Take Ropinirole and Gabapentin at the Same Time?

[Write4u]

I have been battling RLS with 5 mg Ropinirole at night for about 3 years with no augmentation YET. I recently fell and fractured my back where discs are bulging. Entire spine riddled with arthritis and osteoporosis. Pain is crippling. To ease the pain, doctor wants me to add Gabapentin with the Ropinirole. My first reaction was: this highly acclaimed Thoracic spine specialist is out of his mind! So, my question is: anyone taking Ropinirole and Gabapentin at the same time without severe consequences? Thank you for any guidance on the subject.

[Hidden]

The simple answer is yes, you can take gabapentin and ropinirole at the same time. Your specialist is of sound mind.

Furthermore, Gabapentin is commonly prescribed for nerve pain, but it's also prescribed off-label for RLS.

I first started taking gabapentin for nerve pain. I was augmenting on a dopamine agonist (like ropinirole) at the time, after taking it for years. I then weaned slowly off the agonist and my augmentation disappeared. I was taking both gabapentin and the agonist together for nearly a year. I now take only gabapentin for my RLS and, luckily for me, it works fine and with little risk of augmentation.

5mg Ropinirole is in excess of the official maximum daily dose and although you say you haven't suffered augmentation yet, this considerably increases the risk of it.

So as well as taking the gabapentin for your pain (and RLS), I suggest you might consider reducing the ropinirole.

[Write4u in reply to Hidden]

Thank you so much for your awesome response. I will back off the Ropinirole, add the Gabapentin, and hopefully get back relief AND not experience augmentation. I feel better already

[Hidden in reply to Write4u]

Be aware that gabapentin does take a while to become effective. About 3 weeks. You also need a sufficient dose.

Also, if you do decide to reduce the ropinirole, you need to do it slowly say reduce it by 0.25mg every two weeks. Otherwise, withdrawal effects can be severe.

[Write4u in reply to Hidden]

Awesome to get back to me with this. The Gabapentin is 300 mg and I checked my Ropinirole. I was waaaaay off! It is only 1 mg daily. Does this make better sense?? Hope so! Thanks again for the follow-up..

[Hidden in reply to Write4u]

1mg makes better sense. A much lesser risk of augmentation. If it's controlling. your RLS at that level that's fine. I wouldn't advise ever increasing it though.

The starting dose of gabapentin is 300mg daily. This can then be gradually increased until it works.

For nerve pain it's usually taken 3 times a day.

When I was taking it for nerve pain I started at 100mg 3 X a day and went up to 300mg 3 X a day.

It can be increased further if necessary.

[Write4u in reply to Hidden]

You rock......😍

[Write4u in reply to Hidden]

Manerva, I don't know what time zone you are in but when convenient, can you tell me if augmentation makes RLS symptoms worse......or does it make you feel ill, weak, heart palpitations, kinda like the body is going into a death roll? I have been diagnosed with metastasized cancer and don't know if its the flippin cancer or augmentation. Think its the cancer 😩

[TheDoDahMan in reply to Write4u]

Augmentation, just as the word implies, makes RLS symptoms worse. You have my sympathies for your cancer-related problems - I hope you have treatment providers whom you trust in that regard. Best of luck to you!

[Hidden in reply to Write4u]

Gosh! I'm sorry to hear this.

I can confirm from personal experience, it is the cancer.

I hope you're being offered some treatment and have access to people who can support you.

[Covenant1962 in reply to Hidden]

Hi Minerva many thanks for your contribution to this forum you’ve helped many people.I’m still new to full blown RLS but hoping to avoid DAs and augmentation.I am trying to establish an initial course of treatment. So far I have changed my diet and exercise regularly. My ferritin level was 260 when measured two weeks ago. Without drugs I am experiencing quite severe RLS and struggling to get any sleep.

Would it be possible for you to share your experience with Gabapentin? What dosage did you start on and how has it progressed? What side effects can I expect? Do you take anything with it say to help with sleep?

Regards

[Hidden in reply to Covenant1962]

Please bear in mind that not everbody's experience of gabapentin is the same.

When I first started taking gabapentin I was taking it for nerve pain. I took 100mg 3 X a day. I then built it up to 300mg 3 X a day.

After the nerve pain lessened I continued to take it for RLS. I am lucky that now I only take 600mg once a day, at night.

