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Neurontin (gabapentin)
Is there anyone on here that would be able to answer a few questions for me regarding Neurontin? I did read a few of the older posts and articles on here which actually lead me to have more questions. I'm kind of wondering if maybe I am under dosed based on what I have read. (I have had this issue with other meds with my neuro).
I also have some questions regarding missed doses and I can't seem to find any clear answers in the literature.
Thanks.
I also have some questions regarding missed doses and I can't seem to find any clear answers in the literature.
Thanks.
I think that she said that because the neuro originally prescribed the neurontin, but I told her (the nurse) that I would rather not and I told her why. Hopefully my doctor will be cool with it.
darn buck-passing health professionals! I hope your primary will consider your request. there's no reason - that I can think of - why they couldn't/shouldn't do so. Generally one has easier access to their GP/PCP than to specialists ... on an ongoing basis it only makes sense they ought to be involved in symptom treatment.
I also started the same way. I think that is the standard. I am now up to 300, but I have been there for awhile now and I don't think it is the proper dose or a therapeutic dose.
I did call my PCPs office today. The nurse thought that I should call my neuros office. I told her that I would prefer not to. She said she would talk to the doctor and give me a call back on Monday. We shall see I guess.
I did call my PCPs office today. The nurse thought that I should call my neuros office. I told her that I would prefer not to. She said she would talk to the doctor and give me a call back on Monday. We shall see I guess.
I have been on Gabapentin for a short period of time for severe Bilateral Trigeminal Neuralgia and the MS Specialist I'm seeing started me slowly at 100 mg once a day then after a week 200 mg once a day and now at 300 mg once a day.
They do this with gabapentin and slowly increase dosage to what helps ease your neuropathic pain. You do want to slowly increase as needed due to your body building up a tolerance and not working all together.
I personally want to SLOWLY increase if needed for this exact reason. If this dose is what the doctor started you on then that is completely normal in my own experience and from what others have said.
Hope this helps and good luck to u!
Wellness
Valarie
They do this with gabapentin and slowly increase dosage to what helps ease your neuropathic pain. You do want to slowly increase as needed due to your body building up a tolerance and not working all together.
I personally want to SLOWLY increase if needed for this exact reason. If this dose is what the doctor started you on then that is completely normal in my own experience and from what others have said.
Hope this helps and good luck to u!
Wellness
Valarie
I miss doses too. I just try and take it 3X/day, as close to 8 hours apart as I can. I don't see any symptom creep even if I miss an entire dose. This makes me think it's the amitriptilyne that has fixing my feet. I asked my doc about reducing/eliminating the gabapentin and he suggested we leave things as they are.
Kyle
Kyle
I take 300mg gabapentin 4 times a day (1200mg daily). I know this is working for me because I have tried to lower my dosage to 900mg daily and notice the return of TN and other pain zaps and tingles within a day.
I occasionally increase by an extra 300mg at bed time if needed, but so far have always been able to drop back to 1200mg daily.
When I was first rx'd Gabapentin (300mg pills) my instructions were to start at 300mg daily, then waiting 5 days to a week between increases, and up my dose by 300mg per day till my pain, tingling, etc was under control, adding or subtracting 300mg daily to 'balance' to my correct dosage.
I was free to increase as needed up to a maximum of 3600mg daily.
Regarding your question on missed doses, I remember feeling TN and hand pain a couple times in the afternoon in the past, and when I checked my pill holder realised I hadn't taken my noon pills, which include 300mg Gabapentin. If I miss a dose I take it as soon as I discover the miss.
Mike
I occasionally increase by an extra 300mg at bed time if needed, but so far have always been able to drop back to 1200mg daily.
When I was first rx'd Gabapentin (300mg pills) my instructions were to start at 300mg daily, then waiting 5 days to a week between increases, and up my dose by 300mg per day till my pain, tingling, etc was under control, adding or subtracting 300mg daily to 'balance' to my correct dosage.
I was free to increase as needed up to a maximum of 3600mg daily.
Regarding your question on missed doses, I remember feeling TN and hand pain a couple times in the afternoon in the past, and when I checked my pill holder realised I hadn't taken my noon pills, which include 300mg Gabapentin. If I miss a dose I take it as soon as I discover the miss.
Mike
My PCP is pretty good. He was hand selected to replace my old PCP when she left the practice to go teach at the University. He's very patient and thorough. He was the one who referred me to a neurologist in the first place for my migraines which is how I ended up getting diagnosed with MS.
