Medicine Question

My neurologist has suggested that I switch from Mirapex to a time-release drug called Requip XL for severe Restless Leg Syndrome. Does anyone know if this is doable. Can we use time-release drugs? I am almost 3 1/2 years out. Thanks for any help.
Nancy C.- Langhorne

I have Restless Legs too. I take Mirapex I tried Requip some time ago and I like Mirapex better. I am only 3 months out of WLS. I had to increase my dose from .25 to .50  I  did not know Requip came in a time release. Seems like my legs bother me more now after the WLS. I would call my surgeon and ask.

I didn't think it was real great idea for us to take timed released tablets...however...I'm not sure if it is an absolute "contraindication" for us.

Sorry I couldn't be of more help.  Let us know what you find out and how it works out for you, too.

Pam

Hi Nancy

I think we were told not to, however I do take a time release Effexor and it is fine - much better than the non time release tablet version.

arlene 

Hi Nancy,

From my own personal experience and research, time release drugs will not hurt you but they will not help you as well as they could either. I was on a time released med a couple of years ago and after several increases in the dosage, it was still not helping me as much as it should have. The doctor sent me for blood work to check the level of meds I had in my system and wouldn't ya know it - I had none! I was changed to a regular, 3 times a day tablet and did much better with it.

From researching, I found the following:
 
Decreased intestinal length and surface area lead to the reduced absorption of extended-release drug preparations in RNY patients because these formulations are slowly absorbed over many hours. The reduction in functional intestine length makes it likely that extended-release preparations have passed through the gastrointestinal tract before absorption is complete. These same principles can also apply to delayed-release and enteric- or film-coated product formulations. To overcome this problem, the immediate-release dosage forms should be substituted, which could require increased frequency of administration.

Personally, I think meds are just like everything else in that we're all different and there really is no standard as to exactly how much each of us is absorbing or not absorbing. The same way some of us need higher doses of iron or other vitamins to prevent deficienies than the person next to us that also had WLS. For me, I try to avoid the extended release meds if I can but if that's not a possibility then I just make sure the doctor checks the levels in my system so that adjustments can be made if need be. There was one occasion where I was put on a 24 hour extended release tablet but because of the issue with absorption it wasn't working and the doctor changed the dosage to 2 of them each day 12 hours apart. When the bloodwork came back, everything was fine and I had the proper levels in my system.

I would say to talk all of this over with your neurologist and be sure he understands that there is a very strong possibility that you will not absorb this new medication as it's intended. He may be able to prescribe something else or he may be able to make an adjustment to the dosage.

Good luck to you! I hope all turns out well.

Hey Nancy, does the Mirapex not work for you any more?  I only ask because my mom takes Mirapex, she is 4 yrs post op.  Every time I see her, she rubs her legs and complains how bad they hurt.  Or she says "I gotta take my Mirapex".  It seems to get earlier in the day all the time.  She use to take it before bed, now she is taking it in the early afternoon!!  WTH!  I've mentioned it once in awhile, but I've given up!  If you switch to the Requip, keep us posted as to how it works.

Anyway, I remember reading that we weren't suppose to take extended release anything post op.  But (again) my mom takes that Z-Pak antibiotic when she gets an infections, seems to work fine for her!  So maybe the further out you are, they may work better (since you are pretty far out).  Good luck!!

As Valerie said, I was told not to take time released medication. Not that it would hurt me but the medication would not be as effective since it passes out of the system prior to absorption.

I would speak with the prescribing doctor and bring it up. There may be a work around.

Thank you all for the responses. The Mirapex is not working long enough. Doc. wanted me to take 3 a day, but then I'd never be awake. He told me to try Requip. He is aware of my surgery. I'm going to try it over the weeend and see whathappens. Again, thanks to all *****sponded
Nancy