Pregabalin

[Coeso]

Can one add gabapentin to pregabalin or is it better to stick to one. Also what is the highest dose of pregabalin. Is it 600mgs or is that too much. I'm now on 3000 mgs gabapentin and I'm still waking up with my leg. I'm going to change to pregabalin to see if it helps. If it doesn't help I will lessen the dose and take some codeine or tramadol with the gabapentin. I didn't want to take an opioid too but maybe I have to.

[SueJohnson]

Yes the highest dose is 600 mg. I would stick to one although you can take both as long as the total does exceed 600 mg pregabalin which is the highest dose. Divide the gabapentin by 6 to get the equivalent pregabalin dose.

I am confused though. At 1500 mg gabapentin you said it worked and then again at 2100 mg.

If you later decide it is not working you need to do so very slowly to avoid withdrawal effects. Reduce by 25 mg (100 - 200 mg) every 2 weeks. If you do so you will have no withdrawal effects.

Tramadol is the only opioid that can cause augmentation. Codeine is a very weak opioid. If you go the opioid route I would recommend buprenorphine or methadone as they are long lasting. Most of the others need to be taken every 4 to 6 hours or you will have mini withdrawals.

[Coeso in reply to SueJohnson]

Thanks. Although it's working quite well I still wake up once at around 1.30 in the night with my leg. It's not too bad and after a walk around and taking an otc ibuprofen and codeine I sleep till the morning. I have nothing all day and I can go to the cinema in the evening, which had become an impossibility. So that what I mean by it's working. I'm still playing with the dose to see if I can get it to work fully. In Greece they won't prescribe buprenorphine or morphine. My GP and Neurologist, who are lovely and helpful tried but the system wouldn't let them enter it into their computers. All our prescriptions are sent to our phones here. They can only prescribe it in drug addiction centres and pain clinics. If my rls gets unbearable I will try and get an appointment. Thanks for helping.