Swapping Gabapentin for Pregabalin

[Mulberry100]

Can I just ask a question regarding swapping 1200 Gabapentin taken in two doses (7pm and 9pm) for Pregabalin, which has stopped working for me. I also take, most nights, 50mg Tramadol. My doctor has agreed to the swap, however, says I will need to wean off the Gabapentin before taking Pregabalin. I am fairly sure I have read on here that it isn’t necessary to do that. Does anyone have experience of doing a direct swap? My doctor wouldn’t prescribe until she has checked with pharmacy, which I understand totally, as I think she is new to general practice and obviously wants to do what she feels comfortable doing. She seemed perfectly happy when I told her about this site and agreed that she is not very knowledgeable re RLS. Clearly, I don’t want to challenge her but would like to know if I am correct in thinking I don’t need to wean off Gabapentin before starting Pregabalin, also I am wondering what dose I can expect to be given. Any advice would be appreciated.

[Walrob66]

Hi Mulberry,I switched 2 months ago. I was on 1400Mg of Gabapentin. My GP said I needed to ween off it completely, but I only dropped it to 600Mg over a couple weeks, and then started on 150Mg of Pregabalin.

Strangely I found that the lower dose of Gabapentin was more effective!

I’m now on 225Mg of Pregabalin (75Mg at 7.30pm and 150 at 10.00pm).

It’s not a miracle pill, but I find results are far better.

[Mulberry100 in reply to Walrob66]

Thanks for your reply. I have read that the lower dose ofGabapentin often works better.

[SueJohnson in reply to Walrob66]

Why are you taking it in 2 doses? The advantage of pregabalin is you don't need to.

[Walrob66 in reply to SueJohnson]

Hi Sue,Thanks for this.

I guess after only two months, I’m still finding my way with Pregabalin.

I was taking it all in one go, but found that I was really drowsy during the morning.

The prescription I receive, is in a 75Mg capsule (rather than a tablet), so can only change in steps of 75. It was when I moved up from 150Mg to 225Mg I felt drowsy in the morning, so started to take one earlier to lessen the impact.

I guess I really need tablets so I can split it into a smaller dose

Kind regards

[SueJohnson in reply to Walrob66]

Or get 25 mg capsules.

[martino]

I was on 2700mg of Gabapentin and went straight to 450mg of Pregabelin. I had no problem at all.

[Mulberry100 in reply to martino]

Thanks for your reply, I’m hoping that the pharmacy will agree that there is no need to come off Gabapentin before changing over ro Pregabalin.

[SueJohnson]

Definitely you don't need to come off gabapentin to switch. I went from gabapentin to pregabalin and back to gabapentin with no problem. In my case I found I needed more pregabalin than the gabapentin which is why I switched back. For 1200 gabapentin, the same amount of pregabalin would be 200 mg. However if 1200 mg didn't work for you, you would need to try the next higher amount of pregabalin which would be 225 mg.

[Mulberry100 in reply to SueJohnson]

Thank you very much for your reply. I am yet to see the doctor as she has been away, but I will try and stand my ground in the hope she will prescribe before I come off Gabapentin. I went through hell coming off Neupro patches before moving onto Gabapentin so very reluctant to be in the same position again. Did you literally stop one day and replace with Pregabalin?

[SueJohnson in reply to Mulberry100]

Yes.

[wantokporo]

I've taken pregabalin for two years. Overall it's a Godsend. But daytime sedation has never gone away . Now taking 125mg and with a Daytime nap and luckily caffeine until 1PM I have a Pretty normal Life. Don't expect perfect.

[joker826]

Hi Mulberry, I tried Gabapentin for several weeks and the side effects were not good for me. I was always tired and listless. Spoke with doctor and he now has me on Tramadol . I have been on this every night for two weeks. I feel much better now and. Not as tired during the day. Did not have to wean off Gabapentin. Pregabalin did not work for me.

[BAK524]

I switched from 1,200 mg gabapentin to 150 mg pregabalin no problem. The two have the same active ingredient but the effects differ. I’m experiencing more side effects on the pregabalin although for me it has been more effective for the RLS. It has taken several weeks to work. Not sure if I can stick with these side effects though. Brain fog. Daytime drowsiness.

[Mulberry100 in reply to BAK524]

Thank you very much for your reply, I must admit I am concerned about side effects but guess it has to be worth a try.

[Hidden]

You do not have to wean off gabapentin before starting lyrica (pregabalin). Important note is NOT to take them both.

[Biscuitface in reply to Hidden]

I think I know the answer but what is the danger in taking both? I know the dosage is completely different and I would not take both but is there another reason? Also is Tinnitus a side effect of any RLS drug do you know?

[Mulberry100 in reply to Biscuitface]

Thank you for your reply. I certainly wouldn’t take both and I haven’t heard of Tinitus being a side effect of any of the prescribed drugs for Restless Legs,

[Beanson]

Hi I've been told I had to wean off gabapentin before I could start on pregabline I was also prescribed nortriptyline to help with sleep and pain.