Gabapentin simultaneously with Pramipexole

[YoghurtLover2]

While weaning off Pramipexole can I take Gabapentin and Pramipexole simultaneously?

[ChrisColumbus]

You *can*, but it's a waste of gabapentin until about a month before you finally stop taking pramipexole.

As both SueJohnson and Joolsg advised in replies to your first post, you first need to wean off pramipexole very slowly following their instructions. You may need a low dose opioid to help the process.

The standard method is then to start gabapentin around 3 to 4 weeks before the last dose of pramipexole as it won't reduce severe RLS - and won't start working fully -until 3 or 4 weeks after the last dose of pramipexole.

Apparently many (most?) Canadian doctors are no better informed on latest RLS treatment than the vast majority of UK doctors. Re-read Sue's first reply - which I see you printed - if you are in any doubt around the process:

healthunlocked.com/rlsuk/po...

[YoghurtLover2 in reply to ChrisColumbus]

Thanks 🙏 I should be off Pramipexole in about 3 weeks . I cannot take codein as it makes me nauseous. … so I’m trying the iron bisglycinate in the evening to help . I also take magnesium so if I have to take the gabapentin at a different time than the Pramipexole timing gets tricky.

[ChrisColumbus in reply to YoghurtLover2]

I hope that you're not coming off pramipexole faster than Sue and Jools recommend as this could make the last weeks of withdrawal unnecessarily hard...

You'll have noted that Sue says "If you take magnesium even in a multivitamin, take it at least 3 hours before or after taking gabapentin".

While I found magnesium helpful, I wasn't taking pramipexole: my feeling is that it doesn't help much if you have been or are taking pramipexole, so if the timing of Mg with gabapentin is too difficult I'd drop the Mg. As a matter of interest, what form of magnesium are you taking and how much?

[YoghurtLover2 in reply to ChrisColumbus]

I take Magnesium Calm (Carbonate) 250mg and Magnesium Biglycinate 200mg . I find the carbonate one keeps me regular.

[ChrisColumbus in reply to YoghurtLover2]

Magnesium (bis)glycinate is recommended - particularly in the US - as an effective magnesium supplement because it is less likely to cause nausea or diarrhoea than most other bio-available forms of magnesium, and because it is reputed to aid sleep (although it didn't help me with the latter). Doses of up to 250-350mg a day are generally recommended.

Magnesium carbonate is used here as an antacid to combat indigestion/upset stomach (and dissolved in water as a fertiliser to treat magnesium deficient plants!).

I used magnesium citrate, which I personally found more effective than glycinate, but wouldn't recommend switching to it if you are happy with glycinate.

If you continue to take magnesium while taking gabapentin do follow the instructions to keep the doses apart.

[YoghurtLover2 in reply to ChrisColumbus]

🙏 thanks

[YoghurtLover2 in reply to ChrisColumbus]

Do you take magnesium citrate in powder form and what do you take it for ?

[ChrisColumbus in reply to YoghurtLover2]

I took it in tablets (which are rather large) for RLS, and it was a lifesaver to begin with. However, when I was failing to eliminate trigger medications (statins and sedating antihistamines in my case), or when I was including too much sugar, caffeine and artificial sweeteners in my diet, it didn't help.

I was lucky enough never to have taken dopamine agonists like pramipexole (or ropinirole or rotigotine): augmentation on these can seem to stop magnesium being truly effective.

Having now eliminated both trigger medications and reduced trigger dietary items I no longer have RLS symptoms and have stopped taking magnesium.

[YoghurtLover2 in reply to ChrisColumbus]

I’m so relieved to hear that you’re off statins (I hope I understand correctly)

I love sweet coffee … don’t drink a lot … but without honey and bit of sweetener it’s like medicine . I might have to work on this after having heard about your experience!

[YoghurtLover2 in reply to ChrisColumbus]

She recommended 1/2 of .125 Pramipexole every 2 weeks . I’ve been doing 1/4 😉