Gabapentin dosage

[Sunri]

Hi I'm currently on 400mg gabapentin which I take at 8.30pm. I have been on this dose for 4 weeks and up until this week it has been ok. This week my rls is back,not nearly as bad as it was just starting to feel that sensation again. I am in my bed early relaxing by 7.30pm, and wondered if perhaps I took it earlier that may help,or should I see GP about increasing my dose. I usually don't settle to sleep till about 1111pm

[SueJohnson]

400 mg is almost a starting dose. According to the Mayo Algorithm the usual effective dose is 1200 to 1800 mg.

Ask for a prescription for 100 mg capsules and increase your dose by 100 mg every couple of days until your RLS is under control.

[SueJohnson]

And yes take it 1 to 2 hours before you go to bed, 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.

[Sunri in reply to SueJohnson]

thanks Sue,so I could try taking it earlier perhaps 6pm , I will try that till I can get to speak to GP re increasing dose. This last week I've been having a bit of a spaced out feeling at times too during the daytime, which I am putting down to side effects of the medication.

[Joolsg]

I agree with SueJohnson. As you're in the UK- ask your GP to look at RLS-UK website. It sets out the doses of gabapentin under Medical Treatments.Are you on other meds? Many can cause/worsen RLS.

And has your GP taken iron panel blood tests?

[Sunri in reply to Joolsg]

I'm on Amlopidine 5mg once daily, folic acid and B12, I also take Vit D supplement. Not had any bloods done before being prescribed Gabapentin. Last ones done about 4 months ago for my B12 levels.

[SueJohnson in reply to Sunri]

Amlopidine is a calcium channel blocker that makes RLS worse for most.

Some medicines that are safe for high blood pressure are propranolol (Inderal, Hemangeol, InnoPran) a beta blocker that may help RLS, Isosorbide Mononitrate (Monoket, Imdur) which is not a beta blocker nor calcium channel blocker. Other possibilities are: Clonidine (Catapres) an Alpha-2-Agonist used to treat high blood pressure which may help RLS and which also treats insomnia, tenex (Guanfacine, Intuniv), prazosin (Minipress) an alpha-adrenergic blocker that is also useful in managing sleep-related problems caused by PTSD and Tadalafil a vasodilator that in one study completely eliminated RLS. Clonidine can actually help RLS. Discuss these with your doctor. And then there is reducing salt by 1 teaspoon a day nih.gov/news-events/nih-res....

[Sunri in reply to SueJohnson]

thanks, that's very interesting and certainly something I can discuss with my GP

[Joolsg in reply to Sunri]

See SueJohnson reply about this.Many meds trigger/worsen RLS.

And your doctor should have done full iron panel blood tests for RLS.

Raising serum ferritin above 200ųg. ideally, resolves the majority of RLS cases.

[marigold60]

I'm also taking 400mg gabapentin daily, I have been since 2020. I take it with an Ibuprofen after evening meal. I'm usually fine then. However sometimes I do wake in the night feeling a bit twitchy. I then take a 100mg gabapentin and that usually does the trick. Occasionally I take another later in night but not often. This also has the benefit of helping me sleep

[Sunri in reply to marigold60]

Thank you, that gives me hope that my dose will work for me if I take it earlier. Does the ibuprofen help with the rls when taken with gabapentin?

[marigold60 in reply to Sunri]

It seems to, (it's the 400mg Ibuprofen) I've tried different combinations over the years as I didn't want to increase the gabapentin if I didn't have to.

[Sunri in reply to marigold60]

Thank you, I feel the same don't want to increase gabapentin unless I have to. Going to try taking current dose earlier to start with.

[Cobobay in reply to marigold60]

I found taking 100 after my earlier doses took about an hour to kick in and as you say sometimes had to take another 100 around couple later. I took extra on my earlier doses as suggested by Sue and this seems to have helped, or even solved the problem and works better for me anyway.

[marigold60 in reply to Cobobay]

It just shows we are all different. When I take a gabapentin in the night it doesn't take that long to kick in and I can feel it relaxing me

[Cobobay in reply to marigold60]

I'm glad your coping and that your lucky enough you don't have to take more gabapentin.

[Cobobay]

Hi, I am in bed around that time and take my 1st dose of 300 at 5.30pm I then take 600 at 7.30 and 600 again at 9.30. I think Sue or Jules will tell you 400 is quite a low dose and you will have to increase maybe 100 every couple of days till you find the right dose for you. I hope you find the right dose and it settles down for you.

[Sunri in reply to Cobobay]

thanks, I feel a bit stuck really I want the rls controlled but also have concerns the more I take the worse the side effects will be.

[Cobobay in reply to Sunri]

I haven't had any side effects apart from a slight weight gain. Mine seems to be under control atm, but at least I know I can increase my 1st dose up to 600 which I have done a couple of times if I've had a bad night, the next night I up to 400 instead of 300. I have taken brufen at times but it doesn't seem to help me at all.