I have RLS and have been taking the hell tablet Pramipexole for over 20 years. I am now down to 2.5 tablets a day 0.088mg at night. I also take 20mg Oxycodone, one in the morning and one at night. My biggest problem at present is that at certain times of the day, I am fatigued to the point where I cannot walk up stairs or do any menial tasks. I do go to bed but have to get up with the RLS. At this point, I am in a daze or comma-like. My eyes are open but there is no one home. This can last for hours I just seem to lose consciousness.
At the moment life is not worth living and it's been going on for too long. I also take statins. My question is do I feel fatigued all the time because I am trying to come off pramipexole or is it the oxycodone. Before the Oxycodone I was taking codeine 30mg 20 tabs a day. About 4 months ago I was put on oxycodone instead of the codeine. Would I be better off coming off Oxycodone and going onto Bupenerole. If the answer is yes do the swap do I just stop the Oxycodone and go onto Bupenerole, what dose of bupenerole would I go onto? Would I feel more human and less fatigued? If anyone can give me any advice I would be very grateful. Thanks very much, JOE.
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Both withdrawal from pramipexole and opioids can cause fatigue although yours seems extreme. I would definitely see your doctor about it.
I can't find anything that says buprenorphine would be better than oxycodone for fatigue although it is possible I guess that one might affect you differently. If you do switch you would need to taper off the one while increasing the other.
Have you always been this fatigued while taking oxycodone? If not it is probably the withdrawal from pramipexole. In that case I would suggest you go back up to the last dose before you started having this extreme tiredness and reduce more slowly. you can get an inexpensive jewelry scale that measures down to .01 gram from Amazon ($11 in the US) and shave off a bit of the tablet and measure it. Then reduce by that amount every 2 weeks.
Also for the tiredness ask for adderal or ritalin and take it in the morning.
Hi JoeR. Don't despair you will get through it. Better days are coming. The good people in this forum will help you. I identify with your story. I was on Pramipexole for 20 years and stopped it. that was 2.5 years ago. After reading your post I went back and checked in my journal what I experienced. Exhaustion was a big struggle from the time I stopped Pramipexole and continued throughout the time I tried different meds. Like you, I had no energy to do anything - I was really very low. I am now on Tramadol and Pregabalin and they work. I have no rls at all. Recently all the exhaustion left and it was because someone on this forum said I needed to take Tramadol at regular intervals during the day. I had only been taking it once a day and was experiencing exhaustion and terrible nausea. When I started taking both Tramadol and Pregabalin 3 x daily, the exhaustion and Nausea stopped completely. The exhaustion was withdrawals that I was experiencing between doses. Once I took the Tramadol every 5 to 6 hours I felt massively better. I am not sure if this applies to your meds - someone else will need to advise you on that. I just wanted to share my story in case it may help. We all feel your pain. Hang in there - do not give way to despair. You WILL get through this even if it looks very bleak at the moment. Take care my friend.
going from Oxycodone to Buprenorphine is very tricky and you need to be under the guidance of a doctor that understands how to do it. Buprenorphine has a strong affinity for the mu receptors, so it will kick the Oxycodone in those receptors That could lead to acute withdrawal from the Oxy. Some Oxy will fill up any open mu receptors, but shouldn’t cause a major problem other than feeling more drugged. If you continue taking Oxycodone on top of the Bup and miss a dose or discontinue of Bup suddenly and open all the mu receptors, the Oxy could flood the receptors with too much Oxy and possibly cause overdose.
Please find a doctor that knows how to manage this.
It is devastating. In Australia it is difficult to get pain killers for RLS but the codeine has helped me. The main thing that has helped me though is the correlation between alkalinity and relief from RLS. I get a severe shut down when tired, cold to the bone, poor circulation, then the sweats, chronic hypothermia. Then the rls kicks in …. Today I laid down after lunch but …. No sooner asleep and off we go again. stress gets triggered then so much adrenalin, I can’t sleep even if I fix the rls with a strong alkaline drink, as I did today. 45 years of rls and none of the drugs helped me except the codeine. I’d give anything to kick that too though. One book I listened to recently, can’t find it atm. The dr said the rls is a symptom of stages in Epstein Barr virus and cleansing, cutting alcohol and all sugar would help. Makes a huge difference for me. If I eat sugars, my PH level drops a lot and I alkalise more. Good luck. Find what works for you. Kind Regards, Christine
The kind of fatigue you describe is the Devil's own work. I know too well that inability to put one foot in front of the other.
My research on Oxycodone indicates that it is, like other opiates, subject to The Law of Diminishing Return. In essence that means that you need more of the drug to maintain the body's physical and mental status quo in relation to it. In other words, the 20mg is not enough, your body wants more, and it lets you know by imposing the same or similar symptoms that you would experience during a withdrawal from it. You are physically dependent on it.
Have you timed those episodes of intense fatigue? I have, and the worst moments are around 4 hours after taking the Oxycodone when, presumably, it starts to saturate with its full effectiveness. I also find that about one and a half hours prior to the next dose, a similar thing happens.
There are questions being asked about the 'slow-release' action of this drug. Studies indicate that, for some people, one dose does not last until the next.
I think you should discuss this with your doctor. Don't just stop the Oxycodone and go onto Bupenerole. And don't cut the Oxycodone to reduce the dose - you probably know that it can potentiate the release of the drug to dangerous levels. If you are to stop the Oxy, your doctor will have to prescribe a lower dose (I take 10mg, but don't know if there is an even lower dose). There is of course also the quick-acting 'OxyNorm' liquid which acts within 20/30 minutes and wears off after around 3/4 hours.
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Replacement drug for oxycodone for RLS
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Tramadol and oxycodone
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Oxycodone 
