Oxycodone/Naloxone

[texdeb6989]

My husband’s restless legs became severe about 2 months ago. He tried changing diet and several drugs- most recently the Neupro patch which offered some relief. He just had open heart surgery to repair a valve. For several days after surgery there was no restless leg. Now it has come back. I believe the restless legs stopped because he was given oxycodone for his pain. In doing research on this I saw the results of a study done where a combination of oxycodone and naloxone was quite effective in reducing the rls symptoms. Has anyone tried using oxycodone / Naloxone ( think trade name is Targin?)

[Madlegs1]

Oxycodone in both short and long acting forms , has to be the most effective treatment for rls. The naloxone is not necessary for rls- since sufferers will be on too low a dose to get addicted.

Long term treatment at under 30 mg pd is effective and non life threatening.

Now-- if we could just get the general medical profession to accept that- then there would be little need for this site.

Some day- the light will dawn.

[involuntarydancer]

Targinact, which is a combination of OxyContin and naloxone, has been Licenced by the EU for treatment of rls. I found OxyContin excellent for getting my rls symptoms under control when they were very severe. On the downside, it caused me to be very alert at night time so that often I wouldn’t sleep all night (apparently this is a phenomenon observed in rls sufferers who take opioids) even though my rls was under control. Also it was very hard to discontinue.

[Joolsg]

Targinact is licensed for RLS in UK by NICE. The Naloxone is added to prevent constipation ( very common in long term opioid use).

I use the long acting version of oxycodone (Oxycontin) 25mg a day. To counter wakefulness and , in my case panic attacks, I take pregabalin as well.

Both are very effective for RLS.

Hope your husband recovers well from his surgery.

[Parminter]

I have used methadone, which is a close relative to oxycodone. I use it when all else fails, and it works brilliantly. The only uncomfortable side-effect is severe constipation, so I do not rely on it except in extremis. It stays in the system longer than oxycodone, I believe. The opinion - and my experience - is that sufferers from RLS are much less likely to become addicted to opioids than non-RLS folk. Nevertheless, opioid addiction is the 'Scare-of-the-Month' at the moment, so doctors see every patient as a soon-to-be addict. If you refer to Professor John Earley of John's Hopkins you can read his very informed opinion.

For myself, I have just discovered that my ferritin levels are far, far too low for an RLS sufferer - now I must find a physician willing to help me raise levels per IV infusion of iron, from the present low of 20 to 100 or more. There seems to be something amiss with the iron-storage system in the brain of about 35% of RLS sufferers.

It is the opinion of my homoeopath that I should take high-strength cannabis per rectum every night, and I shall try that as soon as I can find a supply. Cannabis per tincture has not helped, except to make me less miserable about the whole thing. It has given me the energy and hope to pursue new healing modalities.

I have learned that one cannot rely upon the assistance of the average doctor, who relies upon the sales-pitch of drug reps. One must be radically active and assume agency for the condition. No-one else will.

(By the way, I have had RLS for sixty years, so I know whereof you all speak).

[involuntarydancer in reply to Parminter]

Hi Parminter, is it really only 35%? I thought it was higher. That’s interesting.

Btw, would you consider taking Kratom? In my experience it is more reliably effective against rls than cannabis (though I would admit to not having experienced it rectally).

[Parminter in reply to involuntarydancer]

I could be wrong about the percentage. But remember, there are different causes for RLS. Perhaps the iron problem is only associated with familial RLS. We must find out.

I have just started experimenting with Kratom, a red vein strain. It helped in the middle of the night, certainly. But how much to take, and which strain to use as a preventive I have no idea yet. I hear Red Bali is best, but I cannot get it at the present time. Perhaps you have some good experience? (I am also trying a white-vein strain for use during the day, after another rocky night, and it certainly helps).

The homoeopath said that taking a large-enough dose of THC orally would lead to a hungover feeling because of the passage through the liver and that the straight-to-the-brian route (to the brain via the bottom, tee-hee) would have a much 'cleaner' outcome.

I would love to hear your thoughts.

[involuntarydancer in reply to Parminter]

Yes; there could well be a hung over feeling. I don’t find either thc or cbd to be particularly helpful for rls but I use cannabis (a strain with about equal thc and cbd) as a sleep aid. I take it as an edible and it lasts about 4 hours - starting about an hour after I take it. I can feel a bit more ‘dopey’ the following day but mostly I think I sleep through the hangover part.

