Important things to know about gabapentin and pregabalin
As your body ages, you become more sensitive to the side effects of these medications for various reasons, including changes in your kidney function and more sensitivity of your brain to sedative medications.
Pregabalin and gabapentin can cause falls, fractures, memory problems and confusion. Even if you are not experiencing these symptoms, speak to your doctor, nurse or pharmacist to decide if there are better options to treat your pain.
Taking gabapentin or pregabalin with alcohol or other sedative medications such as sleeping pills or opioids (narcotics) increases the risk of severe sedation, breathing problems and can even cause death.
If gabapentin and pregabalin are not reducing your pain or are causing you side effects, the best way to stop the medication is to reduce the dose gradually with the help of our practice pharmacist.
Do you feel more tired than usual, dizzy, or off balance? Do you have problems with attention or memory? Are you experiencing leg swelling or weight gain?
If you answered YES to any of these questions, book an appointment with our pharmacist to see if the medication could be causing these symptoms.
Have you recently talked with your doctor, nurse, physiotherapist or pharmacist about the best treatment options for your nerve pain or chronic lower back pain?
Do you have a plan to review your pain levels and pain medication(s) at least once a year?
Are you on the lowest possible dose of this medication?
If you answered NO or I DON’T KNOW to any of these questions, book an appointment to discuss with our pharmacist or First Contact Physiotherapist (FCP) to review if your pain is well managed and your medication dose is as effective as possible.
Other ways to deal with pain
Depending on your reason for taking gabapentin or pregabalin, there are alternative ways to deal with pain with less treatment side effects.
Here are some examples:
- Talk to our FCP about a self-management program for pain. A self-management program can help you take control of how you
deal with pain. - Speak with our pharmacist about alternative pain medications.
- Speak to a clinician about cognitive behavioral therapies or mindfulness based interventions for pain. These therapies change the way you think about pain so that your body and mind react better when you experience pain.
- Depending on your diagnosis, physiotherapy or massage therapy might help the pain you are experiencing. Some physical activities
such as yoga, tai chi, pilates and other structured exercise programs also have benefits for dealing with pain. - Ask your doctor if a specialist pain clinic could better help you deal with pain. Specialist pain clinics provide a range of treatments
and services for people with chronic pain, tailored to your individual needs.
Lifestyle changes
Check What You Eat
Diet is the best way to manage chronic pain and keep your body strong. Diets full of sugars, refined carbohydrates, and processed foods can lead to inflammation and increase your pain. Changing what you ingest is a significant step towards reducing pain if you suffer from chronic pain.
Your diet should include foods like;
- Vegetables about eight portions a day
- Fruits
- Proteins in moderation. Consider focusing more on plant proteins.
- Use healthy fats like olive oil and avocados.
- Choose whole grains and complex carbohydrates
- Include foods rich in Omega-3 fatty acids
Watching what you eat will also reduce weight, relieving chronic pain conditions like osteoarthritis.
Reduce stress
Your body reacts to stress in various ways, such as muscle tension and headaches, which only worsen your chronic pain. To reduce stress;
- Identify your stress triggers and work on them
- Stay active
- Find a distraction like doing something you like.
Improve your sleep
Disrupted sleep increases sensitivity to pain and inflammation, which worsens chronic pain. You can improve your sleep by;
- Making sleep a priority
- Developing a sleep routine to prepare your mind and body for sleep
- Practicing mindfulness and deep breathing
Increase your physical activity
Physical inactivity affects both your cognitive and bodily functions. On the other hand, physical activity improves your sleep, reduces stress levels, and releases endorphins which are feel-good chemicals that will enhance your moods and are natural pain relievers.
Is it time to reduce your dose?
Book an appointment with our practice pharmacist to discuss the best way to reduce your medication.
How do I gradually reduce the dose of pregabalin or gabapentin?
Slowly reducing the dose over time can help reduce these symptoms, this is called tapering. If you have been on very high doses or have been taking the medication for a long time, your pharmacist may consider a slower tapering program.
Everyone is different. To reduce your dose, you will need a tapering program designed just for you.
Some people who reduce their dose of gabapentin or pregabalin may feel symptoms (for example, insomnia, nausea, anxiety or headaches).
If I reduce my dose of medication, will my pain get worse?
Not necessarily. Higher doses of gabapentin or pregabalin do not always improve pain and are likely to cause side effects.
Examples of withdrawing schedules
Pregabalin: reduce the daily dose at a maximum of 50-100mg/week
Gabapentin: reduce the daily dose at a maximum rate of 300mg every four days
Example withdrawal schedule for a dose of Pregabalin 150mg bd
| Week 1 | Week 2 | Week 3 | Week 4 | |
| Morning | 150mg | 75mg | 50mg | 25mg |
| Evening | 75mg | 75mg | 50mg | 25mg |
Example withdrawal schedule for a dose of Gabapentin 600mg TDS
| Week 1 | Week 2 | Week 3 | Week 4 | Week 5 | Week 6 | |
| Morning | 600mg | 300mg | 300mg | 200mg | 100mg | 100mg |
| Midday | 300mg | 300mg | 300mg | 200mg | 100mg | |
| Night | 600mg | 600mg | 300mg | 200mg | 100mg | 100mg |
DO NOT STOP OR CHANGE THE DOSE OF YOUR MEDICATION WITHOUT SPEAKING WITH OUR PRACTICE PHARMACIST OR AN OTHER CLINICIAN
Mr Reid’s story
He had been taking gabapentin, a medication just like yours.
“I’m 73 years old and have suffered from chronic lower back pain for several years from an old sports injury. Three years ago, my doctor prescribed gabapentin (Neurontin©) to help relieve my chronic pain. I wasn’t sure the gabapentin was working to relieve my lower back pain but I didn’t notice side effects either. So I continued renewing it at the pharmacy and taking gabapentin three times a day.
During the past year, I started noticing my legs would swell up, particularly in the evening. I also had “dizzy spells” during the day. One morning, I got out of bed and started walking down the stairs to make coffee. I was a bit dizzy and I missed a step. Luckily, I caught myself on the bannister at the last minute. Even though I was not hurt, it scared me quite a bit.
At my next doctor’s appointment, I mentioned this scary episode. I also complained about my leg swelling. My doctor asked me a few questions
about how I had been feeling over the last few months and told me that the gabapentin could have been causing these side effects. I wasn’t sure if it was still helping me control my back pain, so we agreed that we would try to gradually reduce the medication over a few weeks and see how it went. The doctor also prescribed physiotherapy to help with my lower back pain.
After reducing my medication over a few weeks and starting physiotherapy, my lower back pain has actually improved! I feel stronger and surer on my feet and my leg swelling is practically gone. It feels like a fog had been lifted from my thinking. I wish I had asked my doctor before, rather than having taken this medication for so long. I realize now that asking my doctor the right questions and being aware of changes in my body has helped me improve my health.”