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    Lyrica Dosage

    Hi guys,

    I've been using Lyrica for a couple of years now. It has been way better than Neurontin for me as the latter didn't work at all.

    Anyway, what I did was tell my doctor about the medication and he just prescribed it for me. Doctors have no experience with SCI-related neuro pain here.

    The thing is that I started with 75mg 3 times daily. That worked for a year or so. Lately I have been having more severe pain and upped it to 4x a day and it doesn't help at all.

    I don't feel any side effects that I know of. I do feel like shit constantly but I think that is due to other factors.

    I'm not sure if I should up the dose or not ? I usually tolerate meds fine and hardly have any side effects with any of them.

    I have a sample of 150mg Lyrica. I'm intrigued to up it and see what happens. When I wake up the pain is normal and 75mg would work. I usually split my 4 doses every 4 hours or so. At night I get the most pain and then my 75mg doses don't help at all.

    What do you guys recommend. I know I shouldn't get medical advice from a forum, but you're experiencing what I have so you're the closest thing I can get at the moment. I will get the pain issue looked at while am at the states for sure. That should be real soon.

    Thanks in advance forum.

    - Neo

    #2
    When you say you split your doses, are you breaking tablets in half? I've only found Lyrica in capsules.

    All I can say is that the best plan I've found is to start with 50mg pills in the morning and ramp up to 100mg pills in the afternoon/evening. But like you I always have pain in the evenings no matter how much Lyrica I take. I'd say it isn't helping but if I skip a dose I'm burning in hell for 6-8 hours, but that's probably withdrawal.

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      #3
      I take 200 mg three times a day and I think the dose could be increased. But there are side effects so I balance those against the pain and stick with the current dose, for now. I have no doubt that the Lyrica dulls my burning pain.
      2012 SCINetUSA Clinical Trial Support Squad Member
      Please join me and donate a dollar a day at http://justadollarplease.org and copy and paste this message to the bottom of your signature.

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        #4
        The official maximum dose is 600mg per day. Some people tolerate that much, others get intolerable side effects.

        The thing is, it sounds like you're treating Lyrica like a "rescue" medication - taking it every four hours, and hoping it has an immediate effect on your pain. While some people say that does work for them, the "official" take on it is that it is to be taken regularly, and have the effects build up. The schedule you're taking it on may contribute to the nights being worse.

        Generally it's taken 3 times per day - i.e. every 8 hours. The way you're dosing