Pregabalin increase?

[wantokporo]

First, I apologize for asking a question that I am sure has been asked many times. I am trying pregabalin again after a drug vacation hoping against hope that it might be effective again. The question is how long should I stay at each dose before deciding I need to increase? Of course I want to stay at the lowest effective dose. (This experiment Is complicated by my coming slowly off morphine at the same time. ) Thanks

[SueJohnson]

Wait 3 weeks after you start it and then you can increase by 25 mg every couple of days

[wantokporo in reply to SueJohnson]

Sue, I'm not sure I understand: "wait 3 weeks "....do you mean take a 3 week break before trying again, then start at 25mg and increase every couple of days? So I should know within a few days if the new dose is working?

[SueJohnson in reply to wantokporo]

I assume you have been off it for awhile so you will be starting it again. It will take 3 weeks after you start it again to become fully effective so don't increase until the 3 weeks is up. You can start at anywhere from 25 to 75 mg. 75 mg is the usual starting dose. After that 3 weeks is up you can increase it by 25 mg every couple of days.

[wantokporo in reply to SueJohnson]

Bottom line: don't go past 75mg for 3 weeks before going to 100mg.

[SueJohnson in reply to wantokporo]

right

[wantokporo in reply to SueJohnson]

Thanks

[maggiemay66 in reply to SueJohnson]

SUE, I've recently started taking pregabalin , 7 weeks ago ,. I'm on 75 mg twice a day .I'm scared to increase the dose because my legs have greatly swelled , so much so that the skin on my legs feels very taut . Is this a normal side effect ? Should I be worried or will the swelling lessen as my body becomes used to taking this medication? I'd appreciate your advice

[SueJohnson in reply to maggiemay66]

Edema can be a side effect of pregabalin. Usually it is around the ankles and lower legs. You might want to try switching to gabapentin. Although they are basically the same drug except you need to divide the doses, and the side effects are basically the same, some people find that the side effects that bother them on one don't bother them on the other. Multiply the pregabalin amount by 6 to get the correct dose. 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. If you take magnesium, even in a multivitamin, don't take it within 3 hours of the gabapentin as it reduces the absorption of the gabapentin. If you take calcium don't take it within 2 hours for the same reason.

By the way you don't need to take pregabalin twice a day unless you have RLS symptoms twice a day. It is often prescribed that way because it is usually prescribed for nephropathy so that is what is in the prescribing instructions.

[maggiemay66 in reply to SueJohnson]

Thanks Sue, I'll take note of your advice.

[Amrob]

What dose pregabalin were you on previously? That should be a rough guide to what dose you'll likely need. Given that PLMD is your main concern, there's a lot of variance from night to night in movement. Therefore, if you're looking to stay at the lowest possible dose, i'd be inclined to give each dose increase 5 to 7 days. That way you'd get a better "average" of how that dose helps your sleep.

[wantokporo in reply to Amrob]

Thanks. I was thinking of that. Frankly last time I kept increasing the dose because I thought it would be a magic bullet and I would sleep like the rest of the world. I have much lower expectations now.

[SueJohnson in reply to wantokporo]

However - if after 2, 3, 4, 5. 6 days it is still controlling your PLMD you obviously wouldn't increase it. And if after 2, 3, 4, 5. 6 days it is not controlling your PLMD even if the average is lower, I suspect you would want it to control it every night not just most of the nights. I guess if after the 1st night it doesn't control it, you might wait and see how long until there is a 2nd night like that as it may have been a one-off. Also you can decide if you are willing to live with it being bad only every so often in order to keep your dose low.

[Marzipana]

Hi Wantokporo. I don't think you need to feel dumb asking questions here! I'm relatively new and am so impressed with the knowledge and compassion all of these folks have. I've been on pregabalin (Lyrica) for about 10 months. I started a low dose as I came off Ropinerole and Gabapentin, which I'd been on 25 years. My dose of Lyrica was 300 mg, but after being on that dose for months with no positive effect, I came down to 150 mg. I'm tempted to wean off it to see what happens. Sue gives such good advice, so you should follow that. I'll be interested in following how pregabalin goes for you. What happened with the morphine?

[Bumble34]

Hi, I restarted Pregabalin last Nov. after a break of a few Months, gradually worked up to 300mg no effect whatsoever, in fact had I been in a Clinical Trial I would have assumed to be on the Placebo. A year or so prior I was getting respite at 175mg for a few Months, as is often said we are all different, good luck.

[wantokporo]

I quit pregabalin six months ago when it was making me nervous and keeping me awake. Even tylenol was making me nervous, which is quite unusual. Dr. B and someone on this list hinted at a possible psychological response. I was having big personal problems then and recently learned about that in some fabulous mind/body therapy about how I was experiencing my emotions physically. I feel much less anxious now so I thought maybe the pregabalin might work again, and I have learned not to expect so much from drugs. Some people get "fixed", but not everyone.