Ramiprole v pramipexole

[Fiojohn]

Hi. I have been taking 1mg of ramiprole at about 8pm each evening and I tolerate it pretty well but find that I cannot have even one alcoholic drink after I take the tablet without either feeling terrible or being sick. I’m not a big drinker but I do enjoy a glass of wine, especially on holiday. My dr says I can try pramipexole but when I read about it, it seems to have similar side effects. Would welcome any one’s experience on either and whether I’m better being tea total and no RLS, or changing to see if I can have the occasional drink

Thanks

[Joolsg]

They're the same category of drug so you would get the sickness with Pramipexole as well.Maybe it's a good thing as Ropinirole and Pramipexole are no longer first line treatment because of the highrates of Augmentation and Impulse Control Disorder.

It might be a good time to reduce the Ropinirole slowly and switch to pregabalin or gabapentin which are now first line treatment.

See the Mayo algorithm.

mayoclinicproceedings.org/a...

[Fiojohn in reply to Joolsg]

Thanks for this. I will look into the side effects of these.

[Madlegs1]

Many people find wine is a major trigger for RLS. 😥

[SueJohnson]

As Joolsg mentioned, you need to come off ropinirole and switching to gabapentin since ropinirole is no longer the first-line treatment for RLS? Up to 70% of patients will suffer from augmentation which believe me you don't want. It used to be the first-line treatment which is why so many doctors prescribed it but they are not up to date on the current treatment recommendations. 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 if needed as many doctors do not know much about RLS or are not uptodate on it as yours obviously isn't at

the link that Joolsg provided. Also have you had your ferritin checked? If it is below 100 improving it to 100 or more helps 60% of patients and in some will completely eliminate their symptoms. If you haven't had your ferritin checked, ask your doctor for a full iron panel. Stop taking any iron supplements 48 hours before the test and fast after midnight. Have your test in the morning when your ferritin is lowest. When you get the results, ask for your ferritin and transferrin saturation numbers. You want your ferritin to be over 100. If your ferritin is less than 75 then take 325 mg of ferrous sulfate with 100 mg of vitamin C or some orange juice since that helps its absorption. Take it every other day at least 1 hour before a meal or coffee and at least 2 hours after a meal or coffee since iron is absorbed better on an empty stomach and preferably at night. If you have problems with constipation switch to iron bisglycinate. If your ferritin is between 75 and 100 or if your transferrin saturation is below 20, you probably need an iron infusion since iron isn't absorbed as well above 75. If you take magnesium take it at least 2 hours apart since it interferes with the absorption of iron. Don't take tumeric as it interferes with the absorption of iron. It takes several months for the iron tablets or iron infusion to slowly raise your ferritin. Ask for a new blood test after 8 weeks if you have an iron infusion or after 3 months if you are taking iron tablets To come off ropinirole, reduce by .25 mg every 2 weeks or so. You will have increased symptoms. You will suffer and may need a low dose opioid temporarily to help out with the symptoms. But in the long run, you will be glad you did. On the gabapentin, beginning dose is usually 300 mg gabapentin or 100 mg if you are over the age of 65. Start it 3 weeks before you are off ropinirole although it won't be fully effective until you are off it for several weeks. After that increase it by 100 mg every couple of days until you find the dose that works for you. 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 will disappear after a few weeks and the few that don't will usually lessen. Those that remain are usually worth it for the elimination of the RLS symptoms. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily." If you take magnesium take it at least 3 hours before taking gabapentin as it will interfere with the absorption of the gabapentin.

[Fiojohn in reply to SueJohnson]

Thanks so much for the detailed reply. My GP is very good so I will have a chat with him. I found a magnesium rub which I rub into my lower legs before sleeping, and it seems to help- not sure if it is just the ropinirole or not! I will ask for an iron check. I have just had a hip replacement so these levels might be a bit low now anyway. I have never had an iron check but I do give blood and the routine pin prick test has always been fine. I assume that this is simply not accurate enough though. I will read up about the gabapentin. Many thanks for your reply.

[dklohrey]

Alcohol is a trigger for RLS.

[Tanker1]

Its generally not recommended that alcohol be consumed with most drugs used to treat RLS/PLM but I do and have no issues. I also don't find alcohol to be a trigger although many do. I quit all drinking for a month and it made no difference to me. I use a sleep app to track my sleep and alcohol definitely reduces the quality so I have reduced consumption. Everyone is different in their response to medications, vices, and food.

[Fiojohn in reply to Tanker1]

Thanks- I really don’t miss alcohol and I’d rather not drink than have the restless legs but it would nice on holiday, especially on all inclusive holiday! Everyone with this condition seems to be different! F