He also realized that my Topamax was too low and and put me back on the Flexeril which made a HUGE difference. I feel that his approach to wellness is very Holistic. I've been very fortunate. I may just call his office and ask about the dosage.
He also realized that my Topamax was too low and and put me back on the Flexeril which made a HUGE difference. I feel that his approach to wellness is very Holistic. I've been very fortunate. I may just call his office and ask about the dosage.
Went to the neuro today and he upped the Gabapentin to 600mg 4 times a day now instead of 3-I hope it helps! Also, he wants me to take the Phenytoin(sp) again(it didn't seem to help before).
A good GP can treat neuropathic pain. What's important is finding a GP who has an open mind, listens to their patients, is supportive, and willing to research and consult on ideas that their patients bring to them. My neuro didn't have any better ideas than my previous GP did, and each of them tried me on different meds for pain (Neurontin, amitriptline, nortriptyline, Lyrica, Sativex, Cesamet) at different times. They each knew what the other has done so I didn't dangerously mix meds or OD.
Neuropathic pain is notoriously difficult to treat, therefore having a doc, whether neuro, GP, pain specialist, etc, who is willing to try the various options available, limited as they are, is critical.
Neuropathic pain is notoriously difficult to treat, therefore having a doc, whether neuro, GP, pain specialist, etc, who is willing to try the various options available, limited as they are, is critical.
I did get a couple of recommendations on neuros in the area today. I am not sure if either of them are MS specialists but I do know that two of them see patients with MS and the patients who recommended them have been extremely happy. They are in another health care network, that's the only thing that I don't like. We have two major networks were I live: Spectrum and Mercy. I really like the neuroscience program at St. Mary's - Mercy. If I switch to one of these other providers I will have to switch to Spectrum and their neuro department isn't as new and state of the art.
No one TOLD me that my MS is mild. I feel it is. I don't have a lot of symptoms normally. The symptoms that I have are not usually chronic, or consistent or severe.
I can walk fine, unassisted. I work full-time: One fill-time job, plus one part time job. I have no visual problems.
I have I guess mainly sensory issues I would say. I think I pretty much have my muscle spasms under control. I think I just don't have the paresthesia (if that is the correct word?) quite under control. I feel like I almost do, but not quite. It's like my meds wear off at a certain point in the day until I take them again in the evening and sort of don't seem to quite kick in in the morning. Either that or they are just working long enough for me to get a decent nights sleep without jumping legs. ????? I'm not really sure. I have noticed that I have been sleeping much better since I went on Neurontin. It would be nice to see some improvement during the day as well.
I can walk fine, unassisted. I work full-time: One fill-time job, plus one part time job. I have no visual problems.
I have I guess mainly sensory issues I would say. I think I pretty much have my muscle spasms under control. I think I just don't have the paresthesia (if that is the correct word?) quite under control. I feel like I almost do, but not quite. It's like my meds wear off at a certain point in the day until I take them again in the evening and sort of don't seem to quite kick in in the morning. Either that or they are just working long enough for me to get a decent nights sleep without jumping legs. ????? I'm not really sure. I have noticed that I have been sleeping much better since I went on Neurontin. It would be nice to see some improvement during the day as well.
I take gabapentin for neuropathic foot pain. I'm with doublevision, as I take 1200 3X/day. The dose does need to be built up relatively slowly. I started at 100mg 3X/day.
All by itself the gabapentin did not resolve my foot pain. I have added amitriptilyne (Elavil) 50mg 1X/day. The combination has completely resolved the pain in my feet.
I would urge you to find an MS specialist. They are more likely to understand neuropathic pain issues. If you pain is neuropathic no amount of anti-inflammatory will help.
All by itself the gabapentin did not resolve my foot pain. I have added amitriptilyne (Elavil) 50mg 1X/day. The combination has completely resolved the pain in my feet.
I would urge you to find an MS specialist. They are more likely to understand neuropathic pain issues. If you pain is neuropathic no amount of anti-inflammatory will help.
It doesn't sound to me as if your MS is so mild. Who said that, your neuro? Some in the medical field call MS mild if the patient can walk decently. There's a lot more to life than walking, that's for sure, and dealing with severe nerve pain is a huge quality of life issue.
