Changing Medication

[Felixstowe]

Hi

I’m just looking for some advice on Targinact and just Oxycodone please. My neurologist wrote to my GP requesting that I be prescribed Targinact 10mg at night and 5mg mornings increasing if necessary by 5mg increments to maximum of 20mg twice a day, also changing the Venlafaxine I take to either Bupropion or Tazadone. Also to refer me to him on NHS.

My GP will not prescribe Targinact although licensed for RLS the costs are too high (they are expensive compared) .

My GP appeared unhappy that I had been proactive in trying to get off Pramipexole etc. anyway he will prescribe Oxycodone but at 5mg at night, he says this is equivalent to the dose suggested by Neurologist as the naloxone in Targinact reduce the Oxycodone. I know from looking it up it does prevent it adhering to certain opioid receptors in the gut but can’t find anywhere a comparable dose of Oxycodone alone.

Lastly GP when I mentioned that the neurologist had asked for me to be referred to him on NHS actually said “you’ve seen him now and he’s sorted your medication why do you need to be referred, there’s nothing else he can do”? Honestly I couldn’t believe my ears, all I could reply was this is the first stage and there are other things that may be appropriate. He finally agreed but when that will be is anyone’s guess bearing in mind he has had the request since the middle of February.

I’m sorry for such a long post but I feel my GP is still totally ignorant of RLS and unwilling to learn, this is the one who left me with no medication for 2 weeks (without any mention to me) because he was unwilling to prescribe what my sleep consultant had asked him to and I only sorted this out with a formal complaint.

In case my actual question has been lost amongst my explanations it is;

Does anyone know comparable dose of Oxycodone alone to Targinact or where I could possibly find this out?

Thank you in advance for wading through this. X

[Joolsg]

Your GP is talking utter nonsense.The naloxone in Targinact is there specifically to reduce absorption in the gut and to help prevent constipation.

nhs.uk/medicines/oxycodone/....

Seriously, what do they teach medical students these days!!! I am horrified.

I do think you need to make a complaint to the GMC and the RCGPs because the advice is totally incorrect and ignores the recommendation from the specialist.

I understand refusing Targinact on cost grounds, that's 'acceptable'. But 10mg of Targinact is the same active ingredient of Oxycontin as 10mg of Oxycontin!!!

If the specialist has advised you start on 10mg targinact and increase to 20mg, then the GP should listen and prescribe 10mg plain Oxycontin at night an another 10mg Oxycontin for the morning.

Oxycontin has to be taken regularly o er 24 hours to avoid mini opiod withdrawals. The medication leaflet advises every 12 hours, which does work well for many. Others need to take it every 6 hours.

medicines.org.uk/emc/produc...

The last link confirms Targinact contains the SAME analgesic properties as Oxycontin.

Send it to your GP and copy in the specialist.

I honestly despair.

[Felixstowe in reply to Joolsg]

Thank you so much Joolsg, I thought he was talking hogwash. I will certainly complain and I’ll copy in my Neurologist. Xx

[Jumpey in reply to Joolsg]

Great advice from Jools. Can you change gp? Good luck.

[Felixstowe in reply to Jumpey]

Hi Jumpey, thank you! I’m pretty rural so difficult, but have our house up for sale, hoping to move area completely. 🤞it sells before too long.

[Jumpey in reply to Felixstowe]

Hope your move goes well and you can find a better doctor.

[wildlegs]

I guess I'm the wrong person to reply but I've been on pramipexel and tramadol for three years now and works quite well. I've had RLS for 25÷ years now and the combo of the two works for me.

[Felixstowe in reply to wildlegs]

Never a wrong person to reply wildlegs. Actually I’m pleased that combo works for you. I am also taking Pramipexole 0.18mg X 2 and Tramadol 100mg X 2 but this is becoming ineffective and with side effects from Pramipexole I need to change the meds. Also I’m 3 weeks post total left hip replacement and that has sent my legs (arms & back sometimes) into the stratosphere. I actually had to discharge myself from Hospital the evening following surgery in the morning because they were telling me I had to stay in bed despite me explaining about RLS. The same thing happened 15 months ago when I had the right one done. That was a really traumatic experience. The staff refused to even put the sides of the bed down so I was stuck in one position. The surgeon had already confirmed I could mobilise as soon as I felt able. Both times I ensured that my RLS was noted at my pre op assessment. Thank goodness my husband stayed with me this time and was able to back me up and help me dress etc. Last time he had gone home as had no idea there would be a problem. I called him to come and pick me up which he did but the staff were actually trying to physically prevent me leaving, I was surrounded by 5 nurses all shouting at me. I remained quiet but firm and had to start videoing them to make them leave me alone. I was truly frightened, I thought they were going to try and section me, 5 against 1 is not good odds. Just another example of absolute ignorance regarding RLS in the medical profession. Sorry to go off on a tangent.

[wildlegs in reply to Felixstowe]

Sorry it's happening to you. I'm an 80 year old guy in wisconsin. I've been taking tramadol for 10+ years but all of a sudden they won't give me more. I take 100 MG and I asked for another 50 but won't do. So they gave pram. 1 MG instead. It woks OK but know I'm worried about side effects.

[Felixstowe in reply to wildlegs]

For me personally, the side effects from Pramipexole far outweigh any possible side effects from opioids. To me that seems like a high dose of Pramipexole.

Society’s obsession with opioids caused by a few who misused them means so many people suffer unnecessarily.

My GP tried to warn me about possible addiction to opioids, yet has never once mentioned side effects from Pramipexole. My answer to him was how long have I been taking, prescribed by you Tramadol? Have I ever shown any signs of addiction, increasing my dosage etc. he shut up then.

I pray you keep getting relief.