Do you have to take pramipexole every day for it to work?

[Pluto46]

Although I have a packet of pramipexole (sifrol) hanging around in the kitchen, I've only taken one tablet every blue moon or so, mainly to avoid the augmentation and withdrawal symptoms which seem to accompany daily use.

Does anyone know if they're supposed to work immediately, or do they have to build up reserves in the body over a number of days before having en effect?

The last time I took one was the other evening when the old rls was working overtime, and it had no appreciable effect, which I suppose answers the first question. I'm thinking of taking two later today since I seem to be in a phase of particularly intense rls attacks. Just hoping it'll have an effect.

best,

Chris

[LotteM]

Chris, they should work immediately. That is, they have to be processed by your body which takes at least about an hour. But many people report that you have to take them before the symptoms start, otherwise they are far less effective. I had the same when I took ropinirole (never had pramipexole).

Definitely no ‘building up’ over several days required; your systems clears them fairly rapidly. Hope your symptoms subside soon.

[Pluto46 in reply to LotteM]

Thanks, LotteM. Just took a couple half an hour ago. I'll see they work. If they don't, I may add a third, but that's the limit. Don't want to become addicted to them

[Parminter]

For me, it takes two hours if I am in the middle of an episode. This happens if I have forgotten the dose, and I usually have to add an opioid.

If you do want it to work every day as a prophylactic, you must take it at least two hours before bed. I take mine three or four hours before.

[Pluto46 in reply to Parminter]

Thanks for advice Parminter. As i mentioned yesterday around 2 pm, and had a relatively quite evening. I did feel the symptoms wanted to bubble to the surface, but apart from normal restlessness (having to rock back and forth in the recliner), everything was very peaceful. That was until about ten in the evening, when I felt the start of a new round, so I took the third pramipexole for the day. I had a peaceful night in terms of rls, but slept very little - sleeplessness is a common side effect apparently.

When I measured my fasting blood glukose this morning, I got a shock. I'm usually in a range between 4 and 7-ish mmol/l (72-126 mg/dl), but this morning clocked in at an amazing 12+ mmol/l (216+ mg/dl), which sounds very ominous indeed. I've sent an enquiry to our national diabetes association to ask if pramipexole has that type of side effect. There amy be another explanation. I did overdo it in the donut department yesterday (sort of celebration for getting chemo yesterday morning), but won't be touching them today. Don't think I'll take a prami today either.

The good thing is that I won't be using pramipexole for more than a few days, since I'm being referred to the palliative team at my local hospital this coming week, and they'll be wanting to take a holistic look at everything I expect.

all the best,

Chris

[rls_optimist in reply to Pluto46]

What dose is each of your pramipexole pills?

[Pluto46 in reply to rls_optimist]

0.088mg - the lowest dose. I may have been a bit rash yesterday taking 3 pills in all. Can't find any evidence of a connection between blood glucose and pramipexol, so I might venture a pill later this evening. They're not so good for people with kidney problems - which I've had in mild form for several years.

[involuntarydancer in reply to Pluto46]

Chris, I don’t think I you will come to much harm in terms of building up dependency if you take them for a few days or even a couple of weeks (though I have no idea about interactions with your other drugs/medical conditions). Unless you can get relief using the lowest dose of 0.088, it might be almost better to take them continuously for a few days than to go on and off them intermittently as I would have thought that it might be a bit shocking for your system to get shots of dopamine agonist one day and then none the next.

I am not medically qualified but my understanding was that the reason people are put on d/as permanently rather than as a more as-and-when remedy is because our bodies don’t like getting only intermittent doses of dopamine agonist in any appreciable amounts. You have so much going on and also won’t need them for long, that I would have thought it might be worth taking them for a few days.

[Pluto46 in reply to involuntarydancer]

Thanks for your always invaluable advice, involuntarydancer. Great help!

[involuntarydancer in reply to Pluto46]

Virtual blush!