Hi Sue

[Dexterruf]

I take 1200 mg gabapentin but in bed, 600mg getting into bed, and then 600mg in the middle of the night. This is partly because I have mild ADHD and am quite forgetful. But I don't suffer from RLS anything like some of the poor folk on here. Also I take the following supplements . 1g of vit c. 300 mg of magnesium citrate. 500mg of tumeric root extract ( anti inflammation and arthritis). 200mg of B6. 1300mg of pure fish oil supplements. A quality multivitamin. 100mg of coQ10. I've also recently started on a low dose of blood pressure pills and a statin. And yes I rattle... Phillip Samuels England

[SueJohnson]

Unfortunately statins make RLS worse for most people. Nexlizet is a cholesterol lowering drug that is not a statin, but I don’t know if it exacerbates RLS symptoms. Ezetimibe (Zetia) - reduces cholesterol although It doesn't reduce cholesterol as fast as the statins, but according to Chris Columbus it didn't trigger his RLS although the FDA does show increases RLS for some people and then there is Triglide which seems safe. You might want to discuss these with your doctor. A more difficult way to reduce cholesterol is to go vegan. My husband lowered his cholesterol from 221 to 131 this way.

[SueJohnson]

I see in a previous post that you said gabapentin was becoming ineffective. You may not be taking enough of it. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily." Ask your doctor for 100 mg capsules and increase it by 100 mg every couple of days until you find the dose that works for you. Take 600 mg 1-2 hours before bedtime. Don't wait until you wake up in the middle of the night for the second 600 mg. Instead take it 4 hours before bedtime as it is not as well absorbed above 600 mg. Since you need more than 1200 mg, take the extra 6 hours before bedtime. Take your magnesium at least 3 hours before or after gabapentin as it interferes with the absorption of them. Since you are forgetful, you can either set alarms so you remember to take your gabapentin or you can switch to pregabalin which you can take all at one time 1 to 2 hours before bedtime. The equivalent dose to 1200 mg is 200 mg. and you would increase by 25 mg every couple of days.

Have you had your ferritin tested? If so what was it? Increasing it to 100 or more reduces symptoms in 60% of people.

[jilk in reply to SueJohnson]

thank you for your sharing of your knowledge about coming of siferol, i will take it up with my Doctor. I got mustard while in a meditation , than googled (mustard and RLS) and some peolple have benefitted. I think I will wait until I have a really bed night and try it then. maybe?

[Zorko in reply to SueJohnson]

Thank you for your advise it is do helpful. I have just recently started gabapentin. My doctor gave me 100mg a day did not help I have increased to 200mg x3 at night dud not help at first but now last few nights have been good sometimes I have take panadeine forte as well. My RLS is chronic I never get to bed they start around 8 - 9pm with crawling sensations and PLM as well and I have to continually walk until 3-4 am this happens 3-4 nights a week when medication is not working. But you mentioned blood pressure tablets can make them worse, I am taking Irbesartan 300mg a day.Thank you for help. Zorko

[SueJohnson in reply to Zorko]

I haven't found anything to indicate that it would make RLS worse.

[SueJohnson]

What blood pressure pills are you taking as many of them also make RLS worse?

[Dexterruf in reply to SueJohnson]

Amiodipine

[SueJohnson in reply to Dexterruf]

That is a calcium channel blocker which makes RLS worse foe most. See my post today on clonidine and discuss changing to that with your doctor.

[ChrisColumbus]

As Sue says: statins make RLS worse for most [including me, although some say that statins don't affect them. For me atorvastatin (Lipitor) was the worst, rosuvastatin (Crestor) not so bad].

Again as Sue said, I now take 10mg ezetimibe (Ezetrol; Zetia is a US brand) instead and while it doesn't trigger my RLS at all it apparently does for some. (Although there may be some confusion here, as ezetimibe is often packaged - particularly in the US - with one of three statins).

Nexlizet which Sue mentions as a possible alternative is a US brand name for a combination of bempedoic acid and ezetimibe. A UK brand is Nustendi; initially I'd try ezetimibe alone rather than introduce yet another drug (if you can get it prescribed, as you'll find that many doctors will stick with statins no matter what: they either don't know or don't care about RLS).

As far as blood pressure meds go, I take 25mg losartan (Cozaar); Sue will advise that this will trigger RLS in some or most, but it doesn't for me.

There are few absolutes in RLS: as we often say, we're all different and react differently to the same meds. It can also depend on the strength of the drug and its interaction with other meds.

[Dexterruf in reply to ChrisColumbus]

Thank you Chris. Really helpful.