I’m down to 3 pramipexole (0.088mg) - Restless Legs Syn...

Restless Legs Syndrome

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I’m down to 3 pramipexole (0.088mg)

ving444 profile image
10 Replies

Hi I’ve managed to get down to 3 pramipexole in the evenings(I was taking 6-7). I’m ok in the day as I’m working as a heating and plumbing engineer so constantly on the move, but as soon as I get home and relax, within 30mins my legs are going crazy!!

I started taking gabapentin about 5 weeks ago but I think I have been taking these wrong. At the moment I’m taking a 300mg in the morning , a 300mg at lunch and a 300mg before bed. I’m guessing I’m doing this wrong?? Any help would be so much appreciated as I’m scared I will end up where I started.

I also take 100mg sertraline, 200mg ferrous sulphate, a vitamin C and a cod liver oil in the morning.

many thanks Jason

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ving444
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10 Replies
SueJohnson profile image
SueJohnson

Yes you are taking the gabapentin wrong. Since RLS occurs only at night It is often prescribed that way by a doctor who is not familiar with RLS since pregabalin was originally and still is prescribed for neuropathic pain which is all day.

However 2 things. It is not going to help you much until you are off pramipexole.

Second - you have reduced much much too quickly ( from 6 - 7 tablets to 3 in a month) which is why your legs are going crazy. I would suggest you go back up a half tablet at a time until your legs settle and stay on that for a few days before reducing by 1/2 of a tablet every 2 weeks. I know you are in a hurry but you will suffer much less.

ving444 profile image
ving444 in reply toSueJohnson

Thank you for your quick reply sue.

Ok cool I’ll go up to 4 to try and settle the rls in the evenings and back to taking the gabapentin how do you think I should take it? Eg times of the day and how many? Many thanks Jason

Cobobay profile image
Cobobay in reply toving444

Hello, keep going you will get there as I did with Sue, jools and everyone's help on here. I took information they gave me to my Doctors and she did exactly what I asked, so I hope, you can have the same positive experience with yours. I still find it hard to believe doctors just pass RLS off as something that's in your head. I was treated by a specialist at first the same way as he treated his Parkinsons patients, he demanded I took ropinerole, pramipexole and if those didn't work the patch too. That was the worst mistake ever and that's when I joined here and the help is invaluable. I wish you all the luck in the world, you will get there.

Joolsg profile image
Joolsg

Follow SueJohnson advice.It's also set out on RLS-UK under withdrawal schedule. Gabapentin won't help withdrawals much. Most people need a low dose opioid to settle withdrawal symptoms. If your GP refuses, you can buy solpadeine max which contains a low dose of codeine.

And Sertraline triggers /worsens RLS. Do you take it for depression or anxiety? Did you have RLS BEFORE you started Sertraline?

Safe anti depressants are trazodone or wellbutrin but most GPs are unwilling to prescribe as they know nothing about RLS.

ving444 profile image
ving444

hi jools thanks for your reply

I have some strong 30mg co codamol which I take when I get home from work. I am taking it for both but I’m coming down to 50mg sertraline soon as I’m feeling much better now. . I had rls before I was taking sertraline.

Many thanks Jason

SueJohnson profile image
SueJohnson

Take it 1 to 2 hours before bedtime as the peak plasma level is 2 hours. Then take 300 mg 4 hours before bedtime as it is not as well absorbed above 600 mg. If you take magnesium even in a multivitamin, don't take it within 3 hours of taking gabapentin as it will interfere with the absorption of gabapentin and don't take calcium nor calcium-rich foods within 2 hours for the same reason.

I wouldn't go back up to 4. Get a pill cutter so you can cut the pills in half and first try going up to 3 1/2. If that doesn't work then go up to 4.

ving444 profile image
ving444 in reply toSueJohnson

Ok brilliant, I shall take 1 300mg gabapentin when I get home from work at 5 o clock and then another at 9 o’clock. I don’t take calcium or magnesium at all so Im good in that respect. And I’ll take 3 and a half pramipexole and start to reduce next week. 👍👍

SueJohnson profile image
SueJohnson in reply toving444

You should take the gabapentin 2 hours apart for maximum effect so although you have increased RLS when you get home I would wait and take the 300 mg at 7:00 or move the 9:00 one down to 7:00 although it will wear off sooner towards morning. Once you are off the pramipexole and your symptoms have settled which will take several weeks then you definitely want to take it at 9 and 7.

When you get to that point and not before you can increase it by 100 mg every couple of days until it controls your symptoms adding to the 7:00 dose until you reach 600 mg and if you need more taking the additional amount at 5:00. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin."

ving444 profile image
ving444 in reply toSueJohnson

That’s perfect thank you again sue 👍👍👍

joepublic profile image
joepublic

I take Gabapentin 300 Mg about 11:00 & again at 22:00 one capsule. In addition I have the low dose opiate Targinact 5Mg - 1 pill at 11:00 & 2 pills at 22:00.

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