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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Ame Sans Vie on April 20, 2003, at 17:43:46
I'm not taking Neurontin so much for psychiatric purposes as I am for chronic pain (FMS/CFS). I also take Soma fairly often, but more for anxiety/boredom relief than for muscle pain. Kind of backwards, but that's pretty much the way I am, lol.
I've found that, personally, Neurontin is more like a typical analgesic (aspirin, for example) than some others used for pain (amitriptyline) in that it seems to work on an as-needed basis. So my question is, what is the absolute highest possible dose you have personally found, or have heard from a reputable resource, that one can take in a single dose? I don't have side effects at all from my typical 800-1600mg as-needed dose, but I wonder how high one could potentially go before running into problems? This wouldn't be so much of an issue if I weren't hypersensitive to OTC analgesics, and I'd really like to save opioids as a last resort, since the Neurontin is working for the most part so far. It's just that occasionally I have breakthrough pain/muscle spasms that even a couple Somas or Zanaflex can't handle. Anyone have any knowledge whatsover on this?
Posted by Snoozy on April 20, 2003, at 18:14:22
In reply to Highest possible *single dose* of Neurontin?, posted by Ame Sans Vie on April 20, 2003, at 17:43:46
Here's some info. on Neurontin, including dosage:
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202732.html
Please check with your doctor about what is best for you. (btw How's the blood pressure?)
> I'm not taking Neurontin so much for psychiatric purposes as I am for chronic pain (FMS/CFS). I also take Soma fairly often, but more for anxiety/boredom relief than for muscle pain. Kind of backwards, but that's pretty much the way I am, lol.
>
> I've found that, personally, Neurontin is more like a typical analgesic (aspirin, for example) than some others used for pain (amitriptyline) in that it seems to work on an as-needed basis. So my question is, what is the absolute highest possible dose you have personally found, or have heard from a reputable resource, that one can take in a single dose? I don't have side effects at all from my typical 800-1600mg as-needed dose, but I wonder how high one could potentially go before running into problems? This wouldn't be so much of an issue if I weren't hypersensitive to OTC analgesics, and I'd really like to save opioids as a last resort, since the Neurontin is working for the most part so far. It's just that occasionally I have breakthrough pain/muscle spasms that even a couple Somas or Zanaflex can't handle. Anyone have any knowledge whatsover on this?
Posted by Ame Sans Vie on April 20, 2003, at 18:26:18
In reply to Re: Highest possible *single dose* of Neurontin? » Ame Sans Vie, posted by Snoozy on April 20, 2003, at 18:14:22
Thanks for the link... looks like I'm already taking well above recommended dosages. I'll have to look further into how safe this is (though I trust my rheumatologist on this, as she claims to use Neurontin on patients quite frequently).
> (btw How's the blood pressure?)
Thanks for remembering-- here's a link to my response... not really good news, I'm afraid. :-(
http://www.dr-bob.org/babble/20030417/msgs/220946.html
Posted by Viridis on April 21, 2003, at 1:05:28
In reply to Re: Highest possible *single dose* of Neurontin? » Snoozy, posted by Ame Sans Vie on April 20, 2003, at 18:26:18
If I recall correctly, the average person can only absorb about 600 mg Neurontin (gabapentin) in a 4-hour period. The rest is simply lost via urine, so any more is likely to be a waste. This is why it's just about impossible to OD on this med, and why frequent dosing is necessary.
Posted by Ame Sans Vie on April 21, 2003, at 15:35:11
In reply to Re: Highest possible *single dose* of Neurontin?, posted by Viridis on April 21, 2003, at 1:05:28
I thought I might have heard that someplace... I wonder why they even bother to manufacture the 800mg tablets?
Posted by Viridis on April 22, 2003, at 1:40:39
In reply to Re: Highest possible *single dose* of Neurontin? » Viridis, posted by Ame Sans Vie on April 21, 2003, at 15:35:11
Individual variation? Or just profit motive? I'm not sure.
Posted by pelorojo on April 22, 2003, at 16:23:12
In reply to Re: Highest possible *single dose* of Neurontin? » Ame Sans Vie, posted by Viridis on April 22, 2003, at 1:40:39
Note also that Neurontin inhibits its own absorption, so rising doses involve diminishing returns:
From: RKolli@aol.com (Ravi Kolli, MD) Date: Tue, 17 Nov 1998 23:43:06 EST Subject: Gabapentin dosage
I wanted to elaborate a bit. Gabapentin (Neurontin) is absorbed via the neutral amino acid transport process, which is saturable. So:
for a single dose of (mg) the bioavailability is about (%)
100 80
300 70
600 50
900 40
and so on at a diminishing rate. That is why any single dose > 600 mg will result in less drug being absorbed and the dose has to be divided. I hope this explanation makes sense.
This is the end of the thread.
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