In 2024, What Are the Forms of Buprenorphine That Can Be Used for Restless Legs Syndrome?

[@saltlifegull4091]

AWESOME!! RLS is HELL. So glad I found your video. Appreciated so much!

[@andyberkowskimd]

Glad to hear!

[@Maxmaxmax63]

How about those coming off bupe who has never previously had RLS, but develop it once the weaning off begins? Would you expect dopamine agonists to assist or is the etiology totally diff?

[@evrtgln]

Can you recommend a Pain Management Dr and or point me to some literature one could share with their Dr regarding this scenario: patient had multiple failed back surgeries, chronic pain from multiple surgeries, ie shoulder, bilateral carpal tunnel, hip, etc and severe RLS beginning about 3pm daily and letting up around 3am. Family Dr was allowing 20mcg patch and 90MME Percocet PRN. Said Dr retired and new Dr won’t breach the 90MME ceiling due to prior FDA DEA clarification re: 90MME

[@kesterhoward5942]

I take 2 mg Buprenorphine brand Subutex contains no naloxone . In Australia patients taking Suboxone are required a 14 days washout period prior to surgery. surgery will not be performed if a patient is taking Suboxone . Is this the same in the US ?

[@andyberkowskimd]

Buprenorphine prior to surgery is a complex issue in the US. Surgeons and anesthesiologists are less familiar with it and often recommend a washout to avoid perceived complications or effects, but many addiction medicine and pain experts who prescribe it more frequently will have patients stay on their regular dose through surgery and then just add on opioids for pain if needed during and after the procedure. There are so many variables including dose, surgical procedure, and other factors that a formulaic approach for everyone is unlikely to work.

[@terri5757]

Dr Berkowski, I believe I heard you say that 450mcg of Belbuca is roughly equivalent to about 2mg of Suboxone as far as the amount of Buprenorphine that’s in it? Can you explain this? I’m taking 450mcg of Belbuca and when I converted mcgs to mgs it comes out to approximately .5mg. I’d really like to know how it differs if it is the 2mg. Thank you!

[@aprilsandkuhl7837]

You should not promote Suboxone! Let people know they will have tooth decay,tooth loss. Trust me do the research. I have lossed 4 teeth. Law suites are being filed everywhere.

[@cmstacy]

That was my calculation too. How are you doing on the Belbuca ? That might be in my future for chronic pain.

[@wolf87120]

I am currently on Neupro 3mg patch along with Hydromorphone 2mg 3 x daily. I know since I am on this patch it is basically treating my system the same way mirapex did before the NEUPRO came into interest ? Can you recommend a regime that might help my symptoms but not take me down thr Agonist road?

[@nathanas64]

Doctor, I read that some oral forms of buprenorphine cause severe dental decay. Have you seen this in practice ? Also, another concern I have is whether it’s long elimination time will cause daytime drowsiness and impaired driving. Finally, does it cause problems with urination?

[@andyberkowskimd]

To answer your first question: kzbin.info/www/bejne/qp_Kaoiaa8-Hppo With buprenorphine and any other drug that effects the brain, or even drowsiness or fatigue without medications, one should not be driving a motor vehicle or operating heavy machinery if one feels drowsy or impaired. Urination problems from buprenorphine would be rare but constipation much more common.

[@nathanas64]

@@andyberkowskimd thank you! I asked about difficult urination because it was an issue with Tramadol and another pain medication I was given while passing kidney stones.

[@paulabreedlove9264]

Will medicare cover any forms of buprenorphine ?

[@andyberkowskimd]

Sometimes Suboxone films or tablets, but rarely buprenorphine patch (e.g. Butrans) or buccal film (Belbuca). Once some research is published on buprenorphine for RLS, perhaps the third-party payers will start providing financial assistance to those taking this medication for RLS. academic.oup.com/sleep/article/46/Supplement_1/A307/7182410

[@kimchamberlain8476]

Insurance is denying my Belbuca. It’s the only thing that works!