Pregabalin and Gabapentin at the same time?

[emd123]

Is there any utility in having a patient on Pregabalin and Gabapentin?

Yes, they are similar in class and name, but the mechanisms of action really aren't that well known, are they?

Do you ever add one to a patient that is on the other, specifically if they've tried and failed other adjuvants?

Other than cumulative sedative effects (which applies to almost every medication we prescribe) there are really any noted drug interactions that I'm aware off.


So, is there any utility in having a patient on Pregabalin and Gabapentin?

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[lobelsteve]

Is there any utility in having a patient on Pregabalin and Gabapentin?

Yes, they are similar in class and name, but the mechanisms of action really aren't that well known, are they?

Do you ever add one to a patient that is on the other, specifically if they've tried and failed other adjuvants?

Other than cumulative sedative effects (which applies to almost every medication we prescribe) there are really any noted drug interactions that I'm aware off.


So, is there any utility in having a patient on Pregabalin and Gabapentin?

No. Same receptors, no utility to both.

 

[drf]

I very rarely combine them. The main time i would is when someone gets dose dependent analgesia with no side effects using gabapentin that has reached 1200 TID and is having surgery. Giving more gabapentin won't be absorbed so then ill add Lyrica on a temporary basis preop and continue postop for a week or two.

 

[emd123]

yes, we know they bind the alpha 2 delta subunit, and affect calcium channels but depending on what you read, the actual mechanisms are listed as unknown.

Might affect synapse formation etc. I dunno. Just wondered.

 

[Ligament]

What drf says. I do have a couple folks on both long term , they say it helps, have exhausted most other meds.

 

[bedrock]

I have quite a few highly functional patients who can't perform at work with gabapentin sedation, but have insomnia/jitterness with lyrica at night.

For these folks I prescribe Lyrica BID and gabapentin QHS. Worked extremely well for many of them.

 

[Ducttape]

I have quite a few highly functional patients who can't perform at work with gabapentin sedation, but have insomnia/jitterness with lyrica at night.

For these folks I prescribe Lyrica BID and gabapentin QHS. Worked extremely well for many of them.

what about Gralise for these patients?

to the opening poster - while it seems possible that noone knows how they work, the fact they work on the same receptor makes me not use both together. also, the side effects are very similar.