Increasing Gabapentin dosage

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Brynmr
Posts: 18
Joined: Sat Jul 21, 2018 3:15 pm

Increasing Gabapentin dosage

Postby Brynmr » Fri Sep 07, 2018 7:51 pm

Hey all. I started out on 300 mg of Gabapentin 3 months ago (June 1 after being diagnosed with RLS). Then after a few weeks the dose jumped to 600mg. I take my 1st capsule at dinner then my 2nd around 9. I was supposed to take this drug before bed but found I was getting uncomfortable sensations earlier.

Now I'm occasionally adding 300mg at 11pm because the 2nd 300mg cap had no effect and at those times I wake up with symptoms around 2am. Is this increase in medication common? Will I need to increase the dosage over and over? I'll inform my doctor (who had no problem with me increasing the dose to 600mg btw) and see what he thinks but thought I'd start yakking about my medication progress. Many of you have been through all this before.

QyX
Posts: 360
Joined: Wed Mar 13, 2013 12:53 pm
Location: Berlin / Germany

Re: Increasing Gabapentin dosage

Postby QyX » Sat Sep 08, 2018 8:47 am

600 mg is a small dose for Gabapentin.

Increasing the dosage of a drug in general is very common and especially with RLS developing a tolerance seems to be a huge problem that complicates treatment in many cases.

You most likely have to increase your dose for a while. Then you will either a point where you have a good effect and don't need to increase the dose any further, at least for a while like a couple of years or you will run into the problem that the dosage is still not enough but you can't increase the dosage anymore because of side effects or because your doctor doesn't want to prescribe a higher dose.

You have to see how this plays out. Nobody will know in advance.

Brynmr
Posts: 18
Joined: Sat Jul 21, 2018 3:15 pm

Re: Increasing Gabapentin dosage

Postby Brynmr » Sat Sep 08, 2018 11:24 am

Thanks for the information. I think that's encouraging. Last night I was up again at 3 in the morning so I guess I'm into the 900 mg a day dosage. Considering the max dosage, I have a ways to go.

Rustsmith
Moderator
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Joined: Sat Sep 28, 2013 9:31 pm
Location: Pueblo, Colorado

Re: Increasing Gabapentin dosage

Postby Rustsmith » Sat Sep 08, 2018 1:25 pm

There are two more things about gabapentin that you need to be aware of. The first is that the half life for many is about 4-6 hrs, so it could be that it is simply being eliminated from the blood stream and you are having to take a dose during the night just to have enough to treat your RLS. The second thing about gabapentin is that it is only adsorbed into the blood stream by a short length of the small intestine. So, for some, this means that you can take higher and higher doses (more than where you are now), and none of it actually gets into the blood stream. The modifications that were made to Horizant were partly to address this limitation. Unfortunately, Horizant is MANY times more expensive right now.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

peanut1
Posts: 312
Joined: Sat Jun 04, 2011 8:06 am

Re: Increasing Gabapentin dosage

Postby peanut1 » Sun Sep 09, 2018 5:11 am

600 is a rather low dose. I was told you could increase the dosage up to 1200. And yes, I've also experienced problems with tolerance and have to usually combine medications. I also exercise the best I can (have feet problems) and use a lot of mindfulness meditation which has been very effective with the restless leg. Another thing that really helps me is being on a high iron paleo diet. Iron is imperative to RLS sufferers like us and I eat high iron foods and take bloodbuilder 2 times a day and a gentle iron at night. So sometimes you may want other things to help offset the rls. But like everyone else, I need my meds too.

I like lyrica better than gabapentin, but it will increase the insomnia if you try to get off of it. I rotate the Gabapentin and lyrica, but there are less side effects with lyrica. However, I think there are less side effects if you try to get off gabapentin.
I have tried Horizant and would get ill on it. Usually it takes a while to get the right medication combination.

