Gabapentin v Antibiotics

[auldreekie18]

Just out the hospital with bad leg infection ,before going in to hospital on Gabapentin 1800mg split into 3 600mg doses and it worked fine no R.L.S in hospital put on Fufluxacillin sorry about the spelling anyway it cancelled out the Gabapentin and I had bad R.L.S all the while in hospital and had a weeks supply of antibiotic tablets to take now they are finished very dissapointed to find Gabapentin not working well as it was before the antibiotics do not know to increase the Gabapentin or try something else what do you think .

[SueJohnson]

That is strange and certainly depressing. I would increase the gabapentin. 3600 mg is the maximum dose. Since you will now have to take the additional amount two hours before your current earliest 600 mg dose, you might want to consider switching to pregabalin which you can take in one dose. 300 mg of pregabalin would be equal to 1800 mg of gabapentin. And it is just possible the 300 mg will work without increasing it. If not add 25 mg every couple of days.

[RLSdaily in reply to SueJohnson]

I would consult your doctor, that is a high dose of Gabapentin for RLS

[SueJohnson in reply to RLSdaily]

I wasn't suggesting he increase it to 3600 mg. I was just letting him know that there was still room to increase it beyond what he was currently taking. Check out the Mayo Clinic Updated Algorithm on RLS if you haven't already at Https://mayoclinicproceedings.org/a...

[auldreekie18 in reply to SueJohnson]

Thanks Sue getting a Doctor phone call on Friday will see what she says .

[Butterflysun1]

I would ask the prescribers permission if you increase anything. It will be prescribed at a certain dose with the numbers of tabs supplied to match & if you don’t ok it with your dr you are likely to run out.The other thing is that the Flucloxacillin may not be the cause. It may be something else related to the infection - more inflammation, an effect on iron stores eg.

I would advise you discuss with your drs - we are not qualified here to give you medical advice like this

[Joolsg in reply to Butterflysun1]

Sadly doctors aren't taught about RLS so we have to supply them with the up to date prescribing information. We print out the latest Mayo algorithm & hand over to our doctors. It sets out the meds and the max. doses. Many doctors are also unaware that gabapentin isn't absorbed well above 600mg so the dose needs to be split.I agree that for other medical conditions, consultation with a GP is useful, but not for RLS.

[Butterflysun1 in reply to Joolsg]

I know and I understand and it’s highly frustrating. I’m sure it will always be useful to print out the Mayo guidelines & help educate everyone.But the reason I suggested to discuss with the dr is twofold. The 1st is if someone doesn’t and just follows the advice on here they will run out of their currently prescribed tablets & may not get the Drs agreement to prescribe more which will leave them worse off.

And secondly because the deterioration coincides with the Flucloxacillin doesn’t mean the Fluclox is the cause.

Also if it IS the Fluclox and the course won’t last much longer then altering doses isn’t wise, much as it’s dreadful just now.

Basically it appears that the deterioration coincides with a severe infection and one of the things that happened during the infection is that Fluclox was prescribed.

But other less obvious biochemical things happened as well. There was I expect a great deal of stress. Fighting the infection may have depleted iron stored and some other possibilities.

So, if it is the Fluclox it won’t last much longer. If it isn’t the Fluclox I’d want to know what it is and in particular have some blood tests and especially iron.

And to remember that during infection this is exactly the time when iron and especially Ferritin can appear ok when it isn’t as Ferritin is raised during inflammation but not actually iron level

It could easily be hard to get a GP to consider all this but I think it is unwise to blame Fluclox unless it is well recognised that Gabapentin & Fluclox interact.

What to do requires some thought & discussion, not just blame Fluclox and suggest upping the Gabapentin dose

[restlessstoz]

I wonder if you also have killed off a lot of beneficial bacteria in your gut. The gut biome is extremely important in ways we don't understand so I would make a concerted effort to add lots of good bacteria to your diet, yoghurt, keffir, probiotics tablets, or go the natural way and have fermented foods like kombucha and organic saurkraut. I know when my gut health was bad, I didn't absorb iron at all well and who knows what else! Good luck!

[John_naylor]

I’ve only once been in hospital and that was for just the day. I spoke to the specialist weeks before and warned him of the consequences of operating on me under anaesthetic if my RLS took off. I had great interest from different doctors and nurses and the anaesthetist. They even put a bracelet on me to indicate the problem. I was given special medication and had no problems at all. So if attending hospital for treatment I recommend discussing seriously as they can give the correct medication and care.

[67Waterman in reply to John_naylor]

Such a good idea John. Do you know what special medication you were given? Warm regards Sally

[John_naylor in reply to 67Waterman]

Sorry, no, it came in a syringe and I was gone!

[soupersuzy in reply to 67Waterman]

When I was in hospital several years ago I experienced horrendous RLS and was sure it was the anaesthetic that caused it. Somebody on here told me it's to do with the anti sickness element they put in and to ask for Zofran. Maybe the discussions John_naylor had with his doctor highlighted that.