Dosage

[SurvivorD]

I am in the process of going off Pexola. I am now down to 0.25mg from 1mg. Not an easy journey!!! I had a consultation with a new doctor and she was honest enough to admit she wasn't very clued up on RL but said she would do some research and give me a call in a few days. In the meantime I have been prescribed Lyrica 25mg (did try before on a higher dose) and Vitb6 until I see her again. Could you perhaps advise if I can take all three at night and if I should take them at intervals and if so how?? Thank you kindly for your time

[Madlegs1]

Pexola is Pramipexol.

You are right to be getting off it.

Very slowly and by as small amounts as possible. Let your body tell you the rate. It can take months.

Do read up " Related posts" on this page.

Lyrica / Pregabalin is a good alternative for the treatment of RLS. In some countries it is quite expensive and so Gabapentin may be an acceptable alternative.

Both have side effects. And neither will help with the withdrawals you will experience from reducing the pexola.

As you come to the end of reducing, you should ask for a low strength opioid such as tramadol. Codeine wont cut it.

There are plenty of posts concerning your exact situation, so a good idea to search for them using the button on this page.

All the best.

[SurvivorD in reply to Madlegs1]

Thank you for the advice. Will still take the 0.25mg Pexola for another few days and then I think it's time to "bite the bullet" and stop the Pexola. I am going through hell as it is might as well "get it over once and for all" . Just a quick question.......I have hereditary heart disease and had a bypass 6 years ago. Would you know if Lyrica affects the heart?

[Madlegs1 in reply to SurvivorD]

Fair enough!!

But don't feel a failure if you are unable to cope.

Just go back up a step and let your body adjust.

[ChrisColumbus]

You were on a high dose of pramipexole (Pexola): according to the Mayo Algorithm (the RLS 'bible') "the acceptable maximum daily dose is 0.5 mg in most patients".

I know you've been looking to come off the pramipexole for quite a long time and have struggled with it and with pregabalin (Lyrica).

While pregabalin can be started around three weeks before you are fully off pramipexole it won't be fully effective until you've been off the pramipexole for 3-4 weeks. As Madlegs says, a low dose opioid can help with that tapering process.

Regarding pregabalin, the following is extracted from the Mayo Algorithm:

"It is recommended to start treatment 1 to 2 hours before usual onset of symptoms. Treatment should commence at 75 mg of pregabalin daily (50 mg in patients older than 65 years) and be increased every few days as needed. Effective pregabalin doses are usually in the range of 150 to 450 mg per day."

[SurvivorD in reply to ChrisColumbus]

Thank you for your prompt and informative reply. Please see my reply to Madlegs 1

[ChrisColumbus in reply to SurvivorD]

The British National Formulary states that 'uncommon' side effects of pregabalin can include arrhythmias, atrioventricular block, hypertension, hypotension and vasodilation. Your prescriber must be aware of your medical history and advise accordingly.

[ChrisColumbus in reply to ChrisColumbus]

(The BNF does not list the above possible side effects against gabapentin - Neurontin, Gralise - despite pregabalin and gabapentin being very similar drugs, but of course all medications have long lists of common, uncommon and/or rare side effects).

[SueJohnson]

I assume Vitb6 is Vitamin B. Yes you can take all 3 at once but as Chris said it won't be fully effective until you are off Pexola and there is no point in increasing it before then.

[SurvivorD in reply to SueJohnson]

Thank you Sue for your reply. Please see my reply to Madlegs 1

[SurvivorD in reply to SueJohnson]

You asked if I take anything for my heart. Yes, Zuvamor 5mg. Cardiologist said its merely for "maintenance" and Ecotrin.