Is there any guidance as to what is a low/med/high dose of this drug?
One for Parkinson- high don't go there.
Lower dose for rls . 0.25mg MAX. ie 3 doses of 0.088. MAXIMUM.
Start at one pill of 0.088.
The "official" maximum dose, UK, is 540 micrograms that is 3 X 188 microgram tablets (=0.75mg)
Other sources set it lower than this e.g. 2 X 188 micrograms tablets (=0.5mg)
The higher the dose you take, the more likely you are to experience augmentation, where paradoxically, pramipexole starts making the RLS worse.
Your doctor may say it's OK to take up to 540 mcg. They may not even mention augmentation.
If so then they are not giving the full facts.
It's NOT OK
Best to to stay on as low a dose as possible, i.e. 1 X 88micrograms
Delay increasing to 2 X 88 micrograms for as long as you can
If that stops working then it's probably a good idea to have a medicines review rather than increase it any more.
The doses are confusing you may see 2 values are given but basically for RLS two tablet sizes are used
88 micrograms sometimes written as 0.088mg
Is equivalent to 0.125mg
188 micrograms sometimes written as 0.18 mg
Is equivalent to 0.25mg
Higher doses and stronger tablets are only used for Parkinson's disease.
0.25mg per day is the current maximum advised by the best experts. But that dose does not necessarily mean you will escape the side-effects.
Thanks guys. Confusing isn’t it! I now have to educate my GP
My neurologist has proscribed pramipexole long release for me .52mg morning and night. He is a well respected medical man who told me this is a low dose!! I don't know what to believe anymore I see my gp tomorrow and I'm at loss what to say!!
I have started to cut down the morning tablet to .26mg and I know it is important to go very slowly and I sometimes revert back to the .52mg
And see how I go but I'm very confused I have always believed what the professional have told me.
Having been through augmentation and the torture of dopamine agonist withdrawal - while under the care of an apparently knowledgeable and definitely well respected sleep consultant - I would NEVER increase the dose of mirapexin to more than 1 x 0.088mg tablet daily - no matter how many well respected medical people assured me that it was acceptable to take more.
It is also important to maintain serum ferritin levels at over 100 while taking a dopamine agonist such as mirapexin. There is a link between low serum ferritin and augmentation. Raising serum ferritin helps at least 50% of RLS sufferers with their symptoms in any event.
I wonder how many "respectable professionals" would be so willing to prescribe these medicines so blithely to people if they took their own medicine .
Unfortunately, you need to consider that a professionals perception of a patient's condition is very different to the"lived experience " of the patient. They know the text book treatments, and do consider side effects and consequences, but unless they've experienced them for themselves, they will underestimate their impact.
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