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-   -   neupro patch questions (https://www.neurotalk.org/parkinson-s-disease/221279-neupro-patch-questions.html)

wright2626 06-07-2015 08:32 PM

neupro patch questions
 
this is ending my first week using these neupro patches. started off with the 2 mg, going up to the 4 mg patches tuesday. it is the sample pack i got from the neurologist. just a couple questions for anyone that uses or knows.

i know it is only 2 mg, but it seems to only last about 16 hours. i put a new one on about 6am, seems to kick in around 9-10 am. goes really good until about 8-9 pm. go to bed around 10pm and then around 3 am i wake up to the start of tremors. i do go back to sleep, but it seems that the tremors go and get worse until around 9-10 am. will this get any better as the dosage goes up? and its not like a light switch, the up and down is gradual.

the directions say to move the patch placement around. how many of you do that? do you change the position on your body daily, side to side, different area? i did shoulder one day, other side next, back and both thighs. the side is the one i wont do again.

last one i can think of, weekends. how do you do when you sleep late? normally i am up at about 530am, didnt get up until about 7 this morning. seems those two hours really just impacted my whole day, just shook most of it.

sorry about the long post. sure i have more questions, just cannot remember them at the moment. guess something else to look forward to. i know i am just starting out with this stuff, and the neurologist said i would probably be in the 6-8 mg range, so just wondering if this so far is normal as far as the peak and valley.

thanks if you read down this far.
ron

Nan Cyclist 06-08-2015 11:53 AM

Don't expect much effect from the 2mg patch. You'll see greater benefits from the higher dosage. There seemed to me to be some meds left in the patch so I would leave the first one on when I put the second one on so I didn't have to wait for it to kick in.

For sure move the placement around unless you want chemical burns.

I never had a problem with putting it on a little later.

I don't use Neupro now.

lobo 06-08-2015 06:45 PM

Neupro patch questions
 
Wright2626:

I will mention my experience after 5 weeks of using Neupro, but please, recall PD is different for every patient. I started with 4 mg, minor involuntary movement in my legs; with 6 mg involuntary movements increased; with 8 mg diskynesia was totally out of control (started hurting my abductor muscle). Neurologist suggested to use 6 mg instead but problem remained the same. I decided to use the 4 mg patch. And by the way, I sleep like a baby but I started to wake up at 2:30 am. Fortunately, fell asleep immediately. Apparently, my organism is used to now because I do not wake up at that time anymore. However, doctor prescribed from day 1 of having started Neupro, an antidepressant (Lexapro), to help alleviate side effects.

I visited my neurologist again and he recommended to use one 4 mg patch in the morning (6 am), keep it all day, and use in addition one 2 mg patch in the evening - just before going to bed, around 10 pm - for 2 weeks (total of 6 mg). Starting 3rd week, instead of the 2 mg patch, use the 4 mg patch (making a total of 8 mg). Keep in mind half life is about 8 hours and max. plasma levels will be reached around 16 hours. I am still using the 4 + 2 dose and honestly, I am not too enthusiastic about using the 4 + 4 dose because of the involuntary movement of my leg and diskynesia at night (the first two days of the 4 + 2 dose the placebo effect - no side effects - encouraged me to consider the 4 + 4 option). I feel reluctant now.

It is not my intention to scare you but to warn you each individual responds differently to any treatment. There is no standard formula or treatment for PD.

And yes, rotate application site in order to avoid dermatological issues.

Lobo

wright2626 06-12-2015 04:24 PM

second week, the 2 mg patches were not too bad. the 4 mg patches seem to only let me sleep about 4 hours. when they wear out they wear out quick. i will wake up shaking, sometimes worse than before.

yesterday i didnt think about it. i took off the patch in the morning and then forgot to put on a new one. put one on last night but its like i am behind. today has been awful.

lobo 06-12-2015 05:51 PM

Wright2626:

Hi. I was reluctant to follow with the treatment of Neupro patches. I visited my neurologist and said to him benefit of using patches were too marginal. So he prescribed instead Mirapex but since withdrawal must be gradual, he recommended Neupro 4 mg for 1 week, followed by another week of 2 mg patches and 0 patches the week after.

I woke up in the middle of the night during the first weeks of treatment but sleep pattern came back to normal once adjusted. I am no longer experiencing the stiffness in my left leg anymore.

Regards,

Lobo


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