Doctors letter regarding Gabapentin

[Lambretta175]

Today I have received a letter from my gp's practise regarding the stopping of Gabapentin due to side effects.I presently take 4 x 300mg(2 about 9pm).Although not 100% effective it helps but I'm reluctant to increase after receiving this letter.They have suggested contacting my gp's practise pharmacist,who until now I didn't know existed.The letter refers all the way through about gabapentin for pain relief and no mention of RLS which I use it for.No mention of alternatives or problems with pregabalin either.Has anybody else in UK had a similar letter and what alternatives there is?

[Madlegs1]

Sounds like a generic letter to all patients on Gabapentin.You could query the doctor directly for alternatives.

The NICE guidelines are quite specific, I believe? Ie- for RLS.

[Lambretta175 in reply to Madlegs1]

Thank you for your reply

[Elffindoe]

This may be referring to the new NICE guidelines for Chronic Pain brought out earlier this year.

The guidelines recommend that that patients who've never had gabapentin for chronic pain before shouldn't be commenced on it.

They also recommend that people who are aready taking it and having no difficulties can continue to take it.

They also recommend that where there are difficulties then a withdrawal plan should be disussed.

These guideline are not mandatory, dctors don't have to abide by them They cannot force you to stop taking gabapentin if you were taking it for chronic pain.

However, just to further reasssure you, the guidelines are for chronic pain NOT RLS. Gabapentin is still recommended for RLS.

It appears your doctors are jutr sending the letter to everyone taking gabapentin, irrespective of what they'r taking it for.

[Lambretta175 in reply to Elffindoe]

Thank you for your reply

[Nevermind61]

One of our GPS rang me regarding the discontinuing gabapentin I was taking 2 capsules 3 times daily I went with it and gradually settled at 1 on a morning and 2 in the evening I have coped well with basically half the amount and I told them that was the most that I would do as I wouldn't budge any further which was accepted. I do have some problems with rls but I am managing at the moment. This is the second discontinuation they stopped dihydrocodiene which I managed. With support from Manerva.

[Elffindoe in reply to Nevermind61]

It really depends what you're taking the gabapentin for.

If you're taking it for nerve pain or RLS then it is specifically recommended for those.

It has only been recommended that gabapentin be stopped for primary chronic pain.

It may be that some GP surgeries are interpreting it that gabapentin should be discontinued for ALL conditions, but if so it is a misinterpretation.

If you are taking it for RLS then just make sure that it says this in your medical record.

Additionally, if you are taking it for RLS, then usually you only take it in the evening. RLS is a sleep related disorder.

[Lambretta175 in reply to Elffindoe]

Thanks for the reply.I do take it for RLS.When I started on it after weaning off Ropinirole,I was on the smallest dose which lost effective ness so was increased and told to take one earlier one about 5pm and two at 9pm.

[Elffindoe in reply to Lambretta175]

Great, then there's no reason for anybody to discontinue it.

It does sound as if you're taking 300mg capsules not 100mg. Note that 900 mg is possibly the minimum effective dose and it's written that most people need between 1200 and 1800mg or equivalent in pregabalin.

Pregabalin is better at higher doses.

[Biscuitface]

Hi. Just to say if you are speaking with the Practice Pharmacist make sure they know what RLS is. I mention this as I recently was told by our Practice Pharmacist that once I had seen the Podiatrist my Restless legs would be much better!