buphrenorphine dosage

[kmc12]

Hi everybody

can anyone advise me about what dose Buphrenorphine to ask my GP to prescribe for my RLS? I should add that I also take 1800 mg of Gabapentin for pain and 30 mg of Mirtazapine for sleep

I was taking quite a high dose of opioids for a few years (for pain ). but came off due to developing tolerance . During that period I didn't so much as have a twinge from my RLS

Thanks

Kath

[RiversW]

Hi Kath, there are many more people here that can give you a more educated answer than me but I will tell you my experience with Buprenorphine. I am in Brasil and only have access to the Bup patch. I wear a 7 day 20mg patch. So far it has succeeded in helping me withdraw from a dopamine agonist and keep the RLS monsters at bay. My only issue is the patch is only effective for about 5 days. On the 6th day the RLS starts to creep back in and keep me awake at night. I am experiencing some depression and insomnia but compared to the awful way I felt while taking Neupro and Pramipexole, these are side effects I am willing to deal with.

In the UK I believe you will have access to Buprenorphine in tablet form and will be able to better attenuate your effective dosage. This will certainly solve the problem of the patch losing effectiveness early. It may also help with the insomnia and depression issues since you should be able to find the smallest effective dose you need of Buprenorphine. As I said, where I live my choices are limited to the patch.

Best of luck to you. Rivers

[kmc12 in reply to RiversW]

Thank you so much Rivers W- as I said my GP will have to decide so the more information I have from fellow suffers and their experiences the better !👍. Thanks again

[Joolsg]

Hi Kath,I'm away at moment so will just reply quickly. Mirtazapine is a known trigger for RLS, so you should reduce it slowly and stop. As you are using it for sleep, you can ask your GP for an alternative medication- one that doesn't trigger RLS. Cannabis with THC can help insomnia.

I remember your RLS had improved on CBD oil and by raising your iron. What's your serum ferritin now?

Gabapentin is now first line treatment for RLS but I assume the reason you're asking about Buprenorphine is because you now have severe RLS again?

I wouldn't add any meds until after you have stopped Mirtazapine. Once you're off it for 4 or 5 weeks, if you still have refractory RLS, & the gabapentin isn't stopping it, you could ask for an iron infusion and if that doesn't help, then ask about Buprenorphine.

Many GPs are unable to prescribe it. If it's red listed in your area, only a specialist can prescribe and monitor Buprenorphine.

Finally, if your Specialist/GP agree to Buprenorphine, you should start with 0.2mg sub lingual pills and add 0.2mg each night until the RLS is covered.

Buprenorphine can cause severe nausea but zofran or medical cannabis will help.

[kmc12 in reply to Joolsg]

Joolsg Thanks for such a comprehensive and informative reply. I have been taking gabapentin and CBD oil but I suspect that they are aggravating my bowel disorder. I have been taking 30 mg Mirtazapine for nearly 10 years with no issues but as I say I was taking opioids as well which kept everything under control. I am having a blood test this week but may have to request one specifically to check serum ferritin. I was taking zofran with Duloxetine last year but my Doctors stopped it in January as it can cause heart issues and I have recently developed high blood pressure . I will discuss the situation with my Doctor . Thanks

[SueJohnson in reply to kmc12]

I assume you know to ask for a full iron panel. Stop taking any iron supplements including in a multivitamin 48 hours before the test, don't eat a heavy meat meal the night before and fast after midnight.

[kc1878 in reply to SueJohnson]

Thanks Sue 👍. I will follow your advice

[RLSofManyYears]

I started with 200ugm (0.2mg) Temgesic which gave me full nights sleep for 9 months. My RLS returned though and I had to up the dose. Currently I'm on 3 tablets a night 600ugm and 400mg Pregabalin with an average of 3.5 hours a night. I had upped the Temgesic to 4 tablets but my GP expressed his concerns about this long term for me and so I reduced to 3 tablets over 6 months.I hope this helps

[kmc12 in reply to RLSofManyYears]

Hello - another useful piece of info which I will ask my GP about - I did use Buphrenorphine patches for pain about 2 years ago but I would prefer tablets

[Simkin]

I am on 900mg gabapentin & buprenorphine sublingual 200mcg tablets.A successful dosage for me.

[kmc12 in reply to Simkin]

Thanks Simkin👍