transatlantic flight

[Elsie77]

I have asked for advice about an upcoming trip from the UK to Vancouver before but I didn’t explain my concerns clearly, so please be patient with me this time. The flight from UK leaves at 2.15 pm it lands at 11.15 UK time , I normally take 600 mg Gabapentin at 7.00pm and 600 mg Gabapentin at 9.00 pm, so if I take it at this time my rls should be ok on the flight but( this is the part that concerns me) Vancouver time will be about 4.00pm so how do I take my Gabapentin so that I can sleep when I go to bed about 10.00pm Vancouver time? I have asked my GP who says I should be taking the Gaba 3 times a day all the time so therefore there is no problem! I’m hoping to get a couple of hours of sleep on the plane.

[SueJohnson]

You might want to take an extra 600 mg when you go to bed in Vancouver. It might not last thru the night in Vancouver but with the change in time you are not likely to sleep through the night anyway. Or if you think you would you could take your gabapentin at your regular times in Vancouver. You won't overdose on the gabapentin. While there you might want to see a doctor to get a prescription for a few pills of Horizant which is a 24 hour version of gabapentin. Unfortunately you can't get them in the UK.

[Elsie77 in reply to SueJohnson]

Gabapentin encarbil is licensed in the uk, 5 mg tablets would that do instead?

[SueJohnson in reply to Elsie77]

They usually come in 300 mg or 600 mg.

[SueJohnson]

I do see United Pharmacies normally carries it in 300 mg but they are out of stock. They also carry ten 400 mg at a much cheaper price but they are out of stock on those too. unitedpharmacies-uk.md/Gaba... You might want to search further on your end. I am in the US.

Interesting by the way as others had said it wasn't available in the UK.

[SueJohnson in reply to SueJohnson]

My mistake - the 400 mg one was for just gabapentin. This is the one for gabapentin enacarbil unitedpharmacies-uk.md/Regn... but as I mentioned it is out of stock and is for 56 tablets and costs £ 160.74.

[Elsie77 in reply to SueJohnson]

I have found 3 companies that sell Gabapentin enacarbil in the UK. What would you recommend on dose with Gabapentin while I adjusted to new timings in Vancouver. I will now try to talk my GP into prescribing a small amount. Thanks so much for your help.

[SueJohnson in reply to Elsie77]

That's great.You might want to take it instead of your 7 pm and 9 pm doses of gabapentin at 9 pm on the flight over and continue taking it the following days at the same time including on the flight back to the UK unless you are staying a long time.

[Elsie77 in reply to SueJohnson]

I’m going on to Alaska for 10 days then 8 days in Toronto, we’re on a night flight back 6.40pm arrive 6.30 Am Uk time.

[SueJohnson in reply to Elsie77]

The gabapentin enacarbil will be perfect for you since you will be changing time zones more than once.

[SueJohnson in reply to Elsie77]

If you are staying a long time so want to transition to gabapentin, ask your doctor if it would be OK to take the Horizant at the equivalent of 9 pm UK time and then take your gabapentin that same day at 7 pm and 9 pm Vancouver time. I suspect it would be fine.

[Elsie77]

Sue, what dose of Gabapentin Enacarbil? Same as Gabapentin or less?

[SueJohnson in reply to Elsie77]

The 300 mg of gabapentin enacarbil should be fine.

[Munroist]

This is a difficult one and depends on a few things. I'm not sure anyone can give you 100% right answer as you will know how your RLS works. You've said you take 1200mg a day in two 600mg doses at 19:00 and 21:00. Firstly for your first night I don't see a problem with Sue's suggestion - if you take an extra 600mg at 10pm Vancouver time which is the same as 6am UK time so you could argue you are taking your first dose of the next day early. If you take another two doses that following day then that's quite a big jump in dosage, i.e. 50% and you need to decide whether you are OK with that.

If your RLS symptoms are related to your circadian rhythm where dopamine drops to a minimum sometime between 23:00pm and 01:00 then using Vancouver time this will occur 8 hours early i.e. 4pm on your first day full day in Canada. However it should adjust to Canada time by 1 hour a day so will get 1 hour later each day. If that is what determines your symptoms then you should move your dosage times back the same amount so day 1 would be 11:00 and 13:00, then day 2 would be 12:00 and 14:00, day 3 13:00 and 15:00. After 8 days you should have adjusted to Canada time and be taking the doses at 19:00 and 21:00 again. Alaska time is just one hour later so shouldn't be a big jump

If however your symptoms are more related to when you actually sleep then you might have to move the times of the drugs back more quickly and possibly spread them out to get more coverage so maybe on day 1 try 16:00 and 20:00 Canada time. If this is a bit late you might feel symptoms coming on early in which case I'd suggest that's the time to take the first dose. If on the other hand you got a lot of symptoms during that night then maybe move them back faster.

This is how I'd approach it, I can't say it will work for you. Hopefully some of it might be useful.

[calschwartz27]

I feel your pain. I would add do not eat any sugar for at least 24 hours before the flight. Avoid caffeine if possible. If at all possible take an opioid (unless there is concern for addiction)- even small dose of codeine will help.

[Elsie77]

thanks for all the suggestions, my rls would start around 8 to 9 pm without anything then progressively get worse. Is there anybody who has swapped from Gabapentin to Gabapentin enacarbil or horizontal, was it a straight swap ie same dose or was it less gaba enacarbil? My gp will likely know nothing so I need to be armed with as much information as possible before I suggest anything.

[SueJohnson in reply to Elsie77]

Gabapentin enacarbil comes in 300 mg and 600 mg and 300 mg is generally almost as good as 600 mg, so I would suggest the 300 mg. It can be a straight swap. I forgot to mention that it should be with food because the bioavailability is greatly increased,

[Elsie77]

Sue you are truly a fount of knowledge, now I have to email my Gp.