My doctor is STUPID, STUPID, STUPID !!!

[SueJohnson]

I sent a message to him describing how I had to split the 1500 mg of gabapentin I take at night into 3 doses and said I wanted to SWITCH to pregabalin. I said since they didn't make a 250 mg capsule I needed 2 prescriptions, one for 225 mg and one for 25 mg. He wrote back he was confused. Did I want to take BOTH gabapentin and pregabalin. After straightening him out on that he wrote back did I want to SPLIT the dose of pregabalin.Then he phoned me and said since the side effects of pregabalin were DIFFERENT from gabapentin he wanted to start me out on 150 mg of pregabalin (which is equivalent to only 900 mg) and said I might find out that was ENOUGH. At least after asking what I would do if I couldn't sleep at night, he said I could add gabapentin.

[Hidden]

I definitely wouldn’t add gabapentin to pregabalin. Otherwise I think the questions were reasonable as you never know what a comparable dose might be.

[SueJohnson in reply to Hidden]

Why wouldn't you add gabapentin to the pregabalin? It would only be during the one week trial period if I had restless legs and couldn't sleep.

[Hidden in reply to SueJohnson]

They are part of the same thing. One is a derivative of the other. If you took gabapentin as well as far as I recall you wouldn’t be able to tell what Pregabalin was doing & it would be like taking extra doses.Someone correct me if I’m wrong

[SueJohnson in reply to Hidden]

He wanted me to take 150 mg pregabalin for one week to make sure the side effects weren't too bad, so adding the gabapentin would not interfere with that.

[Hidden in reply to SueJohnson]

I only ever took max 150mg Pregabalin, gradually increased from 50mg & didn’t want to increase further due to side effects. I genuinely believe that adding the 2 together will confuse things & you won’t know for sure what is doing what. There are also withdrawal effects when these meds are reduced.I don’t want to interfere any further. I just responded because of your post.

I am a retired GP but have now forgotten a fair amount.

I am just replying in a genuine way & because you were sounding very frustrated with your Dr.

I have no wish to argue & won’t write more on this subject.

I would be interested to hear how you get on and wish you good health.

[SueJohnson in reply to Hidden]

Sorry if I sounded argumentative. I certainly didn't mean to and I appreciate all the comments on this forum.

[Hidden in reply to SueJohnson]

I was meaning more that it might feel as if I was arguing with you and I didn’t want to.I appreciate all the thoughts and ideas too.

[Hidden in reply to SueJohnson]

You probably could, but you'd have to work out equivalences. The accepted, documented equivalence ratio between pregabalin and gabapentin is 1 to 6. i.e. 100mg Pegab = 600mg Gaba. I think you already know this.

If you want to top up the 150mg Pregab to an equivalence of Gaba 1500mg based on this ratio it would mean 600mg gabapentin.

However, I would at least discuss this with your doctor, as I think they still have good reasons for being cautious.

It can be surprsing how little some primary practitioners/GPs know about some of the drugs they prescibe. Admittedly, there are literally thousands of drugs.

[SueJohnson in reply to Hidden]

He was the one suggesting it.

[Hidden in reply to SueJohnson]

Apologies, I was writing in general, not just about your doctor.

Have you discussed the top up dose?

[SueJohnson in reply to Hidden]

Yes I would take the 600 mg gabapentin. When he prescribes after the week the 225 mg and the 25 mg, I will gradually increase the 150 mg pregabalin by 25 mg to see if I can get by with less than the 250 mg.

[Hidden in reply to SueJohnson]

Great, sorted then.

[SueJohnson]

A sleeping aid wouldn't help my restless legs, and I am unique in that I get terrible pain on the top of my legs without enough gabapentin, and this is the main reason I can't sleep.

[Hidden in reply to SueJohnson]

I'm sorry I can't help you.