PRAMIPEXOLE WITHDRAWAL

[Josana13]

I am taking 1.5 mg of Prami. Tried going down to 1.25 - terrribbble. Horrrible. Tried 1.37. OK for two weeks and then Bad read bad. What would be my next option? Please help. Thank you (I was breaking a .5 tablet.

[Hidden]

I think the best response to your issues is that made by Jools about a month ago.

healthunlocked.com/rlsuk/po...

Who gave you some information about whom you may get some help from.

Since you were on a massive dose of pramipexole and also suffer an ICD, it is likely you are at risk of suffering DAWS, (Dopamine Agonist Withdrawal Syndrome). It's possibly why you're experiencing such difficulty.

If you do continue to reduce the pramipexole reducing it by 0.25mg is too big a reduction. It appears that for you even 0.125 is too big a reduction.

I'd suggest you get smaller dose tablets e.g. some 0.25mg ones and some 0.125 mg ones. Then you can reduce in steps of half a 0.125mg tab. You may also have to give it longer than 2 weeks before withdrawal effects settle.

If you're used to taking hydrocodone, it may be that reviewing your dose or switching to another opioid wil help with withdrawals.

[Josana13 in reply to Hidden]

Thank you, Manerva. Please forgive me if I ask the same question more than once. I am having trouble remembering stuff. God Bless.

[Hidden in reply to Josana13]

No problem

[Josana13 in reply to Hidden]

Manerva, I ended up in the hospital with uncontrolled blood pressure (220/115) and low oxygen. My sight is blurry and my voice crackled. I have asked these people to learn something about Pramipexole and they are doing research. I can't figure out how much to take. If I am taking 1.5 mg and reduce by half of 0,125 mg, What should my prescription be? Opioid changed to Oxycodone. I am going to ask for Methadone.

[Hidden in reply to Josana13]

Firstly, have they sorted out your high Blood Pressure?

If you're currently taking 1.5mg then may need at least a months prescription for 1.75mg a day for the first month then declining thereafter.

I can't work it out exactly but assuming you reduced by 0.0625mg every two weeks, then you would need a mixture of 0.5mg tabs, 0.25mg tabs and 0.125 tabs.

That is depending how many tabs you need to add up to a total dose which is reducing by 0.0625mg (half a 0.125mg tab).

You may need 0.5mg tabs until the dose is down to 0.5mg, still may need 0.25mg tabs until the dose is down to 0.25mg and only need 0.125 tabs after that.

Hope that's not too confusing.

[Josana13 in reply to Hidden]

I wonder if low iron could cause the blood pressure to go up? They connected me by video to a neurologist at the University. He wanted to switch me to Requip? Go figure. I asked the hospital doctor for an iron infusion and he is going to think about it. Ok regarding my 1.5 P. What prescriptions should I ask for? I want to go down the lowest possible. Thanks Manerva.

[Hidden in reply to Josana13]

You should undergo further investigations for High Blood Pressure (BP). Did they not take blood tests at the hospital? Did they give you no medication?

Have they not mentioned further tests. If not I'm stunned!

ow iron is unlikely to casue high BP.

Honestly, to advise you to start taking Requip, i.e. ropinrole which is another dopamine agonist the same as pramipexole appears ridiculous. This wouldn't solve your issues it would perpetuate them!

If that's the case and your BP is still high then you need to consuit your primary care doctor.

AS regards the pramipexole prescriptions, it's actually very complicated on the face of it so I'll try and explain it as simply as I can so that hopefully you may be able to work it out for yourself.

I'm trying to work what's the best/easiest way of going it, but I'll have to think about it and get back to you.

[Josana13 in reply to Hidden]

Sorry for giving you a headache. Regarding Blood pressure. They increased my medication and it has taken 3 days to bring it down. I asked the Dr to give me an iron infusion and he is going to. I am thinking that the blood pressure is due to decreasing the P.

[Hidden in reply to Josana13]

It wasn't you that gave me the headache!

I didn't realise you were already on BP medication.

I'd say, that whatever caused your raised BP in the first place is still the underlying cause.

I don't think the decreasing pramipexole is.

[Hidden in reply to Josana13]

After the "further thought" I have a headache!

Assuming you reduce the dose by half a 0.125 tablet every two weeks, (that is 0.0625mg)

Bearing in mind that it's fairly easy to cut tablets in half, but NOT quarters (or less).

Bearing in mind also that you do not want too many tablets.

You need a mixture of 0.5mg, 0.25mg and 0.125mg tablets

You can off course cut 0.5 tablets in half to get 0.25

You can cut 0.25 tablets in half to get 0.125

You can cut 0.125 tablets in half to get 0.0625

I would NOT suggest you try the following

Cutting 0.5 tabs in quarters to get 0.125 in eigths to get 0.0625

Cutting 0.25 tabs in quarters to get 0.0625

I tried to make an illustrative table but can't copy it into this site.

I hope the following helps

First two weeks Total daily dose = 1.4735mg

Made up of 2 X 0.5, 1 X 0.25, 1 X 0.125 and 1 X 0.0625 doses per day

This could be from a combination (for the two weeks) of 28 X 0,5 tabs, 14 X 0.25 tabs and 21 X 0.125 tabs (14 whole and 14 halves).

Second two weeks Total daily dose = 1.375mg

Made up of 2 X 0.5, 1 X 0.25, and 1 X 0.125 doses per day

This could be from a combination (for the two weeks) of 28 X 0,5 tabs, 14 X 0.25 tabs and 14 X 0.125 tabs

Overall month by month

For the first 4 months you need

At least 56 X 0.5 tablets per month

For months 5 to 8

At least 28 X 0.5 tabs per month

Then none thereafter

For months 1 &2, months 5 & 6 and months 9 & 10

At least 28 X 0.25 tabs per month

The none thereafter

For the first month you need at least 35 X 0.125 tabs

then every OTHER month i.e. 3, 5, 7 etc

For the second month you need 7 X 0.125 (14 halves)

then every OTHER month 4, 6, 8 etc

Sorry, that is the best I can do to explain it.

Be aware that is if everything goes to plan. You may have to review the situation each month.

[Josana13 in reply to Hidden]

Wow! I am amazed. Thank you so much. I am going to copy this and have my doctors call in the prescriptions. You are awesome Manerva. God Bless.