Which RLS medication also works with dialysis?

[MausePeter]

Hello everyone.

First of all, unfortunately I don't speak English and have to translate everything with Google first. I hope that I am still understandable.

I am 84 years old, have had RLS for a long time and have recently been on dialysis. Especially when dialysis is ongoing, my RLS symptoms become extremely severe after about two hours. Each dialysis lasts four hours. The remaining two hours are almost unbearable. On the other hand, I take pramipexole and would like to switch to another active ingredient because pramipexole is broken down by dialysis.

Can someone share their experiences with RLS and dialysis and give me some tips?

I am particularly interested in the question of whether there is an active ingredient against RLS that is broken down by the liver.

MausePeter

[SueJohnson]

This is really a question for your doctor. I can tell you from my research not to use opioids which are commonly used for RLS because there is an increased risk of death.

Also if you switch to ropinirole you should have a reduced dose. I don't recommend coming off pramipexole and switching to gabapentin or pregabalin as I don't know how dialysis affects them and you don't need the to undergo the withdrawal and it's symptoms you would experience with what you are going through now.

How much pramipexole are you taking? Perhaps you just need to increase it.

[SueJohnson]

Pramipexole is not significantly metabolized by the liver. It avoids potential interactions with agents that inhibit the CYP1A2 enzyme, such as ciprofloxacin.

Ropinirole is primarily metabolized by the liver through the CYP1A2 enzyme pathway

Gabapentin is not significantly metabolized by the liver. It is primarily excreted unchanged in the urine.

Pregabalin undergoes minimal hepatic metabolism, with most of it being excreted unchanged in the urine.

meded101.com/comparing-ropi...

[bumblebee_tuna]

I take Oxycodone 5mg, everything else had terrible side effects. I also take Clonidine, not sure how much it helps. Stay away from anything “extended release”.