I posted previously re my husband who has very severe Rls and plmd. He started ferrous glucinate 60mg, magnesium glycinate, vit b12 and vit D in August with relatively good results til about 3 weeks ago. Previously he had been on pramapexiole but augmented on maximum dose and weened off it with gabapentin. He has been prescribed medications free for two years. He went to Gp on Friday and asked for pregabalin based on info on this forum and Mayo Clinic guidelines . He started on 75mg in the evening but the gp said he can increase the dose as needed. How quickly can he increase the dose? He is on his 2nd night and it has made no difference yet. Is there a time frame for the pregabalin to build up in his system? We appreciate all you advice.
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Minijackrussell
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It take 3 week for it to become fully effective. After that he can increase by 25 mg every couple of days. The usual effective dose is 200 to 300mg according to the Mayo Algorithm.
If his RLS /PLMD is severe, 75mg isn't going to be enough and he likely won't experience any benefits on it.
Given that he has been medication free for 2 years, if he can persevere with a low dose for a couple of weeks it might be worthwhile as the aim is to keep the dose as low as possible. But in all likelihood, he will need to at least double it (or treble it) to experience any relief from it.
I have been on pregabalin for 10 years and every 25mg makes a difference in terms of side effects (which for me are considerable).
Thank you for your response, you are spot on with your response! He started low and will go slow. We know he’ll probably have to go up in dose but trying to use the least amount to have an effect while minimising side effects. We’ll give it three weeks and then up the dose by 25mg as necessary. Our Gp was good and wrote the script as 25mg and 50mg to give us some scope to increase if necessary. I think ultimately you are right though, 75mg won’t be enough to manage severe rls and plmd !
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