I agree you should ask your PCP for more neurontin, phasing it in as others have described, because it can be tricky to get the just-right dosage. Often some experimentation is needed.
I also urge you to find another neuro. The one you have doesn't seem to be your partner in managing this disease, and almost seems like an adversary. Who needs that? Find someone knowledgeable, compassionate, and with good communications skills.
ess
I agree you should ask your PCP for more neurontin, phasing it in as others have described, because it can be tricky to get the just-right dosage. Often some experimentation is needed.
I also urge you to find another neuro. The one you have doesn't seem to be your partner in managing this disease, and almost seems like an adversary. Who needs that? Find someone knowledgeable, compassionate, and with good communications skills.
ess
My neuro just bumped my Rx from 1200 mg/day to 2400, after I had tried 1600 and sometimes 2000 on my own, and it seemed to help somewhat with ongoing pain on the back side of the eyeball. However, I don't know what 2400 will do, because I've been FIGHTING THE BLASTED INSURANCE COMPANY and their MAIL ORDER RX SYSTEM FOR EIGHT DAYS RUNNING.
There, I feel better!
I've been on gabapentin since sometime in 2009; it's the only thing that's helped at all, medicine-wise. (Prism added to my eyeglasses Rx helped a lot with the double vision, though it's still there.) It always been something I caution people to ease into, as upward steps in dosing tended to knock me down, at first. I agree with everyone else; it sounds as though your neuro needs to go back to their PDR to see if they might not have picked the wrong number for you.
There, I feel better!
I've been on gabapentin since sometime in 2009; it's the only thing that's helped at all, medicine-wise. (Prism added to my eyeglasses Rx helped a lot with the double vision, though it's still there.) It always been something I caution people to ease into, as upward steps in dosing tended to knock me down, at first. I agree with everyone else; it sounds as though your neuro needs to go back to their PDR to see if they might not have picked the wrong number for you.
My neuro is ridiculously conservative. I had left side pain and muscle spasms so bad that I basically didn't sleep for a year. She prescribed flexeril and Naproxen (prescription strength Aleve). She might as well have given me tic-tacs.
I got a little relief but not really. She finally tried me on Baclofen, but I couldn't handle it. I am not on flexeril and neurontin and it has mad a difference. I absolutely cannot miss a dose but, my symptoms that she said the neurontin would take care of are still there and that is why I am wondering if I am on too low of a dose.
My neuro and I seem to have communication issues. I'm debating on whether or not I should call her or my PCP or start looking going to another neuro or a MS specialist. I sort of think that for as mild as my MS, I shouldn't really be having this many issues. I feel like if I could get the right med combo, I could really get on the right track to getting back on track to getting back to mostly normal.
I got a little relief but not really. She finally tried me on Baclofen, but I couldn't handle it. I am not on flexeril and neurontin and it has mad a difference. I absolutely cannot miss a dose but, my symptoms that she said the neurontin would take care of are still there and that is why I am wondering if I am on too low of a dose.
My neuro and I seem to have communication issues. I'm debating on whether or not I should call her or my PCP or start looking going to another neuro or a MS specialist. I sort of think that for as mild as my MS, I shouldn't really be having this many issues. I feel like if I could get the right med combo, I could really get on the right track to getting back on track to getting back to mostly normal.
I take 300mg TID and add an extra 300 at night. Am supposed to be increased to 600 TID but can't handle it yet. For now the 600 at bedtime keeps the bedbugs away (the pain) but as the others have said, when I am too lazy or tired to take the night dose, I feel it the next day for sure.
I've been cautioned by several of my doctors and my brother in law who is a retired pharmacist, not to get my intake of it too high but to augment it with another medication to synergize the same effect.
Perhaps your doctor feels at night is where you need it the most and is being conservative. Might make a note to discuss his rationale if it still bothers you. It's probably something that none of us have thought of! Hope this helps some.
I've been cautioned by several of my doctors and my brother in law who is a retired pharmacist, not to get my intake of it too high but to augment it with another medication to synergize the same effect.
Perhaps your doctor feels at night is where you need it the most and is being conservative. Might make a note to discuss his rationale if it still bothers you. It's probably something that none of us have thought of! Hope this helps some.
When I first starting taking gabapentin the dose was 400mg each night. I was supposed to add a morning dose the second week and then an afternoon dose in the third week. I was getting relief with the 400mg bedtime dose alone but it made me so sleepy that I didn't dare take it during the day.
