Treatment strategies
for RLS
| Drugs |
Specific Issues |
Dose Range |
| Dopaminergic: (Usually first
choice): |
| |
|
|
| Levodopa DCI |
Rebound/Augmentation
Useful for intermittent RLS |
100-600mg
evening or divided close |
| |
|
|
| Bromocriptine |
Poor
tolerance
(Preferably avoided) |
7.5mg (divided dose) |
| |
|
|
| Pergolide |
Augmentation
reported rarely |
0.1 - 0.75mg od/bid |
| |
|
|
| Ropinirole |
No Aaugmentation
reported |
0.5-4 mg od/bid |
| |
|
|
| Pramipexole |
Augmentation reported
rarely |
1.5 mg (salt) od/bid/td |
| |
|
|
| Cabergoline |
24
hour action
No augmentation reported |
0.5-4 mg (single
evening dose) |
| |
|
|
| Apomorphine |
Specialist
monitoring required |
18-50 mg/12 hrs Overnight
sc infusion |
| |
|
|
| Rotigotine |
Skin patch currently
in trial |
1.125-4.5mg |
| |
|
|
| Other drugs: |
|
|
| |
|
|
| Gabapentin |
Quick dose escalation
Useful second line agent
Painful RLS |
300-2400 mg |
| |
|
|
| Carbamazepine |
Single/divided
doses |
100 -600 mg |
| |
|
|
| Oxycodon |
Painful RLS |
2.5-25mg |
| |
|
|
| Propoxyphene |
As above |
100-260 mg |
| |
|
|
| Clonazepam |
Drowsiness
Useful for associated insomnia |
0.5-2 mg
evening close |
| |
|
|
| Triazolam |
As above |
0.125/0.25 mg |
| |
|
|
| Nitrazepam |
As above |
2.5 - 10 mg |
| |
|
|
| Clonidine |
Uraemia |
0.15-0.9 mg |
| |
|
|
| Iron sulphate |
Iron defieciency
(low ferritin levels) |
200mg tid Oral |
| |
|
|
|
