I have been prescribed Buprenorphine in the form of Norspan 15mg 7 day transdermal patch. Advice needed on appropriate dose.

[Goldy700]

Hello community - I have stage 4 ovarian cancer metastases in the stomach and have been on Targin 25mg a day. Within 3 months my RLS came back with a vengeance. As per advice from this community I asked my doctor to change my medication from Oxycodone and Targin to Buprenophine. She calculated that Norspan 15 micrograms per hour would be an appropriate dose. It is a weekly transdermal patch drug delivery system. I haven't started yet and would love to hear the opinions of those in the know if this is considered a high dose or normal dose for RLS. Also is Norspan a good option as far as Burpenoarphine goes. Many thanks.

[Joolsg]

It should cover your symptoms.However, every single person taking the patch reports that it runs out at day 4/5 & they then get withdrawal opioid RLS symptoms.

So, either ask for a supply of patches that cover this OR ask for sublingual pills - 0.4mg equates to 25mg Targinact.

[Goldy700 in reply to Joolsg]

Thank you Joolsg. - it is interesting that heat makes the patch absorb more quickly. Could it be that in the middle ofsummer it may run out more quickly.

[Joolsg in reply to Goldy700]

Everyone reports it here at ALL times of year, even when it's freezing.I suspect the ingredients just run out.

As nearly every person reports this- perhaps some people absorb it more quickly.

But if it happens you can add another patch earlier OR top up with pills.

[Goldy700 in reply to Joolsg]

That is the wonderful thing about this community - bring forewarned is forearmed. I will make sure I have extra patches on hand

[LotteM in reply to Goldy700]

I don’t have this problem. That is - provided I have been given a Teva or Mylan brand patch. I do have it on Sandoz and Glenmark. Discuss the issue with your doctor. Either start a new patch earlier, but do leave the old patch on for the full 7d, there may be some medicine left. The other option is to ask for small dose (0.2mg or 0.4mg, but I don’t know whether these are available) sublingual pills, to top up when symptoms seep through.

As to the dosing, I was on 15mg Targinact before I got switched to buprenorphine. 0.2mg sublingual worked from the first day and I later made an immediate and clean switch to a 7d 5mcg/h patch. Thus, 15mcg/h should work fine for you. Although we are all different and your ‘case’ is complicated by your cancer. I really hope the patch gives good relief!

Note: put on the patch first thing in the morning as it takes several (roughly 12) hours to build up a dose in your system. It should then work that same evening. I always put the patch somewhere on my shoulderblades, alternating between left and right.

[Goldy700 in reply to LotteM]

Very helpful thank you.

[Nanpat]

I’m on this same medication and dose , completely rls free finally!

My patch seems to last 7 days more often than not. Good luck

[Goldy700 in reply to Nanpat]

How long have you been in the patches for Nanpat?

[Nanpat]

sorry to hear of your health problems

[restlegs1]

Sorry to hear that you have such bad health problems. I have been on Norspan for four months now and have never found it to run out. But then I also keep the old patch on for a day or three after I have put the new one on. I am on half a 5 mg patch. I have never had any breakthrough except the first day I used the patches and the day that I transitioned off Lyrica.

Good luck with your Norspan.

[Goldy700 in reply to restlegs1]

Interesting…do you cut the patch in half? I never thought of that as I am finding it a bit strong

[restlegs1 in reply to Goldy700]

Yes, I do cut it in half. And I tape all sides down with that papery tape that doesn't hurt when you pull it off. This was recommended by my pharmacist. It takes a bit of manoevering but works well, and I have never had the half piece fall off. Good luck!

[LotteM in reply to Goldy700]

Hi Goldy, I have also cut parts off of the patch and taped it on all sides like restlegs1 describes. Works well to adjust dose.

[Shir_11]

I have been on 5mic Norspan for 4 years. My doctor started me on 10mic but it was so strong I couldn’t stay awake. Norspan has been great for my RLS. All the best wishes.

[Jumpey]

I hope you find the right dose fir RLS relief.I wanted yo reach out and wish you peace.x

[HipHop1972]

Hello Goldy700. So very sorry to hear what you are going through and my thoughts are either you.

I was put on Buprenorphine 7 day patches 5 microgram/ hour that didn’t touch my RLS, increased by Consultant to 10 microgram/ hour which was better but didn’t give complete relief. I don’t believe 15 microgram/ hour is a high dose and feel it would work for me. Others will no doubt have opinions on it as I’m sure many are prescribed Buprenorphine either in tablet form or the transdermal patches. I do hope this sorts out your RLS as you have quite enough to contend with at the moment without RLS.

My thoughts are with you HipHop1972 🙏

[restlessstoz]

Hi Goldy, Just go give an idea of the range of doses of patches, I'm on 20mcg and for me I need to add the new patch every four days. When I do that, I have no symptoms at all, (although this Christmas, I did overindulge in sugar, one of my real triggers and had a niggle on the last two days of the patch. No I've reined in my indulgence, I'm fine again.) General diet variations usually don't affect me apart from that described.

Good luck with the patch and with your other issues. I hope it will keep you symptom free.

[Goldy700 in reply to restlessstoz]

Hello restates I have been on the Norspan patch 15mg 2 days now and the first day was brutal as I was having to mix Oxycodone in until the patch kicked in. I was withdrawing from Targin and I didn’t sleep. I have upped the dose to 20mg and hope I will get some relief from RLS tonight. I do hope I am one of the people who gets relief from Norspan. I am on a keto diet in an attempt to starve the cancer as it loves sugar and starch but my RLS still gives me curry. I am up 4 times a night walking on the very grass barefoot as that and for baths are the only thing that relieve it. I am very tired. Thank you for your thoughts.

[restlessstoz]

Good luck with all your attempts to stop RLS and cancer. I wonder if there's a link between the flaring of RL and the cancer itself. There have been people on here who find infections cause a flare up of their symptoms. I wonder if the actual cancer inflammatory process is causing RL symptoms? Just a thought. However, an adequate medication like buprenorphine should cover that once you get the dose right. Good luck.