How to use Buprenorphine?

[libraryannie]

I have been on Mirapex/Pramipexole for over 25 years. My dosages were increased way beyond today’s acceptable limits. I have been able to wean myself down to .5mg which I have been on the past 3 years. My obsessive behavior is online shopping. But I believe it also has affected my relationships with my family as well. I will get an idea in my head and have to act on it RIGHT NOW! I would love to part ways with this medication.

I have not been on this site for a while and I am now reading about the success members have had with Buprenorphine. If you have had been taking it, will you please tell me your experiences or copy me on your success stories.

I also have questions:

1. Can I quit M/P cold turkey if I start on Buprenorphine?

2. What is most successful way of transitioning to Buprenorphine?

3. Do you recommend the patch or the wafer? (restless legs & arms affect me mostly in the evening and bed time. Every once in a while in the afternoon)

4. What are the dosage options?

5. What dosage do you recommend starting with?

6. What are the best articles and arguments I can take to my doctor?

Thank you,

Beth

[SueJohnson]

Others can give you advice on Buprenorphine as I have no experience with it but absolutely do not quit pramipexole cold turkey. To come off pramipexole, reduce by .125 mg every 2 weeks or so. You will have increased symptoms. You may need to reduce more slowly or with a smaller amount. Wait until the increased symptoms from each reduction has settled before going to the next one. You will suffer and the Buprenorphine may help out with the symptoms especially as you near the end. But in the long run, you will be glad you came off it. Have you thought about taking gabapentin or pregabalin which is now the first line treatment for RLS? 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 or s/he would never have prescribed a dopamine agonist at Https://mayoclinicproceedings.org/a...

[SueJohnson]

The Mayo Clinic Algorithm also has suggested amounts for Buprenorphine and you could print out the appropriate section to show to your doctor.

[libraryannie in reply to SueJohnson]

Thank you

[Typicallygaslit in reply to SueJohnson]

I didn’t see anything about Bupophrenine in the article. I took screen shots from the Johns Hopkins video about opioids and RLS.

[SueJohnson in reply to Typicallygaslit]

See Table 4 in the Mayo Algorithm. Buprenorphine hydrochloride/naloxone (sublingual film or tablet) 0.5-1 mg (starting dose) 0.5-6 mg (usual effective dose).

[Typicallygaslit in reply to SueJohnson]

Ok, thanks, I saw it now, that’s good coz I didn’t think it was in there.

[Joolsg]

Sue has given great advice to slowly get off Pramipexole.I am on Buprenorphine but didn't use it to transition off Pramipexole. I know some on here have used Buprenorphine before dropping the last dose of Pramipexole and it seemed to stop the awful withdrawal symptoms that most of us go through for 2 or 3 weeks.

I take the Buprenorphine pill. I cut a 0.4mg in half and take 0.2mg at 10pm and 0.2mg at midnight.

Start low with 0.2mg and titrate slowly to the dose that covers symptoms. Average is around 0.6mg but many do well on lower doses.

Mayo algorithm is probably best article to show your doctors and Dr. Winkelman's opioid study.

[LotteM]

I second Joolsg's reply. My experience is more or less the same. If you get that route, reassess your dose once a few weeks or months when completely off the pramipexole. When withdrawal effects have settled, you may be able to get by with a lower dose. And the lowest effective dose is always the best.

I am now on a 5 mcg/h patch, but started out with 0.2-0.4mg Temgesic. Worked well apart from end of dose rebound effects in the morning and -again- midday and late afternoon, whereas my symptoms used to be evening/night only. But if you don't experience such rebound-like effects, sublingual Temgesic would be better, I think. Allows for more adjustment.

[grant5555]

Hello please please please don't take your first buprenorphine dose in till your body is clear of any opioidAnd I mean CLEAR for example maybe even 4/5 days inbetween

If you have opioid in your system when you take it after 20 mins your going to arrive in he'll. Think worse rattle ever then × by 50 honest

It's called persifitated withdrawal or something

Be carefull