Need info on quitting mirapex

[klee1951]

I have been taking mirapex for RLS since 2012. It doesn't always work and I'd like to get off it and on to another OR from what I'm reading, cannibas is a big help. Can anyone give me so information on any of the above and how hard is it to get off mirapex?

[Hidden]

Hi, Folks on here can give you lots of suggestions for getting off Pramipexole and they will all be slightly different. However the main points are

You need to decrease the dose very slowly and from my experience the slower the better.

I decreased it in steps of 44 micrograms, i.e. 1/2 of a 88 microgram tablet.

in intervals of a month (4 weeks). i.e. I decreased it by 44 micrograms a month. You can do it quicker if you can.

Your RLS symptoms may get worse each time you cut the dose, but then may improve again. Some say stay on the same dose until the symptoms settle, then make the next cut.

When you finally stop taking it altogether it's highly probable you will get withdrawal symptoms. These can last for two weeks or more.

Experts recommend taking an opiate for a short term to help reduce withdrawal symptoms. Tramadol seems popular, but getting a doctor to prescribe any opiate can be difficult., depending where you live.

After this you might return to how you were before you started taking the Pramipexole. Presumably, this wasn't particularly good since you did start on medication. In that case you may need something to replace the Pramipexole.

You mention Cannabis, some people do use CBD oil for relieving RLS and claim it works. The problem with CBD oil is that depending on where you get it from, it's very variable in quality and actual content. Furthermore there is no guarantee it will work for RLS, there is no scientific evidence for it working for RLS only what people say.

Some people use Cannabis itself, which contains the psychoactive ingredient THC. Depending on where you live, firstly, this may be illegal, certainly in the UK. There are some states in the US where it isn't illegal.

If you manage to obtain Cannabis, since it is not regulated it will vary considerably and again, there's no solid evidence it works for RLS, like it does for pain or anxiety.

However more easily obtained medications which are known to work for RLS for most people are either Gabapentin or Pregabalin. Although these do have some side effects they do not h ave the same major problems that Dopamine Agonists, like Pramipexole have.

When I was weaning off Pramipexole, I started taking Gabapentin and continued taking it after I had completely stopped the Pramipexole.

You may find others on this site suggest Gabapentin, but say it won't work until you've completely stopped the Pramipexole. This is not entirely true. Gabapentin can help relieve symptoms while reducing Pramipexole, but it won't prevent withdrawal symptoms when you finally stop Pramipexole. Additionally if you only start taking Gabapentin or Pregabalin after you stop Pramipexole, then it takes several.weeks to start working.

I hope this helps.

To avoid any confusion "Mirapex" is a brand name for the drug Pramipexole which is also made by many companies under different names. Most members on this site who refer to Mirapex are from the US as this brand is not commonly prescribed in the UK or other countries.

Tablets can contain either 0.125mg or 0.25 mg of Pramipexole Hydrochloride. (PHCL) and 0.125 mg PHCL gives 88 micrograms Pramipexole and 0.25 mg give 180 micrograms.

[Joolsg]

Manerva has given you thorough and excellent advice.

The slower you can go, it seems the easier the withdrawal symptoms.

It took me about 3 months to get from 4mg to zero Ropinirole and the withdrawal was very, very difficult with little/ no sleep for 2 weeks. Everyone is different though - raising iron levels helps both RLS and withdrawal symptoms.

Good luck.

[Parminter]

You can and must come off. 'Not working any more' means you are augmenting, and the drug is making the condition worse.

ncbi.nlm.nih.gov/pmc/articl...

If you print this out and take it to your doctor he/she will realize how serious this is, and possibly how to help. It can be relatively easy for some, extremely difficult for others.

Whatever you choose to do, get all the help you can.