How to withdraw from Sifrol ER

[wairoa36]

How do I begin to withdraw from 0.75 mg Pramipexole /sifrol ER ? I am in Australia. No use asking the Neurologist. He put me on it.

This forum is remarkable , and all you wonderful people on it !

[Lapsedrunner]

Hi wairoa36,

I think the main advice is SLOWLY!

I’m assuming that you want to get off it as you’re augmenting? Lots of us on here have been there and have made it back!

My advice would be to cut tablets (fiddly I know) some people crush tablets and then divide the powder. You could try something like a quarter of a tablet decrease a week.

The general advice on here will also be to try to get an opioid to ease the process, if you can’t get anything prescribed you could try an over the counter med such as paracetamol and codeine (I’m in UK)

I only found this forum part way through weaning off pramipexole, having discovered that if you simply stop as my dr had suggested (I was on minimum dose) you quite literally rotate all night in bed, hideous! I didn’t use any opioids, but I do sometimes have the occasional single cocodamol (paracetamol and codeine)

I got off it in 2-3 weeks but be prepared for it to take longer for you as you’re on a higher dose.

Prepare for weaning, ideally do it at a time when you’re not so busy, can have family/friends support you. Consider taking some iron supplements (do you know what your ferritin level is currently, we’re aiming for over 100)

Lastly, keep in touch on here and let us know how you’re doing. All the best.

[picol in reply to Lapsedrunner]

Thanks for the good advice. I must tell you it is one tablet, coated, and slow release.

So it cannot be cut.

I think I will have to get an equal dose, not slow release, and cut that, as you suggest.

Thanks for your concern and help.I know it is not for the faint - hearted!

[LotteM in reply to picol]

Tablets cone in high and low doses. If your is a high-dose tablet, ask your prescribing doctor and/or the pharmacist to replace it with a number of lower-dose tablets. If you’ll explain why - to reduce slowly - it shouldn’t be a problem.

If it is the lowest dose, you can do what you propose, or just take the plunge and stop.

Btw, why do you want to reduce? If it ain’t broken, don’t fix it.

[Shumbah in reply to Lapsedrunner]

Hi Lapsedrunner

Can you buy cocodamol over the counter in the UK

My son lives in the UK and has suffered for 4 years the last 12 months are the worst he is down to 2 hours a night sleep

So appreciate all your input

[Lapsedrunner in reply to Shumbah]

Yes Shumbah.

[Lapsedrunner in reply to Shumbah]

Pressed reply too quick Shumbah!

I would of course suggest that he goes to talk to his GP though

[Parminter]

If you have been on it for a long time - which might be the case, that is a high dose - then your neurologist may no longer be such a complete idiot, not if he ever reads a journal.

The best way is to come off is with an opioid, which makes it pretty easy for most.

Could you find a neurologist who will help?

This forum is full of sufferers who have done it the very hard way. It is exceptionally courageous, but it should not be necessary. We should be allowed to save our courage for absolutely unavoidable miseries - this is not one of them.

To me, it means that the medical profession is happy to watch patients suffer all the horrors of hell. Not good enough.

I tried the hard way, three times, and I could not get beyond a single night of torture. Luckily I convinced my GP to give me methadone, after I had given him all the recent literature on the subject.

No horrid withdrawal, no tapering, no symptoms, lots of sleep, no terror every night before bed. No downside at all.

Most of us are 'of a certain age' - we are not going to be turned into irresponsible junkies with a tiny dose of a very good drug.

The worst drugs of all are the dopamine agonists, and the best RLS experts now recognise this - witness the desperate DAWS sufferer we had on the forum recently.

DAWS is more common than was previously thought, and it can mean months or years or a lifetime of real hell.