Gabapentin and Lyrica

[Littlegran]

Can you take Gabapentin and Lyrica together? I have always taken 1200 mg of Gaba but have been switched to 50 mg Lyrica. I don’t feel like it is working. I wondered if you could take both.

[Madlegs1]

They are both similar medication.

Seems a bit pointless doubling up.

Unless possibly to avoid side effects??

[Littlegran in reply to Madlegs1]

I wondered about that. I have been on Lyrica for 3 weeks, but I have not had good response. Thank you for your response Madlegs1. I guess I thought that the two meds would help.

[SueJohnson]

It's not working because the equivalent of lyrica to 1200 gabapentin is 200 mg.

[Littlegran in reply to SueJohnson]

Would it work if I went down to 200 Gaba with the Lyrica? The doctor has tried so many combinations; therefore, I am trying to figure out the best combination for me. I have had so many bad days. I was on Horizant, then he changed me to Lyrica, Cymbalta and Tramadol. I just know that before this became a major event for me, I was doing fine on Gaba, so I was wondering if I could do Lyrica and Gaba. I finally got an iron infusiion. My ferritin is 16. Thank you Sue for your continued advice for all of us with Restless Legs.

[SueJohnson]

Instead of adding the gabapentin go to 200 lyrica and add 25 mg every couple of days until it controls your symptoms. The normal maximum is 450 mg but you could even take up to 600 mg.

You are better off taking just either gabapentin or lyrica rather than combining them because they both act in the same way.

Did the gabapentin ever control your symptoms? I remember at one time you were on 1800 mg but that may have been when you were on requip. Are you taking any other medicines for your RLS now?

[Littlegran in reply to SueJohnson]

Sue, I was on Gabapentin for over 20 years , and it controlled my RL. Only at the beginning of this year, I started having restless legs every day and night, I was not sleeping, and it was horrible. I thought I was losing my mind. I went to Vanderbuilt and saw a restless leg specialist who wanted me to go on Horizant and referred me to someone at OU Medical Sleep Center. I saw her, and I think I knew more about restless legs than she did. She told me that she had never had a patient who had restless legs as bad as me. She did prescribe Horizant which I took. But when I went to my primary care, he changed me to Lyrica and Cymbalta. I wish I could just go back to Gabapentin, becuase it did work for many years. See, I was also on 4 mg of requip, so when my restless legs got unbearable, I realized that I had augmentation. I diagnosed myself because the doctors here do not understand augmentation. I hope that the Lyrica will help. I am sleeping now which is a blessing.

[Birdland]

Are you taking Cymbalta now? My understanding is that it can make RLS worse.

[Littlegran in reply to Birdland]

I have wondered about that Birdland. I need to found out from my doctor. Thank you.

[Birdland in reply to Littlegran]

Many times doctors do not know what medications can make RLS worse. My suggestion would be to make another post asking this community what their experience has been with Cymbalta.

[SueJohnson in reply to Littlegran]

Yes cymbalta makes RLS worse for many.

[SueJohnson in reply to Littlegran]

If you need an antidepressant the safe ones are wellbutrin and trazodone.

[Tanker1]

I take both but my dose is much higher than yours. As others have noted your dose is low and is likely why it isn't working. I take 300 mg of pregabalin (lyrica) followed by 600 mg of gabapentin 1-2 hours later. I do this because the pharmacokinetics results in a higher concentration for longer during the night. I have PLM with symptoms in the evening to early morning so I try to hit it hard with the meds.

[Littlegran in reply to Tanker1]

Tanker1, this is good information for me. I think I am on the lowest Lyrica and no Gabapentin. I have wondered if I should add Gabapentin, but others on the forum expressed doubt because they are the same. Did you start with this amount or work up to the dosage?

[Tanker1 in reply to Littlegran]

I worked up to it. Over a period of months I went from 600 to 900 to 1200 to 1500 to 1800 mg of gabapentin as I weaned off of ropinerol. At some point I and my sleep doc realized that 300 mg of pregabalin would be easier and more effective for me since I could take it all at once. Later I added 300 and then 600 mg of gabapentin in order to extend the concentration in my body longer into the night. Pregabalin and gabapentin are effectively the same but pregabalin has much better absorption characteristics. From what I have read it appears that gabapentin takes longer to reach a peak concentration than pregabalin. Here are a couple of articles that might be on interest:

ncbi.nlm.nih.gov/pmc/articl...

pharmacytimes.com/view/how-...

I use this medication approach because my PLM is generally only active in the evening and early night, sometimes into the early morning. This allows me to max out on meds in the evening and then not take any more. Many people with RLS have symptoms all the time so my approach might not be as useful.

I have a few side effects that have reduced over time. These include being a bit unstable and fuzzy headed in the morning.