Maximum dose permitted for Requip Modutab Prolonged Release

[Insomniak]

Hi,

I have been using this slow release version of Requip (active ingredient Ropinrole) for about 18 months with great success until recently. I have been taking 2 x 2mg tablets once per day early evening. In the last few weeks I have found that my RLS is starting to break through again but can be controlled by taking the occasional 3rd tablet. I went to my GP yesterday to ask for an increase to my prescription. She was reluctant to do this though as her guidance is that I am already at the maximum. Does anybody else use Requip Prolonged Release for RLS and, if so, what dose level are you on?

[Hidden]

The new recommended dose for Requip is now no higher than 1mg ... 2mg at a push and that applies to the slow release too. The old dosage was 4mg. You are finding that the 4mg you are taking is starting to not work, break through RLS and having to get relief by increasing to a 3rd tablet is a sign of augmentation. Your doctor was correct to not increase your dosage.

[Madlegs1 in reply to Hidden]

Agree fully with Elisse.

Search for augmentation- Pippins2 has a very good post on this.

It's rare enough that we can say that your doctor is absolutely correct.😎

[cicek]

Hi. I reduced from 4mg slow release and am now on 2mg. I was going to try and cut it out altogether but as I am going through a "fairly good" stage of RLS at the moment I have decided to leave well alone. I do also take 2 x 50mg Tramadol at about 5.00 p.m. and 2 x 50mg at about 10.30. Apart from occasional breakthrough this plan seems to be working at the moment and my philosophy is "don't mend it if it's not broken". I know I am presently very lucky as there are a lot of people suffering really badly. I was in a bad place for a long time and if this happens again I too will have to reconsider. Good luck x

[Insomniak]

Thanks for your comments. I'll check out the augmentation article Madlegs. I am hoping that there is something I can do rather than just suffer more RLS. The doctor did mention trying Mirapexin (I think that was it) but to be fair to her when I mentioned I was part of this forum she suggested that I ask for advice here as well. I am back with her next Tuesday and I should be well armed with research.

[Hidden]

If you ARE augmenting on the Requip then the advice is to not change to another dopamine med like Mirapexin (mirapex, pramipexole) as you will just keep augmenting. You could try like cicek to reduce your dose which is not an easy thing to do, because you will suffer with withdrawals and will need a strong pain med like Tramadol. Or what most have to do is detox completely off the dopamine med again using a strong pain med and try a different class of meds Lots of post and comment on here about augmentation, use the search box to find Augmentation and RLS.

[Shaft1952]

I take 1 500micogram at 7-30 to 8pm then 2mg slow release Ropinirole, then 9pm 500micograms. I am taking 500mgs magnesium gluconate, also going to take iron gluconate and then try and come of all my Ropinirole. I do take 1 cocodamol at 7-30 to 8-30pm and a second same dose at 9-30. Trying to get of cocodamol as they are addictive. But better than tramadol which I had following some surgery, but the side effects coming of it was horrendous . Good luck hope you get sorted.

[Harley247]

Hi I'm in the same position as you.i take 2x2mg requip xl a day,and finding that it's just not enough,so,I cut 1mg in half of immediate release requip that seems to do the trick fairly quickly.athough I'm wondering where I go from here.most people on this site say go to my gp and ask for tramadol and come off requip,but,my doc just will not prescribe it.i have found that sometimes if I alternate between requip and mirapexin that sometimes works.but,it's a big problem I know.im still looking for the answer.if you come up with an answer please let me know.im in the uk.i know I'm at the max dose,but,what can you do? Rather than suffer all night,you tend to just take a little more for relief.i also find it now starts early afternoon.best of luck.we will keep seeking an answer.

[Harley247]

Do not cut the requip xl in half to lower the dose ! You have to use immediate release,although I'm not suggesting you increase the dose over 4mg requip xl cos as everyone says,it's augmentation,and increasing the dose is not the way forward.but,getting another opioid to combat the problem here in the uk is almost impossible!!!

[Insomniak in reply to Harley247]

Thanks Harley - my GP has spoken to my neuro consultant and there is a plan which I am going in to find out about on Tuesday with the GP. I'll be sure to share the plan on this forum

[Harley247 in reply to Insomniak]

That's great.i look forward to hearing the outcome.thanks

[Harley247 in reply to Insomniak]

Hi any news when you went to the doc regarding upping your dose on the other Tuesday?

[Doversoul]

I have had similar experience with XL. Personally, the XL was a disaster and I swopped back to basic ropinirole, that allow some small degree over when I take the tabs and how much. I think that it's common that RLS relief tailors off after a period of relief, generally, augementation comes first. The thought is that you need to switch to another treatment when relief fails.

[Insomniak]

Hi all, I had my return visit to the GP earlier this week and she had gotten advice back from the consultant neurologist (this is much better value for me as it costs €50 to see the GP but €250 to see the consultant). Upshot of it is that I am now taking 1 x 25mg Pregabalin hard capsule before bed in addition to my daily 2 x 2mg Requip Prolonged Release tablets. I have to say that for the last few nights I have had the most wonderful nights' sleep that I have had in months - I hope it lasts. If it does my next question is "can I reduce the Requip dosage to try and reverse some of the augmentation?" I know that Pippins has covered augmentation issues thoroughly and I plan to read her blog.

[Harley247 in reply to Insomniak]

Sorry just seen this post!!!!