Gabapentin to pregabalin

[Whippetmama]

I have been taking gabapentin for about forty years. It was originally prescribed for nerve pain back when it first hit the market as Neurontin. Now I would like to switch to pregabalin. I would like to switch to pregabalin because it's less expensive.

Since I have been taking it for so long, do I need to taper first or can I do a direct switch? And is there a formula for converting gabapentin dose to pregabalin? I am currently taking 1800 mgs. of gabapentin

BTW, I live in Mexico and both gabapentin and pregabalin are OTC and so is tramadol.

Thanks.

[SueJohnson]

You can switch directly. 1800 gabapentin is 300 pregabalin and you don't need to take it in divided doses. If you weren't dividing the gabapentin into 600 mg 2 hours apart then you probably won't need as much pregabalin as gabapentin is not as well absorbed above 600 mg. I would then suggest you try reducing the pregabalin by 25 mg every couple of days after you switch. Interesting that pregabalin is cheaper than gabapentin in Mexico. It is just the opposite in the US.

[Whippetmama in reply to SueJohnson]

Thank you. I have been dividing the gabapentin into 3 doses of 600 mgs each -- morning, late afternoon and then at bed time. The reason pregabalin is less expensive in Mexico is simply because I wouldn't need as many pills.

[Joolsg in reply to SueJohnson]

Same here in the UK. The cost of gabapentin for the NHS is more expensive than gabapentin. But we don't pay for our meds if over 60 & max cost for ALL meds for a year is £108 with a prepayment certificate. Maybe it's because of the licence for Neurontin?

[SueJohnson in reply to Joolsg]

With my insurance I pay $48/year for 1500 mg gabapentin. Retail would be $444 whereas retail for pregabalin would be $6,740.

[Joolsg in reply to SueJohnson]

That is unbelievable! Is generic pregabalin available cheaper than branded Lyrica?

[SueJohnson in reply to Joolsg]

Probably since they usually are.

[Whippetmama]

Sweet. But I doubt it has anything to do with the brand name Neurontin. The patent on that expired long ago. Hence, generic version.

[67Waterman]

Hi Whippetmama. About three months ago I switched from 1800 Gabapentin (split up into three doses) to just one dose of Pregabalin (300mg at around 6.00pm at night - I am usually in bed by 10.00pm or earlier). Pregabalin is now the first line choice over Gabapentin and is so much easier to take. Hope this helps. Sally

[ircam2112]

This seems like it’s a question for a doctor, if you have access to one. When I tapered off both gabapentin and Pregabalin, I had some mild withdrawal symptoms but also a major one - significant daytime letheragy. There are other serious withdrawal symptoms esp with Pregabalin - though i know thats not your situation right now. When I increased gabapentin too quickly, I felt quite dizzy, had headaches and lethargy.

Sue may be correct but of possible, I’d speak to a doctor or at least seek some expert opinions - Pubmed or Medline may have published studies on the subject.

I’m extra cautious now through experience not to make med changes without relative certainty. I felt really confident but have paid the price a few times. Plus, I continue to read studies on more and more drugs that are having unexpected health or behavioral impacts e.g.) impulsivity with DAs, antidepressant discontinuation syndrome (what I have. Parasomnias like PLMD/RLS are one of the symptoms). The worse part is that you can never tell when you’ll be the one.

Be careful and safe. Coming to Mexico soon! Oh yea!

[wantokporo]

I switched directly the other way: pregabalin to gabapentin without reducing pregabalin first. First couple of days was a little rocky but not a huge deal. But as I mentioned elsewhere, my hope to reduce daytime sedation with this change did not pan out as my doctor predicted, and also a part of why he was willing to prescribe Modafinil I think to help with that issue.

[Amrob in reply to wantokporo]

How is the Modafinil going for you?

[wantokporo in reply to Amrob]

It's only day three, but I couldn't be more excited to be awake!!! I haven't been awake for years, and the low grade depression that goes along with this sedated state is gone. The other good news was that this can be exorbitantly expensive and somehow this online coupon brought the price down to less than $1 a pill (down from $20 a pill).

[Amrob in reply to wantokporo]

That's fantastic news. Hopefully the good effects continue indefinitely.

[Donnymmm]

i just saw these comments on here and thought I'd offer non another non -doctor opinion. I've been taking a significant amount of gabapentin over 20 years. 1 200mg3xa day! My nerve pain is excruciating still but withdrawal worse. I won't eat, sleep, talk AND being majorly comes with that. I can't eat, and sleep deprivation kicks in LITERALLY after about a week of no sleep AT ALL. My wife says the depression is the worst part though. I mean suicidal depressed. Ive Tried everything to stop. Tapering, cold turkey etc. I can't escape it! Any advice for me maybe? I'm hoping somebody knows a way because I can't find it but as for whippetmama, be very careful and thank you for opening up this discussion because I've never come across anyone having similar issues I felt alone with this. Good luck. I mean that I'm really struggling with this. Can I order them through mail Mexico? Just a

[SueJohnson in reply to Donnymmm]

You need to reduce gabapentin very very slowly. If you do so you will have no withdrawal symptoms. For depression I would recommend Wellbutrin or Trazodone both of which are safe for RLS. And you might want to try a low dose opioid for your pain. For sleep you might want to try ativan or ambien. Check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it if needed Https://mayoclinicproceedings.org/a...