Pramipexole (Mirapex) Extended release

[RestlessC]

Hello all - Am just wondering what people here may know about taking Mirapex - extended release for R.L.S. I know nothing about it really, but as someone trying to cut down from my very high dose of the regular version, it seems like such a good idea! I have cut down from 1.5 mg. to .875 mg. with few problems until now. But seem to be stalled here, having difficulty making it through the night, My feeling is that if I could just take one of the extended ones to get through the night with a decent amount of sleep, then maybe I could make it through the daytime just by moving around and not sitting down for too long at any given time (or if not, take another .125 mg. regular dose...)? There is apparently a .375 mg. tablet, however I'm not really sure if it's readily available here, and if one could combine both types. It seems to me I saw somewhere that the extended release ones were not recommended for R.L.S. Does anybody have any more reliable information than I do?

[Joolsg]

The extended release cannot be cut and is much harder to get off so avoid!Sadly, when getting off Pramipexole, you will have many sleepless nights.

The usual method is to cut the tablets and reduce by half a 0.125 tablet every 2 to 3 weeks while at the same time slowly starting to increase gabapentin or pregabalin.

Very few people have an easy time.

If you can find a doctor who knows about RLS, that would be helpful as they could prescribe an opioid to ease the withdrawal symptoms. Tramadol or Oxycontin are the most commonly used.

Some doctors in the USA prescribe methadone or Buprenorphine and that seems to ease most withdrawal and works very well after to control RLS.

I used cannabis to get through withdrawal so you could try that.

Go slowly and consider taking legal advice as 1.5mg of Mirapex is 3 times the maximum dose. No wonder you are having such a hellish time.

Make sure your serum ferritin is above 100, preferably 300 as that can help to ease the augmentation and withdrawal symptoms.

[RestlessC in reply to Joolsg]

Right! I know I'm way above (now! - as of seeing your comments about a month ago where you asked someone if 1 mg. was a typo and later said that it was harder to get off than heroin or crystal meth!! ) For which, Thanks! That is why I'm now doing this. Have been taking a tramadol here and there but I think I'm going to explore the cannabis. I think it was you who smokes it without tobacco - in a pipe of sorts? Correct? If so, is that not even harder on one's lungs than mixed with tobacco? I don't really want to do either, but guess I'd try to take it that way if it's the best method of getting it into your system - once I find the right thing to take. Anyway, it was just a thought I had in the middle of the night that if an extended pramipexole could just help me get through the night, then by taking less during the day, I'd be able to cut down my daily intake overall. No simple answers though, I guess!

[Joolsg in reply to RestlessC]

I used cannabis cigarettes for 4 weeks during withdrawal. I'm not a smoker but I would have done anything to stop the horrendous withdrawal sensations. You can buy vape machines which cool the cannabis smoke. They are easier on the lungs.The extended prami will just prolong the suffering so I would avoid it. Slow down the withdrawal if it's getting too difficult. Start again when it settles.

I wish there were an easy method. I read recently that someone had visited a compounding pharmacist who converted their Pramipexole to a liquid formula and they could reduce by tiny amounts every week. It took 12 months or more but it stopped the withdrawal symptoms. I have no idea where you would find a compounding pharmacist!

Experts recommend taking at least a year to reduce if you're on a very high dose like you.

You will get off it and your RLS will be so much better.

[Felicity21]

Hi there, I am on Prolonged Release Mirapex (0.26 mg) and have been for 2 years now. I supplement it with 2 co-dydramol (10/500) and 0.5 mg of Clonazepam and I generally get a good night sleep. This combination seems to work quite well. I also take Senekot to prevent constipation. Although I still get restless in the evening I do not intend to increase the dose. I am just very careful with what I eat. My triggers are grapes, raisins, apples, pears, banana’s, melon, strawberries, onions, garlic, margarine and mayonnaise, sweeteners and preservatives. The list is endless, and sometimes difficult to avoid stuff. When I get restless, I either go on my indoor bike and/or play scrabble on my iPad. Something to distract me and wear me out. The big thing for me is that I intend to stay away from medications which contain a higher dose morphine such as Methadone or Buprenorphine. I came off Dopamine Agonists 2 years ago and went onto Gabapentin but that did not help me at all so now I am back on this prolonged release Mirapex and the important thing is not to increase it. Good luck. We are all different.

[RestlessC]

Thanks! Hard to know what to do. Though it does seem to be that the extended release Mirapex may not be available to me here, and I believe somebody here did mention that it is rven harder to get off than the regular Mirapex. Perhaps if, as I am cutting back on the Mirapex, I can transition to the extended release Gabapentin (and it works for me) that it would be a better direction to me to follow. Should probably look into diet implications too. I’m sure there are a lot of improvements I could make in that area.