Gabapentin and pain meds which one to go for?

[Speedbuggy]

I'm taking gabapentin 900 all day for periodic limb movement disorder however I have a very painful arthritic shoulder and torn rotator cuff. The Dr has tried me on codeine but it made me very ill. Does anyone know what pain medication can be taken with gabapentin (I've tried paracetamol, co-codamol, can't tolerate nsaids or codeine). I'm on a lot of other meds for heart, blood pressure, acid reflux, cholesterol Thank you

[Joolsg]

Avoid anti depressants used for pain relief as all anti depressants trigger or worsen RLS and PLMD.Many of your meds could be triggering/ worsening your symptoms.

Statins, beta blockers and PPI meds like omeprazole, all trigger/worsen RLS.

You should discuss possible alternatives with your GP, but ne aware that they don't know that these meds worsen the disease.

Gabapentin only needs to be taken at night for RLS/PLMD. In split 600mg doses 2 hours apart. If codeine made you very ill, other opioids may have the same side effects.

But generally, opioids like tramadol, codeine, oxycodone can be taken with gabapentin BUT there is a small risk of respiratory depression, especially if you have breathing issues.

Medical cannabis might help the pain, but it takes around 4 weeks to get the prescription.

rls-uk.org/medical-treatments

Scroll down to 'medications to avoid'.

[Birdshot]

Dear Speedbuggy, I take 300 mg. Gabapentin in the morning with 1000 mg Tumeric,Ginger and black pepper. I do the same in the evening after dinner. I have trying to all kinds of medications pain pills all of that and nothing worked, it either made me more sick or it would make my RLS worse or my Parkinson's worse! Through all my research in trying different medications and vitamins and supplements I have found this to work the best for me. Especially due to the fact that I have severe osteoarthritis, spinal stenosis, degenerate joint disease , neuropathy Parkinson's, RLS and severe nerve damage caused by 4 major surgeries. I highly recommend trying this out, I think you will feel a lot better please keep me posted sincerely Birdshot.

[Speedbuggy in reply to Birdshot]

Thanks. I will give that a go and let you know if it works for me

[SueJohnson in reply to Birdshot]

300 mg gabapentin is a low dose for RLS. Beginning dose is usually 300 mg gabapentin. I would increase it by 100 mg every couple of days until you find the dose that works for you. Take it 1 to 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, don't take it within 3 hours of taking gabapentin as it will interfere with the absorption of gabapentin and don't take calcium within 2 hours for the same reason.

Check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it if needed as many doctors do not know much about RLS or are not uptodate on it atHttps://mayoclinicproceedings.org/a...

Meanwhile some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, artificial sweeteners, carbs, foods high in sodium(salt), foods that cause inflammation, ice cream, eating late at night, oestrogen (estrogen) including HRT, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, stress and vigorous exercise.

Some things that help some people with RLS include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennel, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, CBD, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices like therapulse, using a standing desk, listening to music, meditation and yoga. Keep a food diary to see if any food make your RLS worse.

Many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute.