My sister and i inherited our late mother's rls, showing up around age 55-60 for both of us; sister's severe, mine (male) moderate. is medication trial and error, or is there a general first try?

See below: You always want to be checked to see if you are iron deficient as iron supplementation does help in some case.

Many things: Meds like ropinirole, pramipexole, Neupro (rotigotine) patches, gabapentin, lyrica, etc. Go Dopamine agonist first.

Typically...: If you truly have rls, the first line agents are the dopaminergic agonists. There are two primarily used: ropinirole (requip) and Pramipexole (mirapex). Dosing and timing of administration is more of an art, and you definitely want to see a physician that knows how to do this correctly, or you can have problems with rebound and augmentation.