Gabapentin to pregabalin: I'm switching... - Restless Legs Syn...

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Gabapentin to pregabalin

healthrls profile image
12 Replies

I'm switching from gabapentin to pregabalin as I'd like to be able to just take one dose on an evening as opposed to 3 times per evening with gabapentin.My gp advised me to taper off gabapentin over a period of 15 days and start a low dosage of pregabalin then gradually increase it. I'm already struggling to sleep after 2 days as rls uncomfortable.

Can I just go on to pregabalin and stop the gabapentin altogether? I was on 1500mg gabapentin. Do I just go to 250mg of pregabalin once a day?

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12 Replies
SueJohnson profile image
SueJohnson

Yes - you don't have to taper off . You can switch directly. I am also on 1500 mg and I occasionally will switch when it is inconvenient to take in divided doses and then will switch back.

healthrls profile image
healthrls in reply toSueJohnson

Thank you Sue

Tailwind53 profile image
Tailwind53 in reply toSueJohnson

I’m glad to read “switching from gabapentin to pregabalin/ and switching back”. I was doing the same but finally my dr just wanted me to stay on the pregabalin. ( I never had to taper). So, for most of 2023, Ive been on pregabalin200, and then 220. It’s worked very well. However, I’ve gained 25 lbs. I never had weight gain with the gabapentin.

Because I need knee surgery, the extra weight is a concern. Just wanted to know how to discuss switching back with my dr. Thanks!

SueJohnson profile image
SueJohnson in reply toTailwind53

Just tell him about the extra weight gain and your concern. Multiple the pregabalin amount by 6 to get the correct gabapentin amount. Take 600 mg 1 to 2 hours before bedtime. Since you need more than 600 mg take the another 600 mg 4 hours before bedtime as it is not as well absorbed above 600 mg. Since you need more than 1200 mg, take the extra 6 hours before bedtime. If you take magnesium even in a multivitamin, take it at least 3 hours before or after taking gabapentin as it will interfere with the absorption of gabapentin and if you take calcium don't take it within 2 hours for the same reason.

When you are ready for your surgery post back here and we can give you some advice.

Tailwind53 profile image
Tailwind53 in reply toSueJohnson

Thank you Sue.

Joolsg profile image
Joolsg

gpnotebook.com/pages/muscul... is NO need to taper off gabapentin before starting pregabalin and doing so would cause severe RLS, distrupted sleep and suffering.

The link above is a GP practice guidance and shows that a straight switch is allowed.

Tell your GP that you're making the switch because you have already lost 2 nights sleep using his method.

healthrls profile image
healthrls in reply toJoolsg

Thank you Jools

Rameau profile image
Rameau in reply toJoolsg

See also: gpnotebook.com/en-GB/pages/...

Ilovepinkfloyd profile image
Ilovepinkfloyd

Hi there. I've taken pregab and am now on gabapentin 1200mg pd. I am only taking 600mg due to not eating much currently due to a rapid methadone detox.... With regards to Ur question, yes you can just go over to 250mg pregab, which is a sixth of your gaba dose. No idea why a Dr would ask u to taper and leave u suffering. Sometimes, I forget I've taken my gaba in the morning, and take another dose, then run out early. When that happens, I get a few pregab from my friend to last until my next script is ready, which is every 2 weeks. So I occasionally alternate them with no problems.....

healthrls profile image
healthrls in reply toIlovepinkfloyd

Thank you

Deesee profile image
Deesee

I was taking 1800 of gabapentin in three doses of 600 mg at five, seven and nine p.m. then later in the evening, I would take another 300 mg. and still have some bothersome symptoms during the night. Then my neurologist switched me to 100 mg tabs of Pregabalin at five, seven and nine with 300 mg of gabapentin at bedtime. That was an improvement with some occasional symptoms breaking through, like once or twice a week. With that regime, I felt like I was taking medication all evening long, and honestly, I sometimes didn’t stay on the schedule. Lastly, I consulted with Dr. John Winkelman who switched me to two 200 mg tablets of Pregabalin at seven p.m. with 300 mg of gabapentin at bedtime, if I needed it. Each time I changed the med routine, it was done in one night and brought improvement each time. Presently I am taking the 300 mg gabapentin at bedtime as I still tend to have symptoms towards the morning. This has been the best schedule for me, and I don’t feel so sleep deprived as I did for years. I can still be occasionally bothered with symptoms during the night, but they are manageable. Hope this helps you with your med change.

healthrls profile image
healthrls in reply toDeesee

Thank you

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