Have you tried slowly ramping up prami dose? Start out at .25mg/day, at night, before bed, with food in stomach. Take that for 1 week then up it to .5mg/day, same time and everything. I usually stop at .5mg/day but if you need to you cant take .5mg/day for a week then up it to .75mg/day for another week, then up to 1mg/day the 4th week where you can stay.
Like I said .5mg/day does the trick for me but wherever you want to end up as far as daily dose try ramping up to see if you respond better. Thats actually the way the drug is intended to be taken. When it is prescribed for RLS or Alzheimers etc those are the instructions for its use so that the sides you mentioned are avoided.