When using Rotigotine (Neupro) patche... - Restless Legs Syn...

Restless Legs Syndrome

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When using Rotigotine (Neupro) patches (3mg currently), is there an initial kicking in time? I apply at 21:00 but am still kicking at 02:00.

Tpebop profile image
13 Replies

After being on Pramipexole for about a year I've started on 3mg patches of Neupro (Rotigotine). They work after a while but the problem I'm having is knowing when best to apply them. There is a suggestion that there is an initial boost release period which seem important to me. At the moment I'm applying them sometime around 9pm but am still "kicking" into the early hours of the morning; no good if you have sleep apnoea too and have to get up for work at 04:45! Suggestions anyone as no one really seems to be able to answer this, even the drugs company itself!?

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Tpebop
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13 Replies

hi Tpebop, when i was using the patches, it used to work in around an hour after applying it, seems as if its not working for you, or maybe they are just taking their time to kick in, weird one this, as the few people i know that have used them, say they work fairly quickly for them

jean

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Tpebop profile image
Tpebop in reply to

Thanks Niah, I'll apply about an hour before going to bed and see if it works. I began to suspect that I was leaving it a bit too long in going to bed after putting on the patch. A weird one indeed as no one else seems to be able to make any useful suggestions. Ta.

in reply to Tpebop

they only other person i know that uses them, comes on here, Elisse, she also has problems with them, but different to you, as she is not very tolerant of the meds we use, she will probable spot this and come and leave a comment later. When i was using them, i used to put mine on at night, after my bath, and about 1 1/2 hours before bedtime, and i was ok with that, but the worse thing with this illness is that we are all so different, with how it affects us, and how we tolerate the meds for it.

jean

Hi, Tpebop, I am not really the best one to ask because as Jean says i have a very low tolerance to all the RLS meds. I can only tell you what i do, but its not recommended to use the way i do. First, i dont leave the patch on all night, i am on at the moment 1mg. i only leave it on for 6hrs, i put mine on at around 6-30 in th evening and then take it off after 6hrs. This is because of the side effects i get from the patch which for me is either very sleepy or dizzy during the day... I get side effects really badly from all the RLS meds. so for me, doing it my way as regards the patch. I have experimented with mine to get the best out of it for me. So i can only suggest you will have to find the right "time" for putting the patch on for you. The only thing i find is that when i put the patch on it can send my legs nuts for a couple of hours, sometimes right up til bedtime, but i have put that down to the way i am dosing myself. Sometimes it just doesnt work at all, and i can be up and down throught the night.

Sorry i cant be more helpful.

Also, as its a 24hr patch and you put it on the same time every night, it shouldnt loose its effect, it should continue through in theory...

BobM profile image
BobM

Hi These are 24 hour patches I believe so you should have relief 24x7 if you aren't then you must be on the wrong dose?

Kindest

Bob M

Hello, I am on 2mg Rotigotine (Neupro patch), and I apply the patch every morning after my shower. I leave it on for 24 hours until I apply the next one the next morning at the same time. These patches are designed to slow release over 24 hours, and they work continuously. They work for me, although i realise dosages may have to adjust in the future. But I know they are meant to be used 24/7. That may be what you have to do, and beleive me it has been a miracle for me. try it that way. You have nothing to lose, and you msy do very well on a low dose if it's a continual feed. Good luck.

Tiredparent profile image
TiredparentRestless Leg Syndrome

I had the same issue too when I started the patches. For me, thro trial and error, I found that the best thing was to put a patch on at least 2 or 3 hours before bed. I know you're not meant to do this, but I leave the old patch on too so I have an overlap period before the new one kicks in. The problem is that by applying a new one at night, the patch that was put on the previous night, is coming to the end of its life and therefore less effective - at the very time when the RLS is worse and we need the medication the most! The ideal for me is to apply it either in the morning or at least 2-3 hours before bed. Whenever practical, I have a shower early evening and apply one then. When I changed my routine as above, it made my RLS considerably better. By the way, I also find that by taking the patch out of the fridge about an hour before I plan to use it, really helps as it can 'hit the ground running'! Hope this helps. Rosie

Hi all, i think the main thing we should all realise here, is that this illness affects us all in very different ways, as do the meds they give us.I was on the patch, and i think the highest dose we are supposed to go to is 4mgs, correct me if im wrong here. But my doctor had me on 8 mgs just before i asked,!!! no told him i didnt want to use it anymore, Also, some of us are more tolerant to the meds than other are, so only we can really cope with the meds as best we can, nobody can feel what we go through on a personal level, and we all have had people give us funny looks when we mention RLS i sure ? i know i have. and just to add, i also used to cut the patch in half if i felt i needed to, or take it of if i couldnt stand the effects,

jean

Tpebop profile image
Tpebop

Thanks Jean, Ellisse and everyone else for your useful comments. I've tried putting a patch on about an hour to an hour and a half before going to bed and it seems to be working. The comments about the 24 hour slow release way of working are true and take some getting used to. I may try the patch overlap idea too. Cheers, Tpebop.

Glad that you got some good ideas from the experience of others using the patch.

When taking meds. for our RLS, we sometimes have to experiment and play around with timings and dosage to get the best from that medication for us as individuals, its not always the way the leaflet tells us. If it works by doing that and we get the sleep and relief from RLS and we are not doing any harm to ourselves then cant see that its a problem, its all good in my eyes.

CathyS profile image
CathyS

Talked to my PA about the expected length of time between application and relief because it seems so incredibly long. She says it varies, but the maximum effectiveness is at 13 hours after application. I need at least 5 before I feel any effect. Keeping it on round-the-clock helps. So glad to hear it's coming back on the US market!!

krissych profile image
krissych

My partner is the one with RLS, he applies his Neupro patch in the morning. He can get away with applying the patch as late as noon, but after that pain sets in as soon as he lies down in the evening. If he forgets and does not apply a patch until the evening he is up all night. We have found - and I am not promising this as a cure :-) That if pain is still in the early stages, if we have sex and he goes into a deep sleep immediately after, we can catch a good nights sleep. But for that you need a partner is understanding and will let you sleep immediately after intimacy.

Papa1bear profile image
Papa1bear

I just researched Neupro for my wife who uses 6mg patches. She applies them anywhere from 2pm to 4pm depending on if they come loose or get water logged in the pool. The research info says that the medicine may take 2 to 4 hours to ramp up but that it does not seem to have a peak. If you are still having symptoms after 2 or 3 hours it could be due to augmentation which is where Neupro is having a reverse effect. Talk to your doctor. Some other medicines, such as Cymbalta, can reduce or eliminate the effects of Neupro. I would suggest keeping a diary of all your medicine and over the counter suppliments for a week or so and see if any patterns develop. Good luck, Papa1bear.

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