I thought with taking 2 x 2mg tablet dosage it wasn't enough but if I take one at 4pm and one at 8.30pm it gets me through the night and until 4pm next day. I do find they upset my stomach if empty so I take some snack 30 mins before I take the first tablet. I had symptoms during the day but find if I keep moving it's not a problem.Hope this helps.
Veneer.
You have split the dose of Ropinirole, which is actually recommended in the Mayo Clinic Algorithm to avoid worsening of RLS caused by Ropinirole (augmentation).If you start to experience afternoon RLS, from 4pm onwards, that would indicate you are in augmentation.
Have a look at the definition.
You are on a very high dose of Ropinirole. 4mg is listed as the maximum dose BUT, most RLS experts feel strongly that the max dose should be 0.5-1mg because of the very high rate of drug induced worsening.
I suggest you read the articles on augmentation and RLS treatment and consider whether you are affected. I think you are. In which case, a slow reduction by 0.25mg every 2 weeks is needed with the help.of a low dose opioid or medical cannabis to help you through the withdrawal. RLS flares up and becomes more severe as you drop each dose. It then settles and you drop the next dose.
rls-uk.org/augmentation-reb...
mayoclinicproceedings.org/a...
Thanks for the reply, so your suggesting I come off Ropinirole I assume and what's the alternative other than Gaberpentin?
You should first ensure serum ferritin levels are above recommended levels by oral iron supplements or iron infusion.Raising ferritin can sometimes completely resolve RLS but most people will need to continue taking meds for life.
After augmentation in DAs, pregabalin or gabapentin are the usual meds. If your RLS doesn't improve/settle on these drugs, low dose opioids like oxycodone or Buprenorphine work well for most.
Currently going through to check on my ferritin levels.
You said it was 61. I may have told you this before but in case I didn't. Take your iron tables with 100 mg of vitamin C or some orange juice since that helps its absorption. Take it every other day at least 1 hour before a meal or coffee or tea and at least 2 hours after a meal or coffee or tea since iron is absorbed better on an empty stomach and the tannins in coffee and tea limit absorption. When your ferritin becomes between 75 and 100 or if your transferrin saturation was below 20, you may need an iron infusion since iron isn't absorbed as well above 75. If you take magnesium or calcium take them at least 2 hours apart since they interfere with the absorption of iron. Don't take tumeric as it can interfere with the absorption of iron or at least take it in the morning if you take your iron at night. Also antacids interfere with the absorption so should be taken at least 4 hours before the iron or at least 2 hours after. If you take thyroid medicine don't take it within 4 hours. It takes several months for the iron tablets or iron infusion to slowly raise your ferritin. Ask for a new blood test after after 3 months since you are taking iron tablets.
I remember you had a side effect you couldn't live with on gabapentin, but you might want to try pregabalin. Although they are basically the same drug except you don't need to divide the doses, and the side effects are basically the same, some people find that the side effects that bother them on one don't bother them on the other. If you take magnesium don't take it within 3 hours of the pregabalin. If you take calcium don't take it within 2 hours.
Hi Sue,I'd rather not try this if it has the same effect causing a low labedo!
I assume you would know fairly quickly and then you could come off it. Nothing ventured, nothing gained. Or just go with an opioid.
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