Combining drugs

[Crazyleggs]

Doctor has added Gabapentin to the Pramipexole I'm already taking. Anyone had this drug combination?

[mami99]

My mother was taking 150 mg of Lyrica during 3 years and when stopped working she has gonne to a new doctor that is suppossed to know more about RLS.

He has added Pramipexole 0.18mg. She is in her second day doing so. I understand that Lyrica is not exactly the same but somehow simmilar mechanism as Gaba. No sure what the doctors plans are ahead..

[martino]

Not quite the same but I have Rotigotine and Gabapentin. I get on with it ok.

[LotteM]

I am on ropinirol and started on gabapentin.

Cutting down on ropinirol ( was 0.75, now 0,50mg) owing to augmentation and bad sleep. Starting out with 100mg gabapentine. Very low,I know. Far from optimal at this moment, but still early days.

[Crazyleggs in reply to LotteM]

Sounds like me Lottie I am up again tonight walking the floor Im on 0.75 pramipexole and 100 Gabapentin Still can't sleep and restless leg is bad

[LotteM in reply to Crazyleggs]

Yep!

[Hidden]

Crazylegs, your pramipexole dose is too high. should only be .25mgs as the highest dose recommended by the RLS experts. so sound like you have Augmentation. Read the posts on here about augmentation and how people deal with it. Put it in the search box. Things wont improve for you until you get off the Pramipexole.

[Bajatom]

Did I read something incorrectly? I think 0.18 is less than 0.25. it's good to start slow on gabapentin. 100mg for a few days too see if you have any bad reactions, then 200, etc. At 300 I started sleeping 7 hours, but after 6 months had to up dose again. Good luck.

[LotteM in reply to Bajatom]

Thanks. That is helpful info. My doc told me to take 200 after a week if the 100g doesn't suffice. It doesn't. Although it helps a bit.

[Hidden]

Right, this is how the difference in how doses are said in the UK and in the USA. So, it can be confusing. medicines.org.uk/emc/medici... If we dont know where a member lives.

[mantel]

Crazyleggs I totally agree with Elisse, your Pramipexole is way to high I would guess too that there is a very strong probability you are augmenting hence why it is not working on it's own any more. If I were in your shoes and I have been (on a similar drug) I would get off it altogether and try the Gabapentin on its own or in combination with an opiate or Tramadol which is like an opiate. While you are still taking the Pramipexole you won't be able to gauge the effectiveness of the Gabapentin as the Pram' will be making your RLS much worse not better. To properly find out if the Gaba' is working you need to start from a blank slate and even then I think it can take a few weeks to reach its full potential. I am on a similar drug to Gabapentin called Lyrica or Pregabelin and I take that with Tramadol .

Getting off the Pramipexole or in my case Ropinerole is the hard part . I was on quite a low dose to start with so it was easier for me than It will be for you but it was still really hard. Against advice I went cold turkey and came off it overnight . It was awful for about 2 weeks I used Tramadol to get me through this period and doubling the dose to 100mg really helped. In your case I would decrease the Pram' very slowly , I am pretty sure there is information on this site how to do this properly.

Look up Augmentation here rls.org/file/what-is-augmen...

If your drug was once working and then you notice it is becoming less effective and you need to take it earlier in the day or are having break through symptoms and eventually symptoms becoming worse, then you are almost certainly augmenting.

Unfortunately many GPs and even neurologists are not familiar with this and so they increase the dosage often to well above the recommended maximum for RLS. These drugs were originally for people suffering from Parkinson's Disease and for those people the recommended dosages are higher than for RLS . I think they have lowered the recommended maximum dose of the Dopermine type drug I was taking because of the risk of augmentation. The lower the dose the less the risk, but even on quite a low dose it happened to me and to some others on here. Read this article too , the author is the world leading expert on RLS sleepreviewmag.com/2015/02/...

Good luck and let us all know how you get on, take the articles to show your GP as he/ she may find them helpful and as they have you on such a high dose I am guessing they are not familiar with this side effect.