4x25mgs capsules pregabalin v 100 mgs capsule.

[Medici]

I recently switched to pregabalin capsules 4 x 25mgs at night instead of 1 x 100mgs capsule , in preparation for reducing the dose, and increasing my Rotigotine patch from a 2mgs/24 hours patch to a 3mgs/24hrs patch because of side effects. I also take 25mgs pregabalin each morning. Since I did this about 3/12 ago, I have had a 99% reduction in my RLS/PLMD. I won’t question why but it’s a miracle.

[SueJohnson]

So did you reduce it?

[Medici in reply to SueJohnson]

No. I am still on 4x25mgs and 2mg patch at night. Also still on 25mgs each morning. I’m not going to rock the boat while all is so tranquil. On the 100mgs capsule I was having a lot of RLS and PLMD, and side effects. Don’t ask me how or why. I’m a nurse and sometimes things can’t be explained.

[SueJohnson in reply to Medici]

That is strange.

[thorp in reply to Medici]

I have also had major problems with some 100 mg capsules of pregabalin

I found out I was allergic to the SLS (Sodium Laurel Sulphate ) in the capsule cover

I switched back to two of my trusted Teva 50 mg capsules and the problems disappeared

[Medici in reply to thorp]

Yes it’s hard for others to get their heads round but as we prove it does happen.

[Joolsg]

Your profile mentions Ropinirole. Were you taking Ropinirole at the same time as pregabalin?Why are you reducing pregabalin?

Rotigitone patch is Ropinirole in patch form.

If you've increased from 2mg to 3mg patch, it will stop the RLS for a while but if you were on Ropinirole previously and it stopped working you should keep a careful eye on the patch.

Do not increase it if it stops working as that just increases the severity of RLS and it's more difficult to get off.

Read all you can about dopamine agonist augmentation and withdrawal.

[Medici in reply to Joolsg]

I never actually increased to the 3mgs patch as things changed drastically with the 4x 25mgs caps pregabalin. Can’t answer why!

[Joolsg in reply to Medici]

Better to stay on lowest patch dose possible. Often 2 meds work better than 1 so hopefully the pregabalin will keep RLS under control.Pregabalin doesn't work if you're suffering augmentation so if you were on Ropinirole and the RLS was severe and happening earlier in the evening, that's augmentation. Pregabalin only helps when your D1 dopamine receptors are not overstimulated.

If the patch stops working, stay on pregabalin and slowly reduce the Patch.

[Medici in reply to Joolsg]

Thank you very much Joolsg.

[Munroist]

I doesn’t make any sense does it? Is it the same brand of pregabalin? I found that the chemist couldn’t always get the right dose pill from the same manufacturer so occasionally they would change brand although I didn’t notice any difference.

[Medici in reply to Munroist]

I get different brands of various pills I take, but only ever had problems with the adhesive on Rotigotine patches from various countries in Europe. That includes before Brexit.

[Chiltrenrise]

That’s great news, it’s lovely to hear something positive. I have been prescribed pramipexole by my GP. I have raised my concerns about augmentation and he was dismissive, said that other drugs will have side affects. I have given up my job as a nurse due to sleep deprivation, it’s not a job you can do unless running on full steam.

[SueJohnson in reply to Chiltrenrise]

I notice you mention sertraline in your profile. It makes RLS worse for most people. An antidepressant that is safe for RLS is Trazodone or Wellbutrin. So is pramipexole no longer controlling your symptoms?

[Chiltrenrise in reply to SueJohnson]

Hi Sue, I was diagnosed with severe anxiety after months of sleep deprivation. They gave me sertraline which as you can imagine made everything worse. The symptoms were across my chest and into my left arm stopping me from sleeping. Sertraline made everything worse and my whole body was affected . It was by chance that I found this site when looking up RLS . I then read that it can affect your arms and torso. I asked the GP for something to help with RLS as they had moved me from Sertraline to antidepressant which did not help. I’m still taking pramipexole. It worked at first but I am waking in the night now with symptoms. I don’t want to increase the dose. I did read that drinking brandy before bed helps, so I tried it last night and it did help . Might just be a one off but I will give it another go . I’m in a better place now but need to get off pramipexole .

[SueJohnson in reply to Chiltrenrise]

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 may need a low dose opioid temporarily to help out with the symptoms especially as you near the end. But in the long run, you will be glad you came off it. Dopamine agonists like pramipexole are no longer the first line treatment for RLS. Gabapentin or pregabalin is. The beginning dose is usually 300 mg gabapentin (75 mg pregabalin). Start it 3 weeks before you are off pramipexole although it won't be fully effective until you are off it for several weeks. After that increase it by 100 mg (25 mg pregabalin) 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. (You don't need to split the doses with pregabalin) Most of the side effects of gabapentin or 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 1200 to 1800 mg of gabapentin (200 to 300 mg pregabalin) daily." 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 you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your ferritin to be over 100 and your transferrin saturation to be between 20 and 45. If your ferritin is less than 100 or your transferrin saturation is not between 20 and 45 post back here and we can give you some advice. 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...

[Medici]

You’re telling me. You certainly shouldn’t do nights as I did for a few years. You can actually get a medical exemption these days. Good luck.

[DTache]

I would make a response but every time I do in the past I have been criticized… Never experienced this in other blogs except this one… Too bad! Rude people!

[SueJohnson in reply to DTache]

I suspect you are confusing criticism with a correction of what you have said. People on this forum are not rude nor do they criticize people. They may express a different opinion. Please do reply.

[SueJohnson in reply to DTache]

And of course if you don't agree with the correction, you can always ask the person for the source.

[Medici in reply to DTache]

Have confidence. Your story is as relevant as anyone else’s. Most of us are very interested to hear it. That’s how experiences get battered around and end up with outcomes that many of us can relate to and benefit from. Just do it.