The first side effects I expereinced were drowsiness, dizziness and stubling a little when walking. These side effects subsided after a few weeks.

Some people suffer weight gain and mental fogginess with gabapentin, but I don't.

I do find that I sometimes I forget words, I know what I want to say but I can't recall the word for it. It doesn't happen often and I'm not entirely sure it's due to the gabapentin.

I also suffer slightly blurred vision, especially in the morning, but it's not major.

Gabapentin can cause breathing problems in people with pre-existing central respiratory depression.

For me, the benefit of gabapentin far outweighs the side effects, which is the best you can hope for.

I had severe problems with the dopamine agonist I used to take.

Gabapentin can help promote sleep!

[Write4u in reply to Hidden]

Thanks again for the ongoing support.... since I have breathing problems from my diagnosis of lung cancer, I opted to NOT taking the Gabapentin. It was prescribed because I fell in December and fractured my already herniated back that has older fractures and is full of arthritis and osteoporosis. I think right now I have to focus on the cancer as they feel it has metastasized to my brain and wherever else. I have always prayed for miracle to alleviate the RLS. Now however, RLS takes second stage as I need supernatural healing from cancer. Oh, I also have venous insufficiency that could be causing the excruciating leg cramps along with the horrid RLS. Cramps get me up during the night more than the RLS. Manerva, you have been such an immense help to me ... and all others. You are very special

[Hidden in reply to Write4u]

I appreciate myself that when you have advanced cancer it can dominate evrything else you might have. However, it's imperative I feel to do whatever is possible to maintain some quality of life.

So if you can do something for your back pain or for your cramps and RLS then it would be good to do so.

If you think the gabapentin might help with pain and RLS then it's worth having a word with your doctor about it.

Gabapentin can cause respiratory depression in people that have a pre-existing central respiratory issue or are taking opioids rather than those who have a problem with the lungs or airways. So it may be possible for you.

Hopefully you have regular blood tests which includes electrolytes as the cramps may be due to an electrolyte imbalance. Low potassium may also be making your RLS worse.

If you have venous insufficiency you may find compression stockings helpful. However, use proper medical ones not any "one size fits all" version.

I hope this in some way helps.

[Covenant1962 in reply to Hidden]

Many thanks Minerva

[Rosalia1]

I’m so sorry I feel your pain I’m in the same boat I can’t walk from all the pain and now nerve pain bad down my left leg it hard to walk my god!!! I can’t handle the pain anymore I feel like taking 20 gabapentin at the same time 😢 I hope u get better

[Sillyvester19]

Yes I do and have been for nearly a tear seems ok

[wcp2008]

Same here, no issues taking the 2 together. I do take them 2 hours apart...the Gabapentin is also for RLS. I am augmenting on Ropinirole and doctor has not recommended my backing off of it yet. I still work and also have epilepsy, so I think she doesn’t want to mess with my sleep which is presently undisturbed by RLS. Backing off of Ropinirole is a long and difficult undertaking, from what I’ve seen herein.

[dklohrey]

I went to a neurology clinic for RLS and was prescribed gabapentin along with the 2mg of ropinirole that I was taking at the time. That lasted about a week. I found myself falling asleep at the wheel in the middle of the day while driving to the grocery store. Fortunately I was in the parking lot at the time. Scared me to death! If you have to take then both I would just recommend taking the gabapentin at night before bedtime.

[Hidden]

I take both ropinirole and gabapentin without any problem

[Tanker1]

I recently started on 1200-1500 mg of gabapentin (1800 mg per day is max) + 0.5 mg of ropinirole and so far (1 month) its working fine. Note that all meds are taken in the evening. The concept is that gabapentin has few side effects (at least for me) and is not subject to tolerance. The low dose of ropinirole is more likely to prevent augmentation. Separately, neither medication at the indicated dose is adequate. I should mention I have periodic limb movement disorder which keeps me from sleeping and not RLS. Treatments for both maladies are very similar.

[Mattly]

Late Reply here: Similar circumstances: I've been on Ropinirole for 4 years and have recently been prescribed Gabapentin following severe nerve damage to my foot. My biggest problem is that since taking both I feel debilitatingly tired and dizzy to the extent I have made an appointment to discuss it with my doctor.