Medications timing suggestions requested

[Yankiwi]

Any suggestions will be gratefully accepted.

Every time I wake up (usually two or three times each night) my legs have fairly severe painful sensations which means I need to stay up for 1.25 or 1.5 hours (or more) before it is "safe" to go back to bed. I am hoping that this can be alleviated by changing the timing of my medications.

Currently I take 1000mg of gabapentin and 120mg codeine.

600mg gabapentin at 8pm, 60mg codeine at 9pm, and go to bed around 10.30.
Then around 11.30 or 12 (when I wake up after an hour of sleep) I take 400mg of gabapentin and at my next "wake up call" around 2.00 or 2.30am I take the next 60mg codeine.

I only recently learned (through trial and error and sleuthing on the internet) that gabapentin has a longer lead in time than the codeine which I had been taking first.
This seems to be working better.

I see my PCP next week and will discuss increasing the gabapentin.

Thanks for your input.

[ViewsAskew]

I wish I had some suggestions - hopefully someone else will. That is a long time to be awake - I imagine you'd really like to reduce that!

[Yankiwi]

Luckily for me (not for her) my PCP has restless legs. Maybe she can shed some light on dosage and timing.

[debbluebird]

I'm not sure. I take my gabapentin at 7:00. I take my whole dose. 1800 mg at one time. I used to take 600 three times a day. My pain Doctor started having me take it one time.
I also take buprenorphine. 5 mg at 2:30 pm. I that early to prevent insomnia. I also have a spinal stimulator. It all works together.
I have many nights that RLS does not wake me up. I keep track.
Maybe you need something besides the codeine. I started with methadone, before that it was Darvocet which you can't get anymore. Only certain Doctors in New Mexico who have a special thing can write for narcotics. So I get my buprenorphine from the pain Doctor.

[Yankiwi]

Thanks Debbie, I appreciate your feedback and will take your suggestions to my doctor on Tuesday.

[stockton2malone2]

I would definitely experiment with taking both meds earlier than 9pm. An hour and a half isn't enough time for them to do their job fully. Try 8 for a few nights, then 7, then 6 and keep a quick sleep journal to more easily compare the differences. Also I dont know if that is how it was prescribed to you but it might make sense to take more of the codeine and gapapentin at one time before going to bed as opposed to spaced out in the night, again to give it a chance to fully do it's job and also because it is generally easier to prevent RLS than to stop it after it has started.

[West_Coast]

I take gabapentin, and wasn’t getting enough relief with 600 mg at 8, 600 mg at 10 and an optional 300 mg around 12-2 am. New doctor prescribed 300 at 6 pm, 600 at 8, and 900 (3 300 mg capsules) at 10 pm. I am now getting through the night without symptoms. But it’s a lot of pills to take. I am thinking of trying Horizant (despite cost) because it is supposed to be just one pill a day.

[DontLikeRLS]

Hi,

I can't help, but would like to say thank you. I take codeine but not Gabapentin, although I have taken Gabapentin on its own in the past. I do not experience pain, only an awful feeling that makes me feel like I need to run a marathon. I recently started taking codeine, but am basically serving as my own doctor, as he does not support the use of opioids for the treatment of RLS. Fortunately, he has still agreed to prescribe codeine. Starting codeine was difficult, because I really didn't know when to take it, and what was reasonable to expect from the drug. I saw your post and noticed your dosage, timing and results were very similar to mine. It confirmed to me that I was on the right track, and was getting adequate results from the codeine.

You later stated you stopped codeine and started methadone. How is methadone working for you? Do you prefer it to codeine? Any side effects?

Yankiwi Me

Takes 60 mg codeine 1.5 hours before bedtime. 60 mg 1 hour before bedtime
Wakes up 2-3 times per night 2 - 3 times per night
Takes 1.25 to 1.5 hours to get back to sleep 1 hour to get back to sleep
Takes second dose of codeine 5 to 5.5 hours after first dose 3.75+ hours after first dose
First wake up 1 hour after first going to bed 0.5 to 3 hours after first going to bed

Thank you,