I have been taking the above 10mcg for a couple of weeks and then changed to 15mcg a couple of days ago. I am still getting bouts of RLS through the night and have not slept a night for weeks. There is no comparison to the symptoms I was getting prior to the Buprenorphine, however I am very uncomfortable every night.Am I expecting too much,will it get better or is this how it is ?
Thanks for your experiences on this.
It can take months for withdrawals from dopamine agonists to settle. As you have only recently come off a DA, it's still early days.Is this 15mcg patch changed every 3 days as well?
Will your doctor consider a switch to Buprenorphine pills?
Hi Joolsg, 15mcg patch changed every 7 days but I have only just started on this from a 10 mcg for a couple of weeks previously. Do you think the pills are a better option. I must admit I would be happier with pills. Not sure my gp could work out the equivalent dose in pills though.
I think I will have to leave it a few weeks before I can approach him with that idea.
Thank you for replying.
I change my patch every 5 days (even though a 7 day patch) and others do too. Unfortunately means Dr has to ring to get authority every time (can't request electronically) and is only a month instead of 3 month script.
The patch is notorious for losing effectiveness at Day 4 or 5. So, you can ask for more patches and change them every 4/5 days OR ask for 0.4mg sublingual pills.
The anecdotal evidence on here is pretty overwhelming. Everyone using the patch for RLS reports that the patches stop working at day 4 or 5.
Hi Joolsg, I have decided to go for the pills. I am on 15mcg 7 days Buprenorphine and as you and others say they do not last. I need to ask my GP for exactly the correct equivalent dosage because as I said before I have no faith in him. Of course this if he will agree.
So do I just request 0.4 sublingual pills and he will know what I am talking about ?
Sorry to be a pain but I must be sure I am asking him for the correct dose.
Many thanks Joolsg.
There is no direct equivalent dose because of the different mechanism of delivery. The patch releases 15mcg an hour evenly over 24 hours. So, roughly 0.36mg a day. The 0.4mg pill releases most of that dose in the first 10/11 hours and then releases the remainder slowly over the next 12/14 hours. I think you should start with 0.4mg pills. You can cut them in half and take 0.2mg at 8 or 9pm. Then try 0.2mg just before you fall asleep.
It should provide 24 hour cover. If it does, you can try just 0.2mg the next night.
Always aim for the lowest dose.
Hi Joolsg, me again. You gave me good advice about iron/Ferritin. My Ferritin level is 75 and have decided to do something about it but can't find your post with the advice you gave.Would you mind re sending. Many thanks
It's easier to repeat it.If ferritin is 75, the RLS experts say it's difficult to raise from 75 to above 100, preferably 200ųg.
An iron infusion is the quickest way to raise levels. If you live near St George's in Tooting, the Royal Cornwall in Truro, or Salford, then the NHS haematology doctors know about the benefits or iron infusions. Otherwise, you can contact the Iron Clinic and get a private infusion for around £800. You just send your blood results.
The Iron Clinic
020 3875 8171
Alternatively you can take 2 x ferrous bisglycinate pills every other day. There is conflicting evidence about the best time to take iron pills. The Mayo Clinic Algorithm advises taking iron pills at night, on an empty stomach. However, UK iron specialists say first thing in the morning on an empty stomach as hepcidin is lowest in the morning and therefore less able to block absorption.
So, if I were you, I'd take pills last thing at night, as there are many anecdotal reports on here that this has resolved RLS for many.
when starting buprenorphine, sublinguals is definitely the way to go. You can titrate up quickly in order to find the optimal dose. The sublinguals are fast acting (generally 30 minutes), so you can take more every 30 minutes until you get relief. I think most of us have been able to find near complete relief immediately when using an adequate dose.
The 15mcg patch is roughly equivalent to .9mg of sublingual. So you could start with 1mg and add an extra .2mg as needed. While the Mayo guidelines say up to 6mg is an acceptable dose, most of us here use under 2 mg.
Tell your doctor that the flexibility of the sublinguals will enable you to find the lowest effective dose that works far faster than with the patch. And they will enable you to titrate down later, as you may get by with a lower dose after recuperating from the DA withdrawal.
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