Table 4.

Drugs frequently used to treat restless legs syndrome (RLS) [34, 69, 88, 101, 110–112]

Drug	Initial dose, usual dose range	Titration	Common side effects	Comment
Carbidopa/levodopa	25/100 25/100–75/300 daily at bedtime	12.5/50 every 4–7 days	Nausea Somnolence Fatigue Augmentation	Not typically used for chronic treatment owing to frequency of augmentation; not FDA-approved for RLS
Ropinirole	0.25 mg 0.50–4.00 mg daily approximately 1–3 h before bedtime	0.25 every 4–7 days	Nausea Somnolence Fatigue Headache Augmentation Impulse control disorders Hypotension	Augmentation less frequent than levodopa. Dose adjustment for significant hepatic impairment. Has a long-acting formulation
Pramipexole	0.125 mg 0.125–1.000 mg daily approximately 1–3 h before bedtime	0.25 mg every 4–7 days	Nausea Somnolence Fatigue Headache Augmentation Impulse control disorders Hypotension	Augmentation less frequent than with levodopa. Dose adjustment for renal impairment. Has a long-acting formulation
Rotigotine transdermal patch	1 mg 1–3 mg daily	1 mg every 7 days	Skin irritation Nausea Somnolence Fatigue Headache Augmentation Impulse control disorders Hypotension	Augmentation less frequent than with levodopa
Gabapentin	300 mg 300–1200 mg daily; may be in split dosing with an afternoon and bedtime dose	300 mg every 7 days	Somnolence dizziness	Likely no augmentation; not FDA-approved for RLS
Gabapentin enacarbil	600 mg 300–1200 mg daily about 1 h before bedtime	May increase on weekly basis	Somnolence Dizziness	With renal impairment, start with lower doses. No added efficacy shown at doses > 600 mg, but increased adverse effects. No reported augmentation
Pregabalin	50 mg 150–300 mg daily in the evening	50 mg increases every 7 days	Somnolence Dizziness Weight gain Suicidal ideation	Lower doses than used for pain syndromes; not FDA-approved for RLS. No reported augmentation

FDA = US Food and Drug Administration