Gabapentin --> Gralise

[The JockDoc]

I saw a patient in clinic who had been on 4000mg gabapentin daily for brachial neuritis for almost a year. Unsurprisingly, he complained of lethargy and cognitive side effects, thus was in the process of being weaned down. I was thinking that a trial of Gralise may be worthwhile to see if he had any improvement in side effects. However, I don't have any experience with transitioning a pt from a fairly high dose of gabapentin onto Gralise. Would you guys recommend going to max dose, say 1800 mg Gralise and stopping gabapentin right away, or titrating down gabapentin as while titrating up the Gralise such as with the dose pack? The former would be far easier obviously, if it can work.

After a quick search, I couldn't find anything from the manufacturer advising how to do such a switch.

---

Members don't see this ad.

 

[101N]

I'd try tapering down to 2,100 -2,700 and see what you get first.

http://www.ncbi.nlm.nih.gov/pubmed?cmd=historysearch&querykey=1

 

[clubdeac]

3600 neurontin = 1800 gralise.... I agree, taper down to ~2400-2700 then switch over

 

[The JockDoc]

Thanks guys.

 

[oreosandsake]

I'd try tapering down to 2,100 -2,700 and see what you get first.

http://www.ncbi.nlm.nih.gov/pubmed?cmd=historysearch&querykey=1

the link doesn't work. interested to see what paper you are citing. can you post again? thanks