ibuprofen & Pramipexole

[Millersman]

Nearly 3am and wondering why the Pramipexole is not working. Have just discovered that Ibuprofen renders Pramipexole ineffective and I took a couple of Ibuprofen as a pain killer. Will I ever get to sleep? Does the Ibuprofen wear off.? If/when it does, will the the pramipexole kick in or do I have to take more?

[SueJohnson]

I'm not sure where you found that ibuprofen interferes with pramipexole. Can you give me a source? Checking with drugs.com no interactions between the two were found. And Drugbank said " Ibuprofen may decrease the excretion rate of Pramipexole which could result in a higher serum level" so that would mean more pramipexole would be in your system. But of course everyone is different and everyone reacts to drugs differently.

Ibuprofen stays in your system for 4 to 6 hours so should be out of your system by now. Did you do anything different or take anything that might have triggered your RLS?

Do be aware of the symptoms of augmentation. The signs of augmentation are when you have to keep increasing your dose to get relief, or when your symptoms occur earlier in the day or there is a shorter period of rest or inactivity before symptoms start or when they move to other parts of your body (arms, trunk or face) or when the intensity of your symptoms worsen. If that happens, post here and we can give you some advice.

Have you had your ferritin checked? If so, what was it? Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. If not when you see your doctor ask for a full iron panel. Stop taking any iron supplements including multivitamins that have iron in them 48 hours before the test, don't eat a heavy meat meal the night before, fast after midnight and have your test in the morning before 9 am if possible. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you some advice.

Meanwhile some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, carbs, foods high in sodium, foods that cause inflammation, ice cream, eating late at night, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, stress and vigorous exercise. Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennel, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, CBD, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices, using a standing desk, listening to music, meditation and yoga.

Many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute.

[Millersman in reply to SueJohnson]

Many thanks Sue. This is the source ehealthme.com/drug-interact...

The survey quoted "drug ineffective" for people 60+ when used with Ibuprofen, that includes me. It definitely affected me and completely cancelled the effect of the Pramipexole. I spent most of the night walking round the living room.

I've taken Paracetamol with Pramipexole before, with no I'll effects.

Norman

[SueJohnson in reply to Millersman]

However see this site pharmacy-nutrition.usask.ca...

[RLSLearner]

Millersman, I dont think that should necessarily to be taken that ibuprofen makes Pramipexole ineffective. It is more that it was reported that the pramipexole did not work as well as wanted/usual when they happened to also take ibuprofen (but over what time period?). it could just be coincidence especially with something that is as variable as RLS. As Sue pointed out it is not a known interaction.

[Millersman in reply to RLSLearner]

I’ve been taking Pramipexole for a number of years now and have never known them not to work when taken correctly. In this instance, I took the Pramipexole at around 7 o’clock and the Ibuprofen around 10 o’clock. By 11pm when I was ready for bed, my legs were starting to jump when normally they would have been quiet. I tried 3 times to go to sleep, but it was impossible. At around 2am I remembered the Ibuprofen and searched for a connection with Pramipexole. That’s when I found the info contained in the link. It does say that rendering the RLS treatment ineffective occurs mainly in people of 60+ years, which includes me. I’m convinced that this is what caused the problem and I think it should be more widely known. Last night I took the Pramipexole as normal and everything was OK.

[Millersman in reply to RLSLearner]

You obviously haven't read the link, it is a known interaction. For my part, I shall never take Ibuprofen in the evening ever again. Being awake all night once is once too many.

[RLSLearner in reply to Millersman]

Yes, seen the link. eHealthme is a patient reported experience, anecdote. Need to be careful of the temporal cause-effect fallacy. Just because something happens after "X" does not mean "X" caused it. That is what a report on eHealthme is like. But if every time you take ibuprofen you get restless legs definitely dont take it. And report it to eHealthme. Once is anecdote, 10 is a series, 100 is evidence.

[Baz33]

Do not increase your pramiplexol

[RLSLearner]

So back to paracetamol then?

[Millersman in reply to RLSLearner]

Definitely!

[teakabeagle]

I take Pramipexole and do not find that Ibuprofen has affected its efficacy. I am 65 and take Ibuprofen a few times a month.

[RLSLearner in reply to teakabeagle]

I think it is going to be a very individual thing. Not something to be too worried about but useful to be aware off in case it affects you.