I’ve been using oxycodone to control my RLS and help me sleep for around 2 years. Recently because of some severe stress in my life and an element of increased tolerance the dosage has crept up to 25mg mostly taken before bed. I think it is time to at least take a rest from this drug and try something new.
I have briefly tried Gabapentin before and did not like the side effects so thought I would try Pregabalin.
Can anyone advise on how best to make the switch?
Regards Covenant
Taper off the oxy slowly with frequent doctor check in. See how it goes. Gabapentin can often amplify an opiod effect. So you need to see how you specifically react to taking both at the same time if that what the doctor advises.
I take OXYCONTIN for my RLS and it is smart of you to have the self awareness to understand that usage has the potential to snowball. All of us who take opiods for RLS but also suffer from anxiety and depression have to be extra careful. Opiods work very well on emotional pain as well, and can be very enticing to use as a means to feel better when life hits you hard.
Also check to see if your diet has changed or you've added any meds or supplements. Often something on the RLS naughty list can overpower your medication relief.
Many thanks Ziggy
I can’t comment on coming off oxycodone but as far as starting pregabalin is concerned I started on 150mg a day which had a mild effect and after two weeks went up another 150mg to 300mg where the effect was more consistent. I was told that there would be a gradual build up of effects both beneficial and also side effects which might appear a few days after starting. I had only a couple of side effects and nothing serious.
Useful info Munorist, thanks for taking the time
Just wondering how Oxycodone helps with RLS, does it make you just sleep thru the urge to move?
On Pregabalin, the usual starting dose is 75 mg. It will take 3 weeks to be fully effective. After that increase it by 25 mg every couple of days until you find the dose that works for you. Take it 1-2 hours before bedtime. If you take magnesium take it at least 3 hours before the pregabalin as it interferes with its absorption. Most of the side effects of pregabalin 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 200 to 300 mg pregabalin) daily."
Many thanks Sue, can I assume that I can continue to taper off Oxynorm at the same time as taking the Pregabalin?
Yes
Check with your doctor. When taking together there are risks.
Have you had your ferritin tested? Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. When you see your doctor ask for a full iron panel. Stop taking any iron supplements 48 hours before the test, fast after midnight and have your test in the morning when your ferritin is lowest. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not , post them here and we can give you advice. When you get your results, if your ferritin is not over 100, post them here and we can give you advice.
Iron panel all exceed your guidelines thanks Sue
Pregabalin is in the same class as gabapentin. My sleep doctor advised against pregabslin because I had a severe reaction to gabapentin. I wouldn’t touch it
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Oxycodone
Pramipexole to Pregabalin 
