mg tablets to use should i need them. Most doctors in Britain will not prescribe morphine but i have a great GP who listens to the experts. I think the problem may have been that Pramipexole and Ropinirole may have been too much alike and that led to the early onset of serious augmentation but thats my opinion it hasnt been stated or proved in any way. The Pramipexole has a chart on the leaflet in it stating what the dosage is for Restless legs and my GP and i went by that. I am not sure what to tell you except to watch carefully for signs of augmentation just in case i am right about the likeness of the tablets. Everyone is different and is affected differently so all i can say is good luck and let me know how it works for you.

[bonehead]

I have no problems using ropinirol on and off - starting and stopping.

[TeddiJ]

Hi. I would toggle between the two every time I started augmenting on each. I was told it was ok, since they are both DA's. I didn't have any issues doing that although, like everyone else here says, it is better to get off of both.I was finally able to get an iron infusion and then methadone short term to get off of them. But now I am in a total mess and unable to find a doctor to help me with a new plan or more opioids.

Mine is a whole new story but just wanted to give you my experience with the two DA's! Short term, you will be ok. Long term-try to get to a new plan!