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Re: Pharma Sticky

Posted: Thu Jan 08, 2015 2:14 am
by ViewsAskew
WOW - Go EU!

Basically, the EU has just approved the oxycodone/nalaxone combo for WED/RLS. Quoted from the following article, " Oxycodone/naloxone is the first opioid which has been granted a licence in the EU for the treatment of RLS.1 This new licence indication provides a viable treatment option for patients who cannot tolerate the existing available treatments or who are not able to gain the level of symptom relief required."2 ... K3ni3u0uzk

Re: Pharma Sticky

Posted: Sat May 09, 2015 11:31 am
by Rustsmith
This link is to an excellent writeup by Qyx that provides a comparison of equivalent doses of different opioid medications

Re: Pharma Sticky

Posted: Mon Jun 01, 2015 4:47 am
by ViewsAskew
For those of you in the UK, you have access to a new drug for RLS/WED!

A quote: "Napp Pharmaceuticals Limited has announced that Targinact, a fixed combination of prolonged-release oxycodone/naloxone, has received approval for use in the UK. This follows the European Commission's positive decision in January 2015 to recommend Targinact as a second line symptomatic treatment for patients with severe to very severe idiopathic restless legs syndrome (RLS), after failure of dopaminergic therapy.1,Oxycodone/naloxone is the first opioid which has been granted a licence in the UK for the treatment of RLS.1 This new licence indication provides a viable treatment option for patients who cannot tolerate the existing available treatments or who are not able to gain the level of symptom relief required.2"

More: ... WupM0a0tE2#ixzz3bmab24y6

Re: Pharma Sticky

Posted: Mon Jun 01, 2015 1:27 pm
by Polar Bear
Ann - thank you for this. Great news :)

Re: Pharma Sticky

Posted: Wed Sep 14, 2016 4:52 am
by ViewsAskew
Requip labeling has been updated. They now recommend a taper when stopping the drug, even when using for RLS. Not sure if this truly means at all dosages, but am guessing it does. ... le/522328/

Re: Pharma Sticky

Posted: Wed Oct 19, 2016 6:36 am
by leggo_my_legs
I have to add to the phenergan nightmare. OMG. Was given that once for food poisoning and I was moving everything! Trunk movements bolting up in bed every few secs. It was horrendous. They called the MD in who said cooly, 'I think you're having a reaction to the medication." I was so far gone I said, "No, this just happens to me sometimes." Which it does NOT, i dont know why I said that. This was like 8 yrs ago, I still remember it like yesterday.

Re: Pharma Sticky

Posted: Wed Oct 17, 2018 10:54 pm
by peanut1
I am on hormone replacement therapy. I notice that if I take too much progesterone, the RLS goes mad.

Re: Pharma Sticky

Posted: Mon Aug 12, 2019 5:29 am
by badnights
From Sleep Review, Jan 2018:
Dopamine Agonists May Cause Psychiatric Adverse Events, Even at Comparatively Low Doses

In 2004, neurologist Daniel Lee, MD, was one of the investigators who declared ropinirole a well-tolerated and effective treatment for restless legs syndrome (RLS), contributing to the US Food and Drug Administration’s (FDA) approval of ropinirole and ushering in an era of dopamine agonists as first-line treatment for RLS.

But now Lee—as well as other prominent sleep physicians—say clinicians and patients must be alerted to the psychiatric serious adverse events that may occur in patients taking dopamine agonists for RLS. Newer studies have found patients being diagnosed with psychiatric illnesses after taking dopamine agonists for RLS, including patients who had no prior psychiatric illness history.....

[Two petitions to the FDA have been filed asking for a black-box warning to be added to dopamine agonist meds, one in 2016 that focused more on Parkinson's patients and one in 2017 dealing with WED/RLS patients. The main psychiatric developments are impulse control disorders. ]

...In a 2010 study, published in the journal Sleep, Silber and co-researchers conducted a prospective case-control study on the frequency of impulse control disorders in patients taking dopaminergic agents for RLS. They found that, out of 100 participants, roughly 17% of the RLS treatment group had one or more of the impulse control disorders. ...

...Patients with RLS can suffer severely, Hankin says, citing examples of patients who inadvartantly bruise their own legs in attempts to get the restless sensations to alleviate. “The worst thing of all,” she says “is to add harm to patients who are already suffering.”

[Full story at ... f=cl-title]

Morphine treats WED/RLS in cancer patient

Posted: Fri Oct 11, 2019 3:32 am
by badnights ... 00457/full

The authors say "To our knowledge, this is the first report of successfully treating RLS with intravenous and oral morphine". I'm surprised that they aren't aware of anyone else who has been treated with morphine for WED/RLS. They do say oral and intravenous morphine but I don't think the distinction is important. There have been at least some WED/RLS patients treated with morphine, but presumably no one has been written up yet.

To summarize the article, a cancer patient complained of WED/RLS symptoms that were giving her more grief than the cancer. DAs and alpha-2-deltas had not worked in the past. Morphine, and later morphine and fentanyl, did work. Who is surprised? At the doses needed to treat cancer pain, she was bound to find relief for the even-more-disturbing but easier to treat WED/RLS.

Re: Pharma Sticky

Posted: Fri Oct 11, 2019 6:45 am
by QyX
I'm taking Morphine for about 5 years now. It is the most effective opioid for me and especially in the first months Morphine had additional hypnotic properties Oxycodone and Hydromorphone did not have.

Also I remember one case report where a patient was treated with intrathecal Morphine (Morphine injected directly into the CNS ... 1 mg per 24h) for severe RLS symptoms that couldn't be treated with oral opioids anymore.

Also, all those patients taking Codeine are technically using Morphine. Codeine itself is only a very weak opioid. What makes it a potent analgesic is the metabolising of Codeine into Morphine in the liver.

I believe Morphine is heavily underused in RLS patients. Its stronger sedative properties compared to Oxycodone and Hydromorphone can make it more suitable for RLS patients, however those special sedative properties are prone to tolerance.

In general it is unlikely Morphine is more effective than Oxycodone or Hydromorphone but it would be a much cheaper solution for the insurance companies and patients.

Unfortunately there seems to be a strange belief that Morphine is some killer super heavy strong opioid that only should be used when Oxycodone, Hydrocodone, Hydromorphone and all those other classic opioids are not working when in fact Oxycodone is, when given orally, twice as strong as Morphine and Hydrmorphone even 5 to 8 times as strong as Morphine, depending on which table you want to believe.