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-   -   What is the lowest dose of Gabapentin (https://www.neurotalk.org/peripheral-neuropathy/169150-lowest-dose-gabapentin.html)

pinehurstcharlie 05-03-2012 10:13 AM

What is the lowest dose of Gabapentin
 
Can you take the lowest dose of gabapentin in the beginning and get relief? My presciption is for 300 mg and I think that is way to high for me as I only take at night as needed ( by doctors orders ) or can take up to 3x's a day but I'm opting for supplements so if I did have a really bad day is a lower dose helpful as this still new for me . I thought I'd read where some that are doing supplement have taken as low as 30 mg for relief and might take that daily but not sure .

Dr. Smith 05-03-2012 01:26 PM

When I was DXed, I was handed a prescription for 300 mg. capsules, with instructions for titrating up to 900 mg./day over 3 days.
http://www.ncbi.nlm.nih.gov/pubmed/12637113

I thought this was high also, so after some discussion, the neurologist agreed to rewrite the scrip for 100 mg capsules, taken at night as needed, and I would titrate up if necessary. AFAIK, 100 mg is the smallest dose available/made.

This amount was sufficient to address the burning pain I was having at the time, and I only took it a few times before learning of and starting R-Lipoic Acid (RLA). The RLA worked extremely well for me, and I haven't needed any gabapentin since (over a year). I read someplace online (can't find the link :icon_sad:) that the sooner RLA is started, the sooner and better it works. Others' results vary.

Doc

surfer00 05-03-2012 04:22 PM

I dont want to highjack this thread, but I have a question along these lines.

Do you take Gabapentin as needed (when you hurt) or at specific intervals. I take 100 4x a day as instructed. I really dont know if it helps or not, but it seems harmless. Does it need to build up in your system or can it be taken like a pain pill?

Thanks!

Quote:

Originally Posted by Dr. Smith (Post 875746)
When I was DXed, I was handed a prescription for 300 mg. capsules, with instructions for titrating up to 900 mg./day over 3 days.
http://www.ncbi.nlm.nih.gov/pubmed/12637113

I thought this was high also, so after some discussion, the neurologist agreed to rewrite the scrip for 100 mg capsules, taken at night as needed, and I would titrate up if necessary. AFAIK, 100 mg is the smallest dose available/made.

This amount was sufficient to address the burning pain I was having at the time, and I only took it a few times before learning of and starting R-Lipoic Acid (RLA). The RLA worked extremely well for me, and I haven't needed any gabapentin since (over a year). I read someplace online (can't find the link :icon_sad:) that the sooner RLA is started, the sooner and better it works. Others' results vary.

Doc


pinehurstcharlie 05-03-2012 04:33 PM

Quote:

Originally Posted by surfer00 (Post 875808)
I dont want to highjack this thread, but I have a question along these lines.

Do you take Gabapentin as needed (when you hurt) or at specific intervals. I take 100 4x a day as instructed. I really dont know if it helps or not, but it seems harmless. Does it need to build up in your system or can it be taken like a pain pill?

Thanks!

Just left doctor's office and that was one of my questions about which ones can be taken as needed for pain or had to be built up in the system to do any good. He said Cymbalta is the only ones the lyrica, gabapentin and amitrypline all can be as needed. That answers alot for me in case the pain is so bad. I'm working on the ala supplement now

Dr. Smith 05-04-2012 05:35 AM

Quote:

Originally Posted by surfer00 (Post 875808)
Do you take Gabapentin as needed (when you hurt) or at specific intervals. I take 100 4x a day as instructed. I really dont know if it helps or not, but it seems harmless. Does it need to build up in your system or can it be taken like a pain pill?

