Change of medication

[LoisTonya]

I've just come back from the doctor with a change of medication. She says stop all the 1.25 mg of Ropinerole and sbstitute 88micrograms of Pramipexole. This doesn't sound like the advice I read on here. Any observations?

[Madlegs1]

It depends why the change?

Was the Rop seeming not to beas effective? In that case you are no better off.

I'll wait for your reply before expanding.

Going to bed now - hopefully to sleep. Oxy is simply not doing the job- Tolerence???

Cheers all.

[LoisTonya in reply to Madlegs1]

Thank you, Madlegs for replying.

The effect of the Ropinerole was not as good as it had been and I am reluctant to increase the dose beyond 1.25 mg at night because of the side effects.

Tonight I took 88 micrograms of Pramexipole at 8.30 pm. Within half an hour my balance went haywire and the legs got worse. I tried going to bed at 9.45 but soon had to get up so took another Pramexipole - more instability but no improvement in the legs. Now at midnight I'm up again and have taken a third which is the maximum the doctor said to take but I don't know how the dose compares with the 1.25 mg of Ropinerole I was taking.

As Pramexipole is another dopamine agonist is it likely to be any different from Ropinerole?

I'm off to bed again before my balance deteriorates further in the hope that my legs will calm now.

[macewan13 in reply to LoisTonya]

Ropinirole, Pramexipole and the Neupro patch are all the same family of drugs. So if you were augmenting on one, you are likely to augment on the others. I found that they all worked for a while but that the side effects were different - nausea, fainting, tiredness in different degrees. I stopped all 3, went onto Lyrica for about a year and then back onto the patch. I have found that nothing works without an additional opiate, at the moment Tramadol for me, taken at 6pm, along with the patch. Sometimes I take another Tramadol in the middle of the night if my RLS wakens me.

Good luck with your search. It's trial and error to find what works for you.

[LoisTonya in reply to macewan13]

Thanks, macewan

And persuading your doctor!

This morning after last night's introduction to Pramexipole I am unsteady, fuzzy head and tired.

The doctor did give me a printout of my blood tests so, later on, when I feel more with it, I'll check them out and post any I'm not sure about.

[Hidden in reply to LoisTonya]

In Australia, Pramipexole is marketed under the names of Sifrol and/or Simipex. You have my understanding and empathy with your current struggle with medication.

I recently posted the saying, 'Different Strokes for Different Folks' and the more I read the more convinced I am that it's so true. I have been taking Sifrol for the last 6 years (and I almost feel guilt in saying this) but I wouldn't be alive if it weren't for the total control that Sifrol has over my symptoms of RLS.

Unless of course I drink alcohol or fruit juice, take anti-nausea meds, or eat strawberries!!

[LoisTonya in reply to Hidden]

Hi Phogan

What dose do you take. I'm familiar with the amount of Ropinerole which is advised but the pramipexole seems to be measured differently.

[Hidden in reply to LoisTonya]

Up until last night I was taking. 0.25mg x 3 each night but last night (after being prescribed an incorrect dosage) I took the 1mg. OMG did I have the best nights sleep in memory.

Today I returned the incorrect packet and temptation (minus 1) to the pharmacy and had it replaced with my correct dosage.

So proud .... OCD? Go to hell.

[Madlegs1 in reply to Madlegs1]

Thanks Lois-- the others have pretty much said it all. Upping the dose of a DA is extremely dangeruos in augmentation terms.

You need to be looking at a different combination -- maybe Gabapentin or Pregabalin (Lyrica) or even Tramadol in extremis.

As usual - check out what may be triggering the rls.

Cheers.

[LoisTonya in reply to Madlegs1]

Thanks for your interest Madlegs1,

Have I upped the dose by taking 3 of .088 of pramipexole as substitute for 1.25 mg Ropinerole?

[Madlegs1 in reply to LoisTonya]

Not sure of the coequivalence of those - but you are on max dose for Prami at .27..

[Hidden in reply to Madlegs1]

I'm lost. My dosage of Sifrol of 0.25 x 3 is that considered a maximum dose?

[LoisTonya in reply to Hidden]

I don't know. That's what I'm trying to find out.Mine seems to be measured differently

[marsha2306 in reply to Hidden]

Phogan, in the US it would probably be triple the dose if you're taking 3 of them. I understood.25 is the maximum doseage.

[WendyBea in reply to marsha2306]

Canada here. Not sure about your idea of maximum doseage. I'm taking Pramipexole Dihydro .25 x4-5 per day and was told some people go higher. I supplement with codeine as needed.

[marsha2306 in reply to WendyBea]

Must be different in the US. See the comments from Madlegs1

[Hidden in reply to WendyBea]

Look through my posts, i have posted an explaination of the different doses of Pramipexole, if you live in the USA and the UK.

[LoisTonya in reply to Hidden]

Thank you Elisse.

My first night and day after taking Pramipexole was so awful I have returned to Ropinerole and had a couple of good nights.

[Madlegs1 in reply to Hidden]

Prami seems to have different measurements depending on where one is and whether we're talking active ingredient or total product. Very confusing. It was clarified here a while back- but I still get mixed up.

0.25 of Mirapex is max for rls- I do know.😎

[WendyBea in reply to Madlegs1]

Please see my reply to Grammie above. I'm taking .25 x 4-5 per day plus codeine as needed.

[LoisTonya in reply to Madlegs1]

Thanks. I'll change something tonight

[Hidden in reply to Madlegs1]

Thanks for thathe informatio. I have tried all of the above (only used Tramadol when I had hip replacement surgery). From reading the many posts on this site I was very lucky to get off Gabba and Lyrica without any problems. I was at the doctors last week actually and requested a script for Tramadol but he sent me away with a script for Clonazepam but am too scared to try it. Can somebody shed some light on their experiences with this particular med?

[ookla]

Trading one DA for another to stop augmentation is as effective as trading donuts for cupcakes to lose weight. The purpose of using alternative DAs is to find one that works. Once you've found one that works and it starts causing augmentation after awhile, I'm afraid your DA time is up.

[LoisTonya in reply to ookla]

Oh dear. Now I need to convince the doctor

[ookla in reply to LoisTonya]

Hopefully your doctor will let you switch to Tramadol.

[Kaarina Administrator]

Here is Elisse's helpful posting regarding pramipexole dosage in UK and USA:

healthunlocked.com/rlsuk/po...

[LoisTonya in reply to Kaarina]

Thank you, Kaarina, that helps to clarify things