I have had restless legs syndrome for many years and with the advise I took from here, I am on Gabapentin.
In October, my doctor prescribed 100mg increasing to 300, he just upped my dosage to 600 mg daily to try.
Should I take the two pills at the same time( as prescribed) or take a few hours apart. Is it better to take them a few hours before bedtime?
Thanks
Your doctor is too conservative. s/he should have started increasing after 3 weeks. Yes you can take them both together. Ask your doctor for 100 mg capsules and increase it by 100 mg every couple of days until you find the dose that works for you. Take it 1-2 hours before bedtime as the peak plasma level is 2 hours. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin." If you take magnesium, even in a multivitamin, take it at least 3 hours before or after gabapentin as it interferes with the absorption of gabapentin and if you take calcium don't take it within 2 hours for the same reason
I may have asked you this before but have you had your ferritin tested? If so what was it? Increasing it to 100 or more reduces symptoms in 60% of people. If not when you see your doctor ask for a full iron panel. Stop taking any iron supplements including multivitamins that have iron in them 48 hours before the test, don't eat a heavy meat meal the night before, fast after midnight and have your test in the morning before 9 am if possible. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you some advice.
My levels are all normal, thank you for all your advice.
What is normal for others is not normal for those of us with RLS.
Hi Sue.. I'm at the mercy of your knowledge on RLS and hopefully you can provide me with some good advice. So currently I'm taking Gab 400mg at 2.00pm. I take another 400mg of gab at 4.00pm, another 400mg at 6.00pm and another 400mg at 8.00pm, so in total 1600mg of Gab . If I go to bed around 9.30pm and go STRAIGHT to sleep, I seem to have a fairly good night for the best part. If I don't go straight to sleep my legs start to play up, then that's it for several hours until I give in and take a 5mg of valium which then takes another hour or so to kick in and eventually I get off to sleep. Obviously, I don't want to be in a position where I'm taking Valium all the time, do you feel I need to increase the dose of Gab and persevere or maybe switch to Pregabalin and give that a try?? Obviously due to the Absorbtion of Gab and the limits of each dose being approx. 600mg I would ask how I increase my current dose to a higher limit and without having to start taking in at very early afternoon??
Are the doses you take at 2 and 4 controlling your daytime symptoms? If so I would try increasing the 8 pm dose by 100 and if that doesn't work after 2 days to 600 and if that doesn't work do the same thing to the 6 pm dose.
Hi Sue, I don't really have any RLS symptoms during the day at all. I can sit and watch TV for after dinner and also have no RLS symptoms, however as soon as I go to bed and try and drift off to sleep it's like a bloody switch is turned on and my RLS starts. If I'm really tire and I go straight to sleep, I seem to be ok for the night (mostly) if I don't go straight to sleep them my RLS start and that it for several hours .. So are you suggesting I take 2 x 400mg tablets say at 6.00pm, then another 2x 400mg tablets at 8.00pm and see how that goes?? Q?? is gabapentin preferred over Pregabalin by most of the members on here??
No - 2 X 400 would actually result in less than 800 mg. For example if you took 900 mg, it would be the same as 540 mg.
I was suggesting move your 8 pm dose up to 600 mg and if that is not enough moving your 6 pm dose also up to 600 mg. If you only have 400 mg capsules ask your doctor for 100 mg capsules or buy an inexpensive jewelry scale on Amazon ($11 in the US) that measures down to .01 gram and open up the capsule and measure the contents and then measure 1/4 of it so you can increase by 100 mg to as mentioned above, since 500 might be enough and if not then use 1/2 of the contents to get to 600 mg.
Also if you can get 100 mg capsules you could try reducing your daytime doses to 300 mg using the reduction to add to your 6 and 8 doses so you are taking the same total amount and see if your daytime symptoms are still under control. They are probably left over from your withdrawal from pramipexole so may be gone by now or at least less.
There is no advantage to switching to pregabalin.
If your doctor is reluctant to have you increase the dose every 2 days, print out and show him/her the appropriate section from the Mayo Clinic Updated Algorithm on RLS at Https://mayoclinicproceedings.org/a...
This sounds like my Dr. started me off at 100mg and said increase 100mg every two weeks. I told her I am never gonna get relief at that rate. Sent her the mayo algorithm but I know she didn’t read it. Anyways- I am now up to 700mg and I am getting some relief now. Last night was the first night I’ve slept in months. Only woke up once around 1pm and had to use cannabis for quick relief but fell back to sleep with no problems afterwards. Sue Johnson, I am taking 100mg at 6pm and 600mg at 8pm. Would it be beneficial to just skip the 100mg at 6pm and take it right before bed at 10pm if the 600mg allows me to fall asleep?
No - I wouldn't suggest that. If your want you could move everything up by 1 hour. 600 mg at 9 pm and 100 mg at 7 pm. I'm glad it is starting to help.
Yes I am finally feeling optimistic about getting relief. Last night was the best sleep I’ve had in months! Thanks for all that you do for this community SueJohnson.
Tbone87, have you ever tried to treat your RLS with cannabis only? When I went to see a Neurologist and got my RLS diagnosis, I asked for a 'medical cannabis' prescription. I have never used cannabis before and don't know if it helps with pain. I assume it helps with falling asleep, but does it help to control the restless legs and pain as well? My Neurologist said that he was not allowed to prescribe 'medical cannabis' for RLS. I am now using Gabapentin which helped me getting rid of the pain in my legs. I can also sleep much better. But I am still interested in trying out 'medical cannabis' for my RLS if they should ever allow it for prescription.
It worked for me for about a year, but then just just became less effective and was waking up 3-4 times a night to use to get relief. The relief would only last 30min-hr.
Thank you Tbone87. Your reply was very helpful.
Hi Sue.
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