gabapentin or pregabalin?

[silvia10]

Which is the best? Or not much difference between the both and just try and see which one works? Or if 1 doesn't work then the other probably will neither ?

[Hidden]

Both of these two work in the same way and have more or less the same side effects.

Some people say that when one hasn't worked or has caused side effects then switching to the other has been better, but it's not clear why this is.

Getting the dose right for both involves a bit of trial and error and it's best to keep the dose as low as possible.

In terms of finding the lowest effective dose gabapentin has an advantage in that it is less potent i.e. pregabalin is approx six times more potent. As an example 50mg pregabalin is the equivalent of 300mg gabapentin.

This lower potency allows any dose to be built up more gradually.

In other respects however, for RLS pregabalin has more advantages.

The main advantage is that pregabalin is more easily and consistently absorbed than gabapentin.

The maximum proportion of a dose of gabapentin that is absorbed is 80% of what is swallowed. In addition this proportion decreases as the dose is increased. Doubling the dose of gabapentin swallowed does NOT double the amount absorbed.

At higher doses as little as 20% may be absorbed.

This can be counteracted to some extent by splitting the dose, but it's been written that there's little point to increasing the dose above 1200mg because any further increase will give no further benefit.

For pregabalin however 90% of what is swallowed is absorbed and this doesn't change no matter how high the dose is increased.

Another advantage of pregabalin is that the effect of gabapentin is more variable, for example the half life of gabapentin is between 5 and 7 hours, the half life of pregabalin is 6 hours. This is a measure of how long it takes for effects to wear off.

[WideBody in reply to Hidden]

Thank you.

[silvia10 in reply to Hidden]

I somehow felt intuitively more for gabapentin, probably because of the lowest dose possible. Im very med sensitive.

[Hidden in reply to silvia10]

The lowest size pregabalin dose is 25mg. The lowest gabapentin 100mg.

100mg gabapentin is roughly equivalent to 17mg pregabalin.

If that helps.

I take gabapentin myself.

[Joolsg]

Really depends on how your body reacts to each med.Everyone reacts differently.

I didn’t get on with Gabapentin- too many side effects so switched to lower dose pregabalin.

[Sampsie]

I second what's already been said. I found Pregabalin more effective with much left side effects than Gabapentin, but my hair is falling out on both so I need to come off it.

Hope it works out for you.

[Jen70]

Cant help very much as have only tried Pregabalin and that works most of the time for me at 75mg but have doubled it a couple of times when over tired which is when its really bad.