ADVICE PLEASE asap: If I take 10mg of... - Restless Legs Syn...

Restless Legs Syndrome

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ADVICE PLEASE asap

Retiredlady profile image
14 Replies

If I take 10mg of zolpidem when I go to bed, is it safe to take 30mg codeine if I wake in the middle of the night with RLS symptoms.

Have googled drug.com and see a MAJOR interaction so am worried about taking both.

My sleep specialist who prescribed them never gave me any advice.

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Retiredlady profile image
Retiredlady
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14 Replies
Joolsg profile image
Joolsg

The general advice is not to take sleeping pills with opioids as there is a risk of respiratory depression.Usually, zolpidem is prescribed for occasional use, not every night. It loses effectiveness if used every night.

Do you use it for insomnia OR RLS? It isn't very effective for RLS.

You might be better taking codeine every night for the RLS and only occasionally use Zolpidem.

Retiredlady profile image
Retiredlady in reply toJoolsg

Thank u so much for your prompt reply.

I haven’t taken zolpidem at all yet.. was only prescribed this week.

I understand that I should only take it occasionally but last night only managed a couple of hour sleep so feeling very exhausted tonight and desperate for some sleep tonight as I need to babysit tomorrow!

I always wake with RLS symptoms which r only relieved with 45mg codeine.

Thinking that maybe I should, to be safe, just take my codeine when needed and forget about the zolpidem tonight???

Retiredlady profile image
Retiredlady in reply toJoolsg

R u advising NOT to take sleeping pills the same night as zolpidem or clonazepam.??

Joolsg profile image
Joolsg in reply toRetiredlady

Sorry for the late response. I think it's actually safe to take a zolpidem with codeine if you don't have any respiratory issues. However, as with all meds, we all react differently. I used to take zolpidem twice a week when on 25mg of Oxycontin and 150mg pregabalin.

It is also stated that opioids and pregabalin/gababentin should not be taken together for the same reason - respiratory depression. However, many experts do prescribe them both and the vast majority do not have any issues.

Zolpidem does not stop breakthrough RLS though. So if you take it hoping to sleep through your usual RLS, I doubt that will happen and you will just be groggy when you have to take the codeine.

I see that you're suffering withdrawal from Sifrol and that is why you are being woken every night.

As you're down to the last 0.125 pill, you could just stop and go straight into the 2 week final withdrawal stage BUT you won't get any sleep for around 3 days and the RLS will be very, very severe. Ideally, you should start your replacement meds 3 weeks before the last dose of Sifrol. So consider an appointment with your doctor to discuss replacement meds like pregabalin or a low dose opioid.

Retiredlady profile image
Retiredlady in reply toJoolsg

When I am finally off sifrol,do I replace the codeine with different low dose opioids (replacement meds) temgesic or methadone? 45mgCodeine/Paracetamol is giving me 2-3 hours relief max.

Joolsg profile image
Joolsg in reply toRetiredlady

That's normal during withdrawal.Usually, pregabalin or gabapentin are the meds prescribed after dopamine agonists but you can go straight onto opioids if your doctors are in agreement.

You may find codeine is sufficient.

Usually, it takes around 2 months after withdrawal for RLS to settle sufficiently to establish which meds will help.

It's trial and error.

Madlegs1 profile image
Madlegs1

Clonazepam and zolpidem are both sleeping pills.

The codeine on its own should sort the RLS , unless you have taken any triggers,( and there is a host possibilities here. Keep a diary.)

You could take a sleeping pill together with codeine --- as long as you are medically allowed to. Respiratory issues.

Retiredlady profile image
Retiredlady in reply toMadlegs1

Sleep specialist who prescribed these meds never gave me any advice..hence the reason for my postIf If I take the codeine( (45mg! when I go to bed, I ALWAYS need another at about 2am as it has such a short half life!

I am going to ask my sleep specialist for Temgesic .. fingers crossed he will agree.

Madlegs1 profile image
Madlegs1 in reply toRetiredlady

You could try taking paracetamol with the codeine. About 250 or 500 mg . That will boost the efficacy.

Retiredlady profile image
Retiredlady in reply toMadlegs1

Thanks Joolsg and Madlegs.

The support I receive from this forum is amazing.. it really helps me cope.

Friends and family listen to us but have absolutely no idea of the amount of suffering we go through.

I get embarrassed talking about it as they just don’t understand why we can’t rest even when exhausted !

In answer to your question.. yes, I do take Panadol with my codeine.Here in Australia it’s called Panadeine Forte.

Seem to be going through a rough patch at present as I TRY to wean off sifrol.

I gave up for a few months but have started back on that bumpy road once again..I have been tempted numerous times to give up and increase my sifrol dose just to get some temporary relief but thank goodness I haven’t.

I am concerned though that I am needing to take more and more codeine as my sifrol works less and less and I have symptoms almost 24/7.

I am now needing 3 panadeine forte(each pill has 30mg codeine and 500 mg Panadol) over 24hours.

I am down to three quarters of a .135mg sifrol which I am reducing by a quarter every month.Do u think I am reducing too slowly thus prolonging my agony?

NJB71 profile image
NJB71 in reply toMadlegs1

Clonazepam is not a sleeping pill. It is a benzodiazepine which is used to control seizures or fits brought on by epilepsy, panic disorder and sometimes restless leg syndrome.

It works by increasing the levels of a calming chemical in your brain called gamma-aminobutyric acid (GABA). This can relieve anxiety, stop seizures and fits or relax tense muscles.

One of the side effects is, however, drowsiness.

Drs do sometimes prescribe these together with Pregabalin, and codeine, but under strict supervision. Every patient is different and only drs know what the individual patient should or should not tolerate, according to other existing conditions.

Madlegs1 profile image
Madlegs1 in reply toNJB71

Thankyou for the clarification.

"Clonazepam belongs to a class of medications known as benzodiazepines. It can be used for short-term treatment of insomnia (difficulty sleeping), anxiety or panic."

From internet.

Retiredlady profile image
Retiredlady in reply toNJB71

Yes, my sleep specialist prescribed clonazepam as I begged him to give me something to help me get a reasonable nights sleep.

He assured me it would help with my RLS as well but I find on the occasional night that I take it I still wake 2-3 times and try to postpone taking codeine until 5am.I am aware that clonazepam has a long half life and therefore stays in my system for quite a long time.

I have only ever had zoom appointments with this specialist.He does not know I have fluctuations in blood pressure and AF.He never warned me about taking the 2 drugs together…I have decided to be cautious and NOT take them together.

in reply toRetiredlady

You have good reason to be cautious. Combining benzodiazepines and opioids is not generally recommended. I always double check drug interactions with the pharmacist as i always find them to be more helpful in this regard.

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