Mirapex is evil.

[RLSdaily]

So good and bad. Taking the Mirapex and waiting to see a sleep specialist. I am on a low dose 0.125 2 -3 times daily. ( I may have posted incorrect dose in previous post) I was taking just 0.125 as needed at bedtime, was working somewhat.... until daytime RLS kicked in so severe I was ready to lose my mind. Doc says oh take more meds.....wrong answer. I did and now I am afraid to cut it off completely. I don't ever want to feel that way again. So he declined codeine for the in between, so I wait for the specialist. I also take Paxil( when I remember) so we shall see.

[Madlegs1]

Sounds like ,maybe, a high dose.

Hope you get a good neurologist.

Read up on all the similar posts. They are listed at the end of this set up.

"Related posts"

[involuntarydancer]

Although it is less than some poor souls have ended up on, I'm not sure it is correct to say you are on a low dose. If you are in the US the recommended upper limit for pramipexole (mirapex) is 0.25mg and in Europe it is 0.165mg (these represent the same amount of pramipexole but the pills are measured differently in some way I don't fully understand). I hope you manage to get a prescription for opioids because it sounds as though you might need to withdraw from mirapex and that will be torture without the temporary assistance of opioids.

[DocUndy in reply to involuntarydancer]

In respect to the apparent dosage difference of pramipexole in the US and elsewhere, it boils down to how the actual drug (pramipexole) is measured compared to its salt (dihydrochloride monohydrate).

Here in Australia at least, 0.125mg is equivalent to 0.088mg pramipexole.

For an excellent, although fairly technical meta-analysis of various dopamine agonist treatments for RLS, see this link: (it's from France but is in English)

has-sante.fr/portail/upload...

[Hidden in reply to DocUndy]

I did a post showing the dosage for Pramipexole in the USA and elsewhere, a while ago now when i posted it. Yes, its to do with the salt which makes the dosage seem different, altho they are the same.

[involuntarydancer in reply to DocUndy]

Thanks for that, DocUndy. I realized it would be to do with ratios in the pills but an accessible explained such as you give was beyond me. Also the equivalents are the same here as with you. The simple maths of doubling 0.088 is also clearly troublesome for me. I blame the meds.

[DocUndy in reply to involuntarydancer]

Hi Involuntarydancer,

I've been on an extremely low dose of 0.03125 mg (312.5 micrograms or 1/4 of the Aussie 0.125mg tablet) pramipexole for about 12 months now, for Periodic Leg Movement Disorder (PLMD). It is extremely confusing to see the 2 different expressions of dosages given when looking for information online. After spending half an hour or so online reading various sources of information, I was able to see the difference boiled down the drug's base salt.

When the manufacturers (Boehringer) were looking for a suitable presentation of the drug they came up with some moderately soluble benzene sulfonic acid salts of pramipexole for use in pharmaceutical compositions and treatments.

For my Boehringer "Sifrol" tablet, the presentation is a 0.125 mg tablet presenting as a hydrochloride monohydrate with an equivalence of 0.087 mg pramipexole.

So yes the actual dose is actually around 50% of the stated dose when taking its salt into consideration. Confusing indeed. It's good to clear this distinction up for newer members who may also be wondering wtf is going on. lol

I've only just decided to cease taking the pramipexole as a precautionary way of preventing the development of tolerance. Also the strong possibility of symptom augmentation and that it could actually induce RLS on top of the existing PLMD. Very frightening.

I've commenced on a low dose of 75mg/day pregabalin (Lyrica), split over 25 mg in the morning and 50 mg at night. This dose is working very well so far & at present see no need to increase it. I've read that the maximum recommended dose is 300 mg/day pregabalin, so I have a wide window of room to go should this dose need to be tweaked.

Cheers Doc

[involuntarydancer in reply to DocUndy]

Glad to hear the pregabalin is working for you. I suppose in due course you could introduce an alternating regime with pregabalin and mirapexin. That way you would give your system a chance to resensitise to which ever drug you are taking a break from.

[Hidden]

Best to get a Dr to help u get off and on a safer drug. Mirapex is a nightmare.

[RLSdaily]

Thank you all. Yes GP was just “winging it” with the meds. I am so discussed that I was not informed and that I didn’t do my research better. I feel all out of sorts, not myself. Am so grateful for this group of supporters and the understanding of how real and bad RLS is.

[Hidden]

You are also taking Paxil a anti-depressant which for most will make your RLS worse.

[Joolsg]

You’re absolutely right- Mirapex snd similar dopamine agonists are evil. At first you think they are miracle drugs and then they become a nightmare.

I wish you strength in getting off mirapex. As ID advises above, you will need a strong opioid to get you through withdrawal.

Take care

[Hidden]

good luck

[Suhavard]

Yuck. So sorry.

[Gazleebryan]

I found the only thing that helps me is 50mg tramadol, only need one at night.