My GP suggested I stick with the once daily dosing for a while. She told me that many of her patients never have to add daytime doses to get adequate pain control.
After about six months the bedtime dose still knocked me out but I realized I needed a dose to help me through the day as well. So the pain management doc prescribed 100mg capsules that I could use to establish a workable daytime dose at my own pace. Within three months I was taking the second 400mg dose in the morning. The pain was controlled without becoming overly sleepy.
For the most part this dose has been adequate for my pain control but there are some days that I take a third dose. I believe most people would begin to notice a dose is due about 6-8 hours after the last one they had. As with drugs like baclofen though, blood levels fo the drug build when gabapentin is taken on a regular basis. In that case the return of pain might be more subtle.
Hope something in here helps. I’ve taken my bedtime medications for the night and it’s getting difficult to keep my thoughts collected. I need to go to bed. If you have more questions - please ASK.
My GP suggested I stick with the once daily dosing for a while. She told me that many of her patients never have to add daytime doses to get adequate pain control.
After about six months the bedtime dose still knocked me out but I realized I needed a dose to help me through the day as well. So the pain management doc prescribed 100mg capsules that I could use to establish a workable daytime dose at my own pace. Within three months I was taking the second 400mg dose in the morning. The pain was controlled without becoming overly sleepy.
For the most part this dose has been adequate for my pain control but there are some days that I take a third dose. I believe most people would begin to notice a dose is due about 6-8 hours after the last one they had. As with drugs like baclofen though, blood levels fo the drug build when gabapentin is taken on a regular basis. In that case the return of pain might be more subtle.
Hope something in here helps. I’ve taken my bedtime medications for the night and it’s getting difficult to keep my thoughts collected. I need to go to bed. If you have more questions - please ASK.
Yes, that's quite a low dose you're on. I'm at the other end of the spectrum.....1200mg x 3 doses per day, which is the max that can be prescribed. I've tried to reduce on a few occasions, but I really feel it, and since I don't experience any side effects from this med, I stay on the high dose. I also take 60-80mg of nortriptyline at night. I get greater pain relief with this combination of these two meds than on either of them on their own. And yes, I do notice when I miss a dose of either one. Are you taking Neurontin for neuropathic pain? You definitely have room to increase. Talk to your doc. You might also want to consider adding nortriptyline or amitriptyline to enhance treatment of your symptoms, again, if it is pain you're taking it for.
I've been taking it since last Summer. I think I started at a small dose(300 mg) at bedtime to now taking 600mg 3 times a day. In the beginning it made me VERY sleepy! It worked well for a while, but now I feel like I need more.
To answer your question, I definitely feel it when I miss a dose although that rarely happens because the nerve pain is screaming so loud before the next dose is due-I can't forget it!
I've read that some take up to 3600 mg a day but my doc won't up my dose. He just keeps paring it with another med hoping for a combo that will work for me. I see him tomorrow and am hoping for something that will give me longer lasting relief. He also said that he'd love to give me Lyrica, but my insurance won't pay for it.
It sounds like your neuro is very conservative and that's okay. There are so many pill pushers! But, if your dose isn't helping as much as you'd like, I'd consider asking for more.
Blessings,
Colin
To answer your question, I definitely feel it when I miss a dose although that rarely happens because the nerve pain is screaming so loud before the next dose is due-I can't forget it!
I've read that some take up to 3600 mg a day but my doc won't up my dose. He just keeps paring it with another med hoping for a combo that will work for me. I see him tomorrow and am hoping for something that will give me longer lasting relief. He also said that he'd love to give me Lyrica, but my insurance won't pay for it.
It sounds like your neuro is very conservative and that's okay. There are so many pill pushers! But, if your dose isn't helping as much as you'd like, I'd consider asking for more.
Blessings,
Colin
I am at 3 capsules (100mg each) so 300 mg at bedtime daily from what I am reading therapeutic levels are a significantly higher dose, and is usually also taken during the day as well. Is this correct or no?
It also seems that if I happen to fall asleep and miss a dose, I definitely notice it the next day. Has that been the experience of others when they miss a dose?
It also seems that if I happen to fall asleep and miss a dose, I definitely notice it the next day. Has that been the experience of others when they miss a dose?
I've been taking Neurontin for about five years now. I may be able to help you. What did you want to know?
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