Questions about Neupro

[Mikatrap]

Hello,

Is it fine to taper off Neupro (rotigotine) patches by cutting out pieces?

And what is the equivalent dose of Mirapexin extended release to a patch of Neupro 2mg ?

Thanks!

[DesertOasis]

I think you need to tell us how you’re feeling and what you’re taking right now besides Neupro.

[Mikatrap in reply to DesertOasis]

I feel better. My anxiety and pain attacks are much less severe since a few days, and I can manage them through respiration exercices.

I take each day 3x0.25 mg alprazolam, 1x0.5mg rivotril (before bed), 2x150mg pregabaline, 1x100 mg tramadol retard (before bed), and my Neupro 2mg patch.

My neurologist’s plan is to taper off Neupro by cutting 10% of the patch every two weeks, then to taper off benzo and tramadol, and to end up with a base RLS treatment of pregabaline or dypirimadole. But I read that you cannot cut a Neupro patch.

The equivalence question is pure curiosity. Before my DAWS, my DA dose was 0.26mg Mirapexin extended release per day. Now I’m at 2mg Neupro. Is it equivalent?

Thanks

[DesertOasis in reply to Mikatrap]

I think I speak for all of us when I say how wonderful it is you’re feeling better. I think we’ll all sleep better tonight knowing this. I will leave Sue and Jools to answer your questions about tapering. I’m a one trick pony - oral iron at night.

[Mikatrap in reply to DesertOasis]

Thanks a lot for the kind words!

[SueJohnson in reply to Mikatrap]

You can cut the patch. No it would be equivalent to 3/4 of your mirapex unless you consider that the ER is rally two times .26 regular mirapex in which case it would be equivalent to 1 and 1/2.

Good luck trying to cut the patch in tenths.

[Joolsg]

Yes you can cut the patches, even though the med leaflets and doctors say you can't.Many people on here have successfully reduced the patch by cutting it into quarters.

If possible, ask for 1mg patches x 2. It's easier to cut into 0.25mg.

The pregabalin won't help the RLS until around 3 weeks after you've stopped the Neupro patch, but it will help your anxiety as it's a sedating med.

[Merny5]

mikatrap, I’m so glad you are feeling better!! You certainly have had a difficult time. I know the manufacture indicates that you can’t cut the patches but I did and it worked out fine. It took me about 18 months to completely come off of the drug, but I was coming off of 9mg! I made a template and drew lines on my patches. I tried to make the cuts as accurate as possible. ( which I think is critical) At the end I was left with just slivers of the patch. In fact, most of the time it came off my skin and I needed to put tape over it to keep it in place. Just make sure you come off of it very slowly. Don’t worry about your doctor’s schedule for you. YOU need to listen to your body and make your own schedule. Your body will let you know when it’s time to reduce. Good luck and keep us posted as to your progress.

[SueJohnson in reply to Merny5]

That is a clever idea to draw lines on your patch.

[VanillaOatMilk]

I agree with Merny5. The manufacturer says no to cutting, but if you are careful, you can easily do this - and it works! Over the last 11 months I have come down from using a 3mg patch daily to currently 0.5mg, cutting the patches to make incremental doses that were approximately a 10% decrease each time. I used up the various strengths of patches I had left over from when my doc initially ramped up my dose. At one point, I needed more 2mg patches to get me through a span and my doctor was willing and able (insurance challenge) to get me more. Right now I’m easily cutting 2mg patches into quarters to get 0.5mg, but some of the other in-between doses are harder to figure out just how much square area is needed. I really honed my math skills during this time as I figured out how to cut up the different strength patches to get as close as possible to the dose I wanted.

The smallest time I spent at a dose was ~14 days, but often more. Whenever there were “stress” times in my life, personal things going on or just the holidays where I wanted to be my best, I would stay longer at a dose and then resume my taper afterwards.

I cover my patch with waterproof adhesive tape to ensure it doesn’t come off. Also, I cut the corners of the tape at an angle, so that the corners are less likely to get snagged on clothing and come loose.

I had started pregabalin before beginning the taper process. Starting that, or gabapentin, would be important to do before anyone starts getting off the patch.

Good luck!

[Caperry]

I have 2 mg Neupro patches and am successful at cutting them down, the 1 mg might be an easier choice but these patches are so expensive I could not afford buying double the amount ( whether it’s 4 mg or 1 mg )

They are the same price! Good luck