Please could you give me some advice, I was in hospital last week for 4 days and the Dr there has taken me of sifrol ( .125mcg ) I was in augmentation stage, instead he has put me on ........
Neupro/ rotigotine 2mg 24hrs patches, pregabalin 25mg 2 morn/ 4 night, tapendol SR 10mg night, and tapendol 10mg IR take when needed. will I get withdraw symtoms from stopping sifrol although I am on the patches? thank you in advan
ce.
It is slightly less than what you were taking so it is possible you may have a little withdrawal symptoms or you may not. However you will soon suffer augmentation again.
Do you want to come off it? If you do reply back here and I can give you some advice.
Yes Sue I would like to come off sifrol
Then I would go back on sifrol since it is easier to come off that than the patch.
But my first question before I give you advice is - you were taking .250 mg & 1/2 which would be .375 mg 23 days ago. How did you get down to .125? And why were you in the hospital?
Oh I'm so sorry Sue , but I am so confused, I'm afraid I have got myself in a bit of a state worring about it. yes you are right, I was taking point 375 mcg of sifrol. I really am so worried I don't know who to turn to here. I see my GP Wed 24 but I don't think he knows very much about RLS.
I was in hospital because I had a very bad reaction to paracetamol/ tramadol.
OK - go back on the .375 sifrol and in fact I would increase it to 3 tablets and let your symptoms settle for a day or two. Then to come off Sifrol, reduce by half of a .125 tablet every 2 weeks or so. You will have increased symptoms. You may need to reduce more slowly or with a smaller amount or you may be able to reduce more quickly. Wait until the increased symptoms from each reduction has settled before going to the next one. You will suffer and may need to increase your tapendol temporarily. But in the long run, you will be glad you came off it.
Ropinirole and pramipexole (sifrol) are no longer the first-line treatment for RLS, gabapentin or pregabalin are. They used to be the first-line treatment which is why so many doctors prescribed it but they are not uptodate on the current treatment recommendations. You are already on pregabalin. Stay at that dose until you are off sifrol for several weeks. After that increase it by 25 mg pregabalin at night only every couple of days until you find the dose that works for you. Take it 1-2 hours before bedtime as the peak plasma level is 2 hours. . According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 200 to 300 mg pregabalin." This would be at night. You can continue your other dose you take in the morning.
Check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it if needed as many doctors do not know much about RLS or are not uptodate on it as yours obviously isn't or s/he would never have prescribed a dopamine agonist at Https://mayoclinicproceedings.org/a...
Did your ever have your ferritin checked? If so what was it? Improving it to over 100 will help you come off the Sifrol.
Thank you Sue, I value your advice. will do as you advised, Dr in hospital checked my iron level, said it was ok , no need to take extra. will talk to GP on Wed about it all. I am going to ask to have a referral to see a neurologist,
Doctors will say your iron is fine but you need to ask specifically what your ferritin is as the normal iron tests do not test for it so it may not have even been tested. In any case what is fine for others is not fine for those of us with RLS. It needs to be above 100 so ask for the number. If it is not reply back here for some advice. Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms.
If it wasn't tested when you see your doctor ask for a full iron panel. Stop taking any iron supplements including in a multivitamin that has iron in it 48 hours before the test, don't eat a heavy meat meal the night before, fast after midnight and have your test in the morning before 9 am if possible.
That's good - neurologists are more likely to know more about RLS.
Thank you Sue, will do as advised. It is so good being able to talk to someone who understands what we are going thru and getting good advice.
Oh yes. Augmentation. It’s serious and long term with me. I’ve taken everything. Pregabalin was ghastly in that it scrambled my brain.
Oxford specialist recommende Rotigotine 3 mg one patch daily and Brunov (Bruphenophine ?) 10 mg weekly patches I had awful augmentation before this concoction. terrific. I hope it lasts with no augmentation but apparently the dose can be higher. Now very good and I sleep deeply Has not been easy before these drugs. I wish you well
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