Help with changing Meds please.

[bedith6]

I have been taking Tramadol 200mgs for approx two years now and it has helped in the past. However for the last months or so my RLS is getting worse day and night. I want to change the Tramadol for Pregabalin but am wondering how I achieve that My dr. has admitted she knows nothing about RLS so it will be up to me to tell her what I need. I am very elderly (nearly 90) so don't think I could stand going through withdrawal symptoms. Could I slowly come off Tramadol but at the same time slowly begin Pregabalin? If so what sort of dosage should I stop and start? Hope someone can help me so that I can then discuss with my Dr. I am just so tired of never getting enough sleep or even being able to rest during the day. Even as I am typing this my legs are going like mad. Last thing to be said has anyone got any other suggestions perhaps better than Pregabalin?

[Hidden]

Yes, you can start the pregabalin first, then start reducing the tramadol, if you wish.

At the same time as reducing the tramadol, you can increase the pregabalin.

The starting dose for pregabalin is 50mg and for RLS that's once a day. You can then increase it in steps of 50mg. The official guidance says that the dose can be increased every 7 days, but your doctor may say it can be increased faster.

The average minimum effective dose of pregabalin is 150mg. It can take 3 to 4 weeks before it fully works, so don't expect it to work immediately.

If you were just to reduce the dose of tramadol and didn't take pregabalin, your RLS symptoms would get worse. All being well, the pregabalin will prevent this.

However, tramadol has it's own withdrawal effects and so you will have to reduce the dose to avoid these being too severe.

If the pregabalin works whilst you're still taking the tramadol then there's no need to rush to reduce it. Some people take both.

You will need to be careful of pregabalin side effects at first, it can make you drowsy, dizzy and can affcet walking at first. This usually improves,

[Hidden]

On top of taking pregabalin, you could also ask your doctor to do some blood tests for any deficiences and any underlying conditons that might be making your RLS worse.

If you have iron deficiency particularly, correcting this could improve your RLS. In addition it's possible you have a deficiency in magnesium, Vitamin B12 or Vitamin D. Taking supplements in these could help.

If you read other posts on here you will see that your ferritin level is important. This is a measure of stored iron levels and if it's below 100. taking an iron supplement can help.

Other health conditions which could be affecting your RLS are anaemia, an underactive thyroid gland, diabetes or kidney problems. You might ask youre doctor about these.

If youi're taking any other medications, for whatever reason, these may be making your RLS worse, There are quiate a lot of a variety of medicines which make RLS worse, anhything from antidepressants to cough medicine.

Ultimately, if the pregabalindoesn;t suit you and the tramadol is failing then a remote possibility kis to take a more potent opiate for your RLS, This could be a low dose of oxycodone or methadone. Oxycodone, in the form of targinact can be prescribed for RLS.

[Unhappygirl in reply to Hidden]

I marvel at your knowledge Manerva, such brilliant advise, especially for the elderly x

[bedith6 in reply to Hidden]

Thank you for your help and advice Minerva. I already do a lot of what you recommend I.e I take iron tablets and it has indeed raised my ferritin level I also take vit.b12 and magnesium and have just ordered some vit. D so am really trying to help myself as much as possible. Sadly I have also given up alcohol I hope I will achieve the change of meds without too much trouble. Thanks again.

[Hidden in reply to bedith6]

Marvellous. I usually write about supplements and other medicines as I never know if anybody is aware of these already or not.

I wished somebody had told me years back!

I hope things go well for you.

[bedith6 in reply to Hidden]

Sorry I spelled your name wrong Manerva.

[Hidden in reply to bedith6]

No problem, Minerva was a goddess, I am just a man.

[Lindy14]

Hello Bedith5,

I wouldn't know much about the medication you are taking or the one you are thinking of going on to, here's just a few points about being in charge of this situation.

Whoever prescribes the medication should give you support and guidance as to how quickly to decrease the tramadol and increase the pregablin.

I recently had to change medication that I have been taking for years and luckily the neurologist did listen to my fears about how to do it successfully. She gave me a prescriptio and instructions as to how to increase and decrease simultaneously with very small doses.

The problem was the pharmacist and the staff at the GP surgery. They tried to tell me that what the Consultant neurologist was wrong! I insisted that I needed to stick to what the neurologist had said, and suggested that they check the correspondence from the neurologist at the GP surgery from her to the GP.

I outlined in detail what I had been instructed to do, insisting that I be given the medication so as not to be subjected to unnecessary deterioration of health.

Because I kept a check on the medicine I managed to do the change over successfully.

Also, check the medication picked up from the Pharmacy so as not to be landed with the wrong medication or the wrong dose.

i told the Neurologist what had happened and she agreed that I had done the right thing.

Lindy14

[Hidden in reply to Lindy14]

Well done Lindy, you have to be assertive about these things at times.

I'm glad you had such a supportive neurologist.

The neurologists I've seen caused more harm than good.

[martino]

I have tried to come off Tramadol but gave up. I now take it with 600mg of Pregabelin and also have a 2mg Rotigotine patch. This combination is very effective most of the time. I have a bit of memory loss but age is a factor here

[bedith6 in reply to martino]

How much Tramadol do you take with the Pregabalin Martino?

[martino in reply to bedith6]

200mg. I use a longer lasting tablet called Tramulief every 12 hours. I am only a boy, 72, but don’t mind being dependent as long as it keeps working.

[suesweda]

You probably built up a tolerance to the Tramadol. You may need a higher dose or you may need to add another medication, but at your age, you need to be careful as many prescription medications must be used with caution in the elderly. You should try to see a doctor with some expertise in RLS at least once, if you can, or possibly a geriatric specialist. I know these options are not available to everyone. Good luck and I hope you feel better soon.

[bedith6]

Thank you all so much for your advice and help. I don’t know what I would do without this site

[Oma67]

I am taking 0.25 mg of Pramipexole dihydrochloride monohydrate just before bedtime for about a year now. I found it has worked for me. The only time it hasn’t helped is if I have a couple of glasses of wine in the evening.