Gabapentin at Bedtime

[ILoveMyDogSunny]

For those who have had success with gabapentin at bedtime: did you find that it works from night one or it takes a few nights/weeks of nightly dose to be effective? I'm on 300mg. **please no comments from those whom gabapentin wasn't helpful** Thanks

[SueJohnson]

It takes about 3 weeks to be fully effective and 300 mg is just a starting dose. After that 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.

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, 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 up-to-date on it at Https://mayoclinicproceedings.org/a...

Have you had your ferritin checked? If so what was it? You never answered that question.

[ILoveMyDogSunny in reply to SueJohnson]

Thank you so much Sue and my apologies about not answering the ferritin question yet. Last month my level was 106 which is technically not low but I'm supplementing nightly with heme iron oral to see if I can get it to 200. I feel better about the gabapentin now as I was afraid to take it consistently (tolerance, dependance, eventual withdrawal etc) and I seem to get twitchy in my hands and feet when I take it but not sure if that's the gabapentin or just medication anxiety; it sounds like I need to move past these fears as it will work better when taken consistently.

[SueJohnson in reply to ILoveMyDogSunny]

If it works you will definitely become dependent on it but that's true of any medicine one takes that solves a problem. Don't worry about tolerance though. Once you find the amount that works it might be years before you need to increase it and then just by 100 mg. As far as withdrawal that is also not a problem as it is not like a DA. If you reduce it slowly enough you will have no withdrawal effects.

[ILoveMyDogSunny in reply to SueJohnson]

Do you think I need to be concerned about the toes and fingers twitching from gabapentin usage or do you think that's more likely from medication anxiety than from the medication itself? Or another possibility is perhaps it's from the gabapentin but could go away with consistent usage...

[SueJohnson in reply to ILoveMyDogSunny]

It's possible it is from the gabapentin although it is not very common. I would wait a few weeks and see if it goes away. If not you can try switching to pregabalin. Although it is basically the same drug except you don't 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. Divide the gabapentin amount by 6 to get the correct dose. You can switch directly.

[ILoveMyDogSunny in reply to SueJohnson]

Thank you Sue; do you know if anyone has issues with the pharmacy with pregabalin as it's my understanding that pregabalin is a scheduled drug whereas gabapentin is not?

[SueJohnson in reply to ILoveMyDogSunny]

Both pregabalin and gabapentin are Schedule V the lowest but no, there is no problem getting either one.

[Moonwalker1967 in reply to ILoveMyDogSunny]

I get twitchy toes as well. It started with the Gabapentin and Pergabalin which I initially took. Lucky me, it's not in my fingers. It only happens in the evening and nighttime.

[Guitarpickin]

Gabapentin worked for me from day 1. My initial dose was 300 mg but I soon dropped to 100 and stayed there for many months. I am now on 200 mg plus 5 mg indica THC. I also had finger and toe twitching but it was prior to getting my symptoms under control with medications and eliminating aggravating factors (certain alcohols and foods). I hope gabapentin works for you as well as it works for me.

[Rameau]

I experienced some reduction in RLS symptoms from taking an initial dose of 200mg. Now taking 900mg (600mg 2 hours before bed and 300mg at bedtime) which has eliminated 90% of symptoms in the evening but has been less effective overnight particularly when nighttime temperature have been high. I hope this will be less of a problem when temperatures have reduced.