Dr.M.Buchfuhrer

[bedith6]

Does anyone know Dr. Buchfuhrer’s e.mail address please and have I spelled his name correctly? Thank you

[LotteM]

[e-mail]

You can find it under the yellow button in the middle of the home page of his website rlshelp.org

And you got his name right!

How are you doing on the Temgesic, Bedith?

[bedith6 in reply to LotteM]

That’s why I want to email Dr.Buchfuhrer, because I have titrated the Temgesic up to 400mcg with no results. Surely my RLS should have responded in some way to that amount, but I am still getting it night and day with no let up as yet. Although I had weaned off the Temazepam in desperation last night I took one to see if I could get a little sleep. I am not experiencing any side effects but how high can you go before it becomes unsafe? I am feeling desperately disappointed as I feel this is the end of the road for me.

[LotteM in reply to bedith6]

Bedith, do you have the liberty to increase the dose? Or will that make you run out of tablets too early and the doctor not yet renewing your prescription?

I think dr B will answer that you should try to slowly increase your dose. Half a tablet extra every few days or so. Some people do need high doses. Remember Shumbah, she takes 1-2mg which equals 5-10 Temgesic tablets of 200microgram.

And didn't you discuss with your doctor to evaluate at least every week until your reach sufficient relief? If not, phone and ask for it. Until you find tue dose that works for you.

[bedith6 in reply to LotteM]

Thank you for your reply. I did email Dr Buchfuhrer and received a prompt reply. He said 400mcg is a relatively small dose and yes some people need to take more. My Dr is not going to speak with me until June 20th but in the meantime he has sent me a new prescription. He wants me to completely wean off the Tramadol before I increase the Temgesic dose so I will have to try to do that as quickly as possible. I am amazed that Shumba can take the amount that she does. I hope I won’t need to go that far, but I certainly think I will have to titrate up from 400mcg as I am feeling no relief at all yet from my symptoms. I hope you have a peaceful Easter

[LotteM in reply to bedith6]

Bedith, there is a very small chance that you are/were on the road to augmentation with the tramadol. As tramadol is the only opioid that binds to dopamine receptors and a few cases have been reported of augmentation on the tramadol.

It may be that now you need more Temgesic but once off the tramadol maybe you can somewhat reduce the Temgesic again. It will be trial and error. It does seem a very normal advice from your doctor to dirst reduce the tranadol before you increase the Temgesic. Hang in there, you'll get there.

[Nanpat in reply to bedith6]

I can fully relate to your disappointment, as I’m about to start buprenorphine and if that doesn’t work my pain Dr suggests amitriptyline which he said has helped many patients but I know it’s a big NO NO! I won’t be trying.My next stop will be pramipexole another NO NO but even a few mths symptom free may restore may sanity.

I also feel like then it will be the end of the road for me also, such a hard way to live.

I would keep taking the temazepam if it helps, some nights I take 2, good luck to you 🙂

[bedith6 in reply to Nanpat]

Hello Nanpat thanks for your reply. Although I was completely off the Temazepam I have decided to take it again if Ifeel I need to. When my legs are really playing up it helped to calm them down a little. I am still persevering with the Temgesic. Good Luck to you

[SueJohnson in reply to Nanpat]

Before you try pramipexole, try Dipyridamole which has completely eliminated RLS symptoms in some. And if you have to resort to a dopamine agonist, try the neupro patch which is less likely to lead to augmentation.

[Nanpat in reply to SueJohnson]

Okay, thanks for suggestions

[rls-insomniac]

Hi Bedith.. I also take Temgesic. I started off on 200 mcgs which wasn't enough to control my symptoms. I then took 400 mcgs but that still wasn't doing the trick. My consultant agreed to increase my dose to 600 mcgs. My symptoms seem to be controlled at around 500 mcgs. But if I get symptoms in the evening, I've got the option to take an extra half tablet.When I started to take Temgesic, it didn't work straight away but took a few weeks before I noticed my symptoms were beginning to feel better.

As Lotte had said, some people need a higher dose for it to be effective. As the saying goes, we're all different.

I hope you get the help to manage your symptoms soon.

[bedith6 in reply to rls-insomniac]

Thank you for your reply. It seems obvious now that 400mcg is not enough for me but my Dr. doesn’t want me to increase yet as I am still taking two Tramadol and seems to want me completely off these before going higher on the Temgesic. I had a very quick reply from Dr Buchfuhrer who said that 400mcg is still a relatively low dose and yes some people just need more. Have a peaceful Easter

[rls-insomniac in reply to bedith6]

You too. When I started to take Temgesic I was taking 15mgs of Targinact plus 300mgs of pregabalin. I had to stop the Targinact immediately and did a straight switch. I still took the pregabalin for a short while whilst taking 200mcgs of Temgesic. I then gradually stopped the pregabalin and increased the Temgesic as the pregabalin wasn't helping. Now my symptoms are managed solely with Temgesic. So I can see why your doctor wants you off the tramadol before increasing your Temgesic dose.