Desperate to withdraw from pramipexole! - Restless Legs Syn...

Restless Legs Syndrome

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Desperate to withdraw from pramipexole!

Dotmowatee profile image

I am in 0.088 mg of pramipexole three times a day. Not very effective. Can't imagine how I am going to withdraw. My GP has scant knowledge.

6 Replies

At least you are on a low dose which will help. Do you need it 3 times a day? I would try cutting out the midday dose or perhaps cut it in half. After couple of weeks, either cut it out entirely or cut your morning dose by half. Continue in this fashion. You will suffer greatly and you should try to get your doctor to prescribe a low dose opioid to help. Start gabapentin at least 3 weeks before you are off pramipexole since it takes at least 3 weeks to be effective, although it won't help much until you are off pramipexole for several weeks. Beginning dose is usually 300 mg gabapentin (75 mg pregabalin) or 100 mg gabapentin (50 mg pregabalin) if you are over the age of 65. Once you are off pramipexole increase by 100 mg every few days until you find the dose that controls your symptoms. Take it 1-2 hours before bedtime. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. Most of the side effects of gabapentin or pregabalin will disappear after a few weeks and the few that don't will lessen. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily" It is important that you check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it at


Thanks for the advice. I have oxytocin as a back up. Can't tolerate gabapentin. I will have to start decreasing, it's so difficult. Will I be back to square one of I do get off this infernal drug ? I wonder. Useful information.

What other medicines do you take? Have you had your ferritin checked? If so what was it?

I am not on any other medication. I have had an iron infusion because my ferritin level was below 100. I am monitored by my haematologist.

The painless way to withdraw from pramipexole is to have your physician write a prescription for a compounding pharmacist. I’m not familiar with how pramipexole is available in the UK, but in the US you can have a compounding pharmacist take a 0.125 mg tablet and render it into a 15 mL suspension. Instead of taking a huge cut of 0.125 mg all at once you can taper down slowly. On day one you would take 14.9 mL the next day 14.8 mL and so on. The idea is to trick the brain into not noticing the absence of pramipexole. Your doctor and compounding pharmacist can help you come up with how to do this in the UK.

Dotmowatee profile image
Dotmowatee in reply to tagaxel

Thank you, I will definitely look into this. Will find a compounding pharmacist. Excellent advice

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