Brynmr
Posts: 18
Joined: Sat Jul 21, 2018 3:15 pm

Re: Increasing Gabapentin dosage

Postby Brynmr » Mon Sep 10, 2018 3:50 am

Rustsmith wrote:There are two more things about gabapentin that you need to be aware of. The first is that the half life for many is about 4-6 hrs, so it could be that it is simply being eliminated from the blood stream and you are having to take a dose during the night just to have enough to treat your RLS. The second thing about gabapentin is that it is only adsorbed into the blood stream by a short length of the small intestine. So, for some, this means that you can take higher and higher doses (more than where you are now), and none of it actually gets into the blood stream. The modifications that were made to Horizant were partly to address this limitation. Unfortunately, Horizant is MANY times more expensive right now.


I'm thinking my RLS has been getting worse. Before I started on meds, symptoms would begin late just before bed around midnight and 300mg would see me through the night. Now I'm noticing mild symptoms around 7 or 8 so I start with 300mg at 6:00. My next 300mg is around 9 or 10 and one more at midnight to get me through the night. That's been working fine so far but it's only been a week. And yeah, I noticed that sometimes the dose make me very sleepy and sometimes not. Sometimes absorbed - sometimes not so much.

Brynmr
Posts: 18
Joined: Sat Jul 21, 2018 3:15 pm

Re: Increasing Gabapentin dosage

Postby Brynmr » Mon Sep 10, 2018 3:55 am

Peanut1: I'll try adding more iron to my diet. I've read about that. Might help. Also, I should really exercise more. I'm learning Tai Chi at the moment. Good for these old bones.

Brynmr
Posts: 18
Joined: Sat Jul 21, 2018 3:15 pm

Re: Increasing Gabapentin dosage

Postby Brynmr » Wed Oct 24, 2018 1:05 pm

Up to 1200 mg but it's been working well for over a month. Timing seems to be important. 600 mg at 5pm then another 600 mg at 9:30. I sleep through the night. Hopefully we're settled in for a while.

QyX
Posts: 360
Joined: Wed Mar 13, 2013 12:53 pm
Location: Berlin / Germany

Re: Increasing Gabapentin dosage

Postby QyX » Thu Oct 25, 2018 3:53 am

Brynmr wrote:Up to 1200 mg but it's been working well for over a month. Timing seems to be important. 600 mg at 5pm then another 600 mg at 9:30. I sleep through the night. Hopefully we're settled in for a while.


Should you become tolerant, you can increase the dose even higher. In Germany a dosage up to 4.800 mg / day is considered safe for teenagers and up to 3.600 mg / day per adult. So don't worry when 1,200 mg is not working anymore. As long as you tolerate the drug, there is some potential to increase the dosage.

Of course please speak with your prescribing physician before making any changes but I just wanted to you know that you have some options in case you should develop a tolerance.

Also when you tolerate Gabapentin but it is not working anymore, switching to Lyrica which is a more potent version of Gabapentin is also an option.

Brynmr
Posts: 18
Joined: Sat Jul 21, 2018 3:15 pm

Re: Increasing Gabapentin dosage

Postby Brynmr » Sat Oct 27, 2018 11:08 pm

Thanks Q. I've seen the ads for Lyrica. I hope it's not too expensive if I need to go that route. Where I am, Gabapentin is pretty cheap.

curqlink
Posts: 67
Joined: Sat Jul 21, 2018 6:38 am

Re: Increasing Gabapentin dosage

Postby curqlink » Sat Oct 27, 2018 11:21 pm

Lyrica is expensive. Even with insurance its a higher copay than Gabapentin.

Rustsmith
Moderator
Posts: 3434
Joined: Sat Sep 28, 2013 9:31 pm
Location: Pueblo, Colorado

Re: Increasing Gabapentin dosage

Postby Rustsmith » Sat Oct 27, 2018 11:51 pm

Gabapentin is a generic medication, which means that it is about as inexpensive as you are going to get. Lyrica can be pricey, but is still less expensive than Horizant. The patents on both Lyrica and Horizant are fairly new, so generics are not likely to become available anytime soon.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.


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