[malawigirl08]

I am currently taking 2400mg gabapentin, 8 cocodamol tablets as well as 25mg imipramine. My day consists of getting up at 7.30 and I try to do without meds until 10am when I take 2 cocodamol and 600mg of gabapentin, I repeat this dose 2pm, 6pm and 10pm adding imipramine with my last meds. At the pain clinic the nurse was surprised that I take gabapentin four times per day, she said it is more usual for them to be taken three times per day at a higher dosage. Am I taking my meds at the wrong time of the day for max effect?

[Dr. Smith]

Originally Posted by malawigirl08

Am I taking my meds at the wrong time of the day for max effect?

Possibly. How were they prescribed, 3x a day (800 mg every 8 hrs) or 4x a day (600 mg every 6 hrs)?

The general idea is to keep a relatively constant blood level to keep reasonably comfortable around the clock.

Doc

[malawigirl08]

Originally Posted by Dr. Smith

Possibly. How were they prescribed, 3x a day (800 mg every 8 hrs) or 4x a day (600 mg every 6 hrs)?

The general idea is to keep a relatively constant blood level to keep reasonably comfortable around the clock.

Doc

Thanks Doc, the prescribing of these drugs was very vague and over the few years that I have been taking them I have just been instructed to increase the dosage with no advice on when to take them. Gabapentin is not working very well for me and this may be the cause - I will try taking then earlier in the morning then at lunch and bedtime and see what happens.

[Dr. Smith]

It's also possible, as many others have noted in past discussions, that you're just acquiring a tolerance to the gabapentin. Some have rotated to Lyrica or Topamax or others. In time, the tolerance to gabapentin may dissipate (or not).

Couldn't hurt to revisit some of those previous discussions for advice/suggestions.

My day consists of getting up at [whenwever] and I try to do without meds until [whenwever]....

A lot of people do this with all kinds of meds (but especially with pain meds) for all kinds of reasons. I get it, but it turns out that it doesn't make much sense, and in some situations may actually be counterproductive (e.g should a diabetic wait until they're going into a sugar coma before taking their insulin?)

With pain meds, it often means a patient needs more to address the acute pain (flare?) that occurs by not maintaining a constant low(er) level in the bloodstream.

....the prescribing of these drugs was very vague and over the few years that I have been taking them I have just been instructed to increase the dosage with no advice on when to take them.

I think these dosage questions are worth taking up with your docs. Very often medicos assume nothing is wrong (or that a patient doesn't have any questions) unless we make it a point to bring these things up and persevere until we get it.

Doc

[glenntaj]

--and Pregabalin (Lyrica) are both excreted almost whole through the kidneys and not appreciably metabolized through liver enzymes, the rates at which people "clear" these drugs (or, to put it another way, their "half-lives") vary considerably from person to person, and I've certainly seen people prescribed doses divided up in different ways--twice a day, three times, four times. Often some experimentation is needed to see what works best for the individual.

[malawigirl08]

Originally Posted by glenntaj

--and Pregabalin (Lyrica) are both excreted almost whole through the kidneys and not appreciably metabolized through liver enzymes, the rates at which people "clear" these drugs (or, to put it another way, their "half-lives") vary considerably from person to person, and I've certainly seen people prescribed doses divided up in different ways--twice a day, three times, four times. Often some experimentation is needed to see what works best for the individual.

Just a quick update, I have changed my meds toGabapentin 8am- 900mg, 4pm- 600mg and 10pm- 900mg, I have kept my cocodamol at 10am,2pm,6pm and 10pm.
This is now ideal timing for me and I am in a lot less pain.

[Jazziferjoodles]

Originally Posted by malawigirl08

Just a quick update, I have changed my meds toGabapentin 8am- 900mg, 4pm- 600mg and 10pm- 900mg, I have kept my cocodamol at 10am,2pm,6pm and 10pm.
This is now ideal timing for me and I am in a lot less pain.

I was told my GP that cocodamol was no good for nerve pain so I stopped taking it. Might have to start it again!!!!! I'm on 2100mg Gabapentin per day plus 2 Amytryptiline at night but I am still in pain so I'm upping it by 600mg thro 1 week. The max I have been told by my doc I can take is 3600mg per day

[Susanne C.]

Originally Posted by Jazziferjoodles

I was told my GP that cocodamol was no good for nerve pain so I stopped taking it. Might have to start it again!!!!! I'm on 2100mg Gabapentin per day plus 2 Amytryptiline at night but I am still in pain so I'm upping it by 600mg thro 1 week. The max I have been told by my doc I can take is 3600mg per day

It was conventional wisdom for doctors to say that opiates don't help nerve pain, but recent studies have contradicted that. Many people with PN pain are on a combination of gabapentin or Lyrica, an opiate, and possibly an anti-depressant.
If you have severe pain, not just the burning, zapping kind, I don't think maxing out your gabapentin will help. For myself, it only seems to help with the burning, zaps, and hamsters running all over my feet and legs. It does not remove those sensations entirely, nor does it touch the crushing, twisting type of pain. Was the cocodamol helping?

[Idiopathic PN]

Originally Posted by malawigirl08

I am currently taking 2400mg gabapentin, 8 cocodamol tablets as well as 25mg imipramine. My day consists of getting up at 7.30 and I try to do without meds until 10am when I take 2 cocodamol and 600mg of gabapentin, I repeat this dose 2pm, 6pm and 10pm adding imipramine with my last meds. At the pain clinic the nurse was surprised that I take gabapentin four times per day, she said it is more usual for them to be taken three times per day at a higher dosage. Am I taking my meds at the wrong time of the day for max effect?

I take my Gabapentin at 7am, 1pm, and 7pm. My first neurologist told me that I can adjust the dosage depending on the pain. But, for me it helps to take same dosage through out the day.

I dont know how your doctor prescribed you with your dosage, but my first neurologist gave the impression that "I can play around with the dosage of the Gabapentin". Looking back, I think this impression will apply to those who have just mild PN pain.