any successful stories switching from opioid to pregabalin?

[halperinchen]

I need to try to switch from oxycodone 5 mg to pregabalin due to the profound insomnia it causes and feel trepidatious about it. I have never tried pregabalin before and started taking oxycodone from the beginning, 4 years ago with success except the profound insomnia it causes. I did take Gabapentin to relieve my not so serious RLS about 11 years ago. I don't know how to proceed the whole process, how to taper off the Oxycodone I am presently taking and in the meantime how to start pegabalin and in what dosage? Is this doable? I need the experienced and knowledgeable members to give me guidance. I'd appreciate it so very much, and thanks in advance from some one lost and confused.

[Steg12]

HiI have been on oxy for approximately 20 years the doctors are now trying to ween me off as government guide lines I am on 50mg now I was on 80mg and pregrabalin

75mg day and 25mg night and the messing about has caused me no end of problems

Every bone and joint ache my legs feel like they are on fire 24/7 life is hell.

[LotteM]

Halperinchen, you are on the lowest dose of oxycodon, Am I right? Only one 5mg tablet in the evening, I assume? If so, you can only taper by cutting the tablet. If it is the normal oxycodon, this can be done. With slow release version, Oxycontin, cutting disturbs the release process and should not be done.

Most people's experiences here on HU are that pregabalin takes a while to become effective, 2-4 weeks. Following that, you should start the pregabalin already and wait a little to stop the oxycodon. Typical doses can be found in the latest updated guidelines: mayoclinicproceedings.org/a...

As 5 mg is t he lowest dose, stopping it will make you feel the RLS symptoms again. As the dose is so low, withdrawal effects should be minimal, but it is hard to tell, as all people are different.

[halperinchen in reply to LotteM]

Dear LotteM, thanks for your guidance, Can I start taking pregabalin 300 mg right away and taking Oxycodone in the meantime and then taper off the oxycodone by cutting the tablet a little at a time? Thanks in advance. I have been taking pregabalin 300 mg about once a week for sleep all these years. So Can I start taking it 300 mg right away or I have to take lower dose in the beginning and increase the dosage gradually?

[LotteM in reply to halperinchen]

Halperinchen, I really don't know about restarting pregabalin 300mg right away. It may depend on how long it is since you stopped taking that dose and how well you tolerated it and most of all how you feel yourself about it. I am not a medical doctor and I don't know you or your medical history, so difficult to give specific advice. We can inly share experiences and reliable general resources. Sorry not to be of more help.

[halperinchen in reply to LotteM]

LotteM, thanks.

[HeBgBgirl in reply to LotteM]

Hi Lotte im just curious why your doctor is not providing any guidance to you? Although you’ll probably get better advice on this forum!! Are you in US? Or Uk?

[LotteM in reply to HeBgBgirl]

Hi HeBgBgirl, I have no problems with my doctor and have been on the samen effective medicine for RLS for several years now. Maybe your reply was intended for someone else?

[HeBgBgirl in reply to LotteM]

You are correct except I can’t find the person etc I was responding to!🥴

[Munroist]

Hi, in my experience pregabalin was reasonably straightforward to take and come off and had relatively few side effects. My doctor started me on 150mg a day in two 75mg doses 12 hours apart which I then raised a week later to 300mg a day, again in two doses 12 hours apart. The full benefits came in after about a week. The side effects were a slight loss of mental sharpness although only noticeable to me. 300mg a day is not the maximum dose but is normally enough to be effective. I took it for neuropathic pain which it helped but didn’t completely eliminate. I think it also helped my RLS but that wasn’t as bad at the time so difficult to say. I came off it in the end because I preferred some of the nerve issues to the loss of sharpness and it took a while decreasing 75mg at a time on the overall dose and leaving it at the new level for at least a week. The main obstacle to reducing for me was a worry about whether I’d manage but it was ok. Main thing is don’t rush and get anxious, just take your time. Overall though it was a useful drug and helped me move on and the benefits in reducing anxiety were very welcome.

[halperinchen in reply to Munroist]

Thanks Munroist, are you still taking pregabalin 300 mg and is it effective to relieve the rls symptoms?

[Munroist in reply to halperinchen]

Hi, I don’t take pregabalin any longer. I was taking it for neuropathic pain and eventually didn’t need it. I think that it improved the RLS while I was taking it but didn’t remove it completely. I was certainly getting up fewer times while taking it and the RLS got worse after coming off it. However there could be other factors such as general progression with age and effect of increasing exercise. Overall I think it helped but didn’t remove RLS completely.

[SueJohnson]

I would suggest gabapentin rather than pregabalin because you can increase it by smaller doses (100 mg). Once you find out what dose works you can switch to pregabalin if you want (they are basically the same except at higher doses of gabapentin, you don't need to divide the dose of pregabalin but can just take one dose - divide the gabapentin dose by 6 to get the pregabalin dose). I would start it at least 3 weeks before you are off oxycodone since it takes at least 3 weeks to be effective, although it won't help much until you are off oxycodone. Beginning dose is usually 300 mg gabapentin (50 mg pregabalin) or 100 mg if you are over the age of 65 , and increase by 100 mg every few days until you find the dose that controls your symptoms. Take it 1-2 hours before bedtime. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. Typical effective doses are 1200-1800 mg. Most of the side effects of gabapentin or pregabalin will disappear after a few weeks and the few that don't will lessen.

[halperinchen]

Thanks SueJohnson, unfortunately, I have difficulty tolerating Horazant it give me terrible stomach ache, I am fearful gabapentin would do the same to my stomach. By the way will pregablain lead to augmentation eventually?