You should take meds as directed, and consult your doctor about any changes. Gabapentin, once begun regularly, must be tapered off of gradually, as your body becomes dependent on the chemical, and you may experience withdrawal. There is also a slight risk of seizure (it is an anti-seizure med) if stopped abruptly or too quickly.
http://en.wikipedia.org/wiki/Gabapentin#Withdrawal

In my case, the need was occasional, and I was on the minimum dosage, so there was no place to taper down to...

If you can't tell if it's helping or not (you should have within a few days) then your dose may not be high enough, or the med just isn't effective for you. In either case, let your doctor know; s/he may want to try increasing the dosage before discontinuing/tapering off. This med does work very well for some people, so I think it should be given a chance when the side effects are not intolerable, and it doesn't sound like they are.

Doc

pinehurstcharlie 05-04-2012 08:22 AM

Quote:

Originally Posted by Dr. Smith (Post 876002)
You should take meds as directed, and consult your doctor about any changes. Gabapentin, once begun regularly, must be tapered off of gradually, as your body becomes dependent on the chemical, and you may experience withdrawal. There is also a slight risk of seizure (it is an anti-seizure med) if stopped abruptly or too quickly.
http://en.wikipedia.org/wiki/Gabapentin#Withdrawal

In my case, the need was occasional, and I was on the minimum dosage, so there was no place to taper down to...

If you can't tell if it's helping or not (you should have within a few days) then your dose may not be high enough, or the med just isn't effective for you. In either case, let your doctor know; s/he may want to try increasing the dosage before discontinuing/tapering off. This med does work very well for some people, so I think it should be given a chance when the side effects are not intolerable, and it doesn't sound like they are

Doc

My doctor said of the 4 ( lyrica , gabenpentin , cymbalta and amitriptyline) that cymbalta was the only one that had to build up in the body to be effective. Like you I"ve tried the lowest dose of all but Lyrica ( that is a new one for me ) . The others just make me sleep too long and /or make me like a zomibie into the next day. So he says it is a trial and error thing so we are trying to find one that I can take when it is really bad but I'm doing the supplement route once i get the A1C back to below 5.8 as it has been for years , that is my goal so lifestyle changes will be the goal for this old lady lol

Dr. Smith 05-04-2012 09:17 AM

Quote:

Originally Posted by pinehurstcharlie (Post 876053)
The others just make me sleep too long and /or make me like a zomibie into the next day. So he says it is a trial and error thing so we are trying to find one that I can take when it is really bad

:I-Agree: That's the risk vs. benefit equation (game? :rolleyes:) we're often faced with. I have some different things for occasional use (or that I only use occasionally) that cause me to question/fight with myself every time I'm faced with the decision (and I hear/read that from a lot of people) - do I stubbornly suffer for 1-2 days with (whatever) or take the cussed pill and lose 1-2 days from the "hangover"? (for lack of a better term)

My DW & I help each other with these little battles, as we can view each others' situations more objectively than ourselves - our own judgment/objectivity colored by misery. Generally (but not always), if it comes down to losing a day either way, why lose it in abject misery? That's the way our doctor sees/puts it; we just have to remind ourselves/each other.

Doc

zygopetalum 05-04-2012 09:32 AM

Thanks for this thread, I was given 300mg and told to titrate up to 1200 in 3 weeks so didn't take it. I tried to get him (pain clinic) to give me a smaller dose and he wouldn't do it, maybe I won't go back there.

thanks,
judi

mrsD 05-04-2012 09:42 AM

People really vary in how their brains are wired. Different ratios of neurotransmitters, and receptors. So they tend to respond differently to drugs.

This has been a huge problem with antidepressants, which now we hear
"really don't even work" !

So what works for one person many be very different for another.
And some doctors do not like anyone questioning them, or making suggestions. I personally think those types of doctors are insecure, and become combative when threatened by knowledgeable patients.

I never took gabapentin. Luckily for me it wasn't available when I was at my PN worst, and today, I am loathe to even consider it. In fact only Elavil was around then! I tend to bloat/edema and I don't even want to try either gabapentin or Lyrica.


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