Neuropathy and Dialysis

[HellboundAlleee]

I am about at the end of my rope. I have come to "accept" that I will be in pain during my chair time, because any drug is going down the drain.

But now they have me prescribed. ONE gabapentin per day. ONE. I honestly don't know why I even take it, because it's just not effective at all. I just can't sleep anymore. I'm fighting with myself and my feet all night long, getting up now and then to look at the computer.

Anyone try cymbalta? I wonder if I can get my nephrologist to agree to prescribe me that, at a high enough dose that I can flipping get to sleep.

[LisaBart]

I think you should be made comfortable, my husband asks for an oxazepam every night. He won't even try to sleep without now. He is sleeping well, so he feels better for it.
Cant hurt to ask??  Mind you, its not because of hgis neuropathy he doesn't sleep, he did go through that but he doesnt feel his feet at all now.

[jeannea]

They always start with one gabapentin. Tell them it's not working and ask for more.

[obsidianom]

Gabapentin has a wide dose variation. I had a patient the other day who takes 1600 mg FOUR TIMES PER DAY giving her a total dose of 6400 mg per day.
Most patients are underdosed I find. The dose that often works best is around 1600 mg  two to  three times daily. 

HOWEVER with renal patients the dose should be reduced . See the following from Epocrates on dosing for renal patients.

renal dosing
[adjust dose amount, frequency]CrCl 30-60: 200-700 mg bid; CrCl 16-29: 200-700 mg qd; CrCl 15: 100-300 mg qd; CrCl <15: decr. dose proportionately to CrCl; HD: give 125-350 mg as supplement; PD: no supplement

[noahvale]

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