What dose of Gabapentin

[Goagal]

Hello Lovely People

I'm now down to 1/2 a tab of 0.08 pramipexole and got a prescription for 300mg of Gabapentin which I take 2 hours before bed. Ive been doing that for around a week now - as well as the iron every second night

The thing is I wake up around 3 hours wanting to thrash around the bed - I have then been taking 50mg of tramadol (which I had previously been using to drop down the dosage to where I am now now) to reduce the symptoms.

What's the best combination to proceed now?

Thanks

Clare

[SueJohnson]

Congratulations on getting down that far.

Stay at 300 mg, It won't be fully effective until you are off pramipexole for several weeks. After that 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. Most of the side effects will disappear after a few weeks and the few that don't will usually lessen. Those that remain are usually worth it for the elimination of the RLS symptoms. 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 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.

[Goagal in reply to SueJohnson]

Thanks for your detailed explanation Sue.

How soon should I bite the bullet & come off my last Pramipexole? And am I right in thinking to use the tramadol until the gapapentin dose is at right level?

Ever grateful

Clare

[SueJohnson in reply to Goagal]

Yes on the tramadol. Wait until your symptoms have settled from the last dose reduction to stop your pramipexole.