Pregabalin and Gabapentin come from a family of medications called ‘anti-convulsants’. These medications affect how nerves send pain signals. Other drugs from this family of medications are used to treat epilepsy (fits), but pregabalin and gabapentin are used to treat pain.
They are particularly useful for sharp, stabbing or burning pains and less likely to cause sleepiness than amitriptyline. It is best to start with a small dose and then increase it. If you start to get side effects, stay at that dose or decrease it slightly until you adjust to the medication.
A slow and easy way to start pregabalin is:
- 25mg at night, then
- 37.5mg at night, then
- 75mg at night, then
- 37.5mg in the morning and 75mg at night, then
- 75mg twice daily
If you have been given 75mg capsules of pregabalin, you can lower the dose by opening the capsule and dissolving the contents in water. If you drink 1/3 of the water, you will have drunk 25mg of pregabalin. If you drink half the water, you will have drunk 37.5mg of pregabalin.
A slow and easy way to start gabapentin is 100mg at night, then 200mg at night then 300mg at night, then 100mg in the morning and 300mg at night, then 200mg in the morning and 300mg at night, then 300mg twice daily.
Starting medications at a low dose is great for avoiding side effects but might mean it takes longer to get to a dose that helps your pain. If you find that a low dose is enough to help your pain, then there is no need to keep increasing the dose.
Their side effects include dizziness, sleepiness, swollen ankles, impaired memory, bowel disturbances and sometimes weight gain. These medications should not be taken during pregnancy.
Pregabalin and Gabapentin don’t affect a chemical called Serotonin in the brain, so can be used together with other neuropathic pain medications like amitriptyline or duloxetine.