I find Kratom great. I use red vein Borneo generally but I think most reds are fine. Some are stronger than others (red Thai is strong I think). I usually need about 1 and a half teaspoons to get symptoms under control and sometimes I take another teaspoon through the night. I dissolve it in a small amount of grapefruit juice. I would be inclined to start with half a teaspoon. It takes between 10 and 20 mins to take effect. If half teaspoon is not sufficient take another half teaspoon 20 mins later. It’s best not to start too high as it can induce nausea. It can also cause alerting (even the red strains) which is why I use cannabis.

[Parminter in reply to involuntarydancer]

Thank you Dancer, that is all helpful. I am new to Kratom, so I have a lot of experimenting to do. I have used one level teaspoon thus far, of a Red Indo, and in the middle of an awful night it kicked in within half an hour, blissful.

My sleeping issues are severe, so I shall try the cannabis suppositories for that.

One way or another, you have to get your vegetables! So weed and kratom should help with that. Now we only need to add magic mushrooms for a complete balanced diet. Woohoo!

Keep posting please, you know more than I do.

[involuntarydancer in reply to Parminter]

I love your logic - it hadn't occurred to me to consider that I was getting part of my 5-a-day vegetable requirement with kratom and Cannabis!

I hope the suppositories work for you. Please let us know. All new information gratefully received.

I hadn't heard of kratom two years ago. Now it is a much appreciated element of my rls management. I picked up almost everything I know about it on here and other rls forums (fora?) and a little bit of reddit. Rls truly takes us on a journey of discovery.

[Parminter in reply to involuntarydancer]

Ah well, Dancer. I am afraid the fruit and veg numbers have gone up to nine a day, at least, so we'll have to find more! We could start with wormwood, the long ban has been lifted. Legal veggies.

[Wonko_TheSane in reply to involuntarydancer]

Digging this out from months ago - do you have a specific subreddit you can recommend for knowledge that we restless, drug-experimenting experts can make use of?

[Hidden]

I've had some great relief with Targinact. They say the Naloxone is for constipation although in my understanding it is to prevent the tablet from being crushed and injected as it cancels out the Oxy if prepared fro injecting.

+1 on Madlegs1 too.

[texdeb6989 in reply to Hidden]

Thank you for your reply. Have you had any bad side effects from the Targinact?

[Hidden in reply to texdeb6989]

No I haven't thankfully. I've had enough problems with DA's but not opioids.

[connie50]

yes they do call it targinact,& it suppose to help with RLS but it didn't do a thing for me,(its all down to the individual everyone of us is different)when it comes to meds. But please tell your husband to carry on with the targinact it may do him good,Oxycodone on its own is supposed to be very good, as well they give this med to patients that suffer with cancer, or any other illness,I've had it for RLS in liquid form but its like any other RLS it only lasts for a few days, I have had RLS know must be going on 20yrs & I can honestly say there is no cure for RLS I think I have a cupboard full of meds what as been recommended to me, but its like anything else it only lasts for a few days then its back to square one. But please tell your husband to try the targinact or even the oxycodone (liquid form)it may help him. Hope it does.

[Smiler53]

Hi, i've been taking Oxycontin for nearly a year now following my 1st total knee replacement, as that was what they give you for the pain. I had no idea at the time that it was oxy that stopped my RLS. Only when the RLS returned after finishing the course when discharged and a post from joolsg did the penny drop! Although my sleep is very poor and sometimes non existent the RLS is far worse.

Following a recent appointment to UCLH sleep clinic in London, I have just started Pregabalin and that seems to be knocking me out most nights, along with a hypnotherapy CD that i'm trying (which I haven't heard the end of yet!) I want to try using the CD without the Pregabalin to see if it works on its own!!

Wishing your husband all the best and a speedy recovery.

[involuntarydancer in reply to Smiler53]

Hi Smiler, be careful about stopping pregabalin (if you do decide to try the hypnotherapy on it’s own). For some people it can be a difficult process depending on the dose and the length of time you have been on it. It is best to reduce very gradually rather than stopping abruptly. Found this out the hard way!

[Smiler53 in reply to involuntarydancer]

Hi Involuntarydancer, I won't be coming off them yet, it's only my 2nd week on them. I just don't want to be on them permanently. I just need to recoup some sleep following my 2nd knee replacement and extremely poor sleep (sometimes days at a time!) They do make me feel quite groggy in the morning with a headache, but hoping that will wear off soon. Although they don't seem to knock me out every night, just glad when they do! Thanks for the info though, very much appreciated.

[Jeandario]

You are right. All opioid based medications are effective against restless legs. I was given fentanyl patches ( fentanyl is of the opioid family) for severe pain . My restless legs disappeared completely. I was on 150 micrograms. I reduced the dose I was on gradually but I cannot go below 50 micrograms as the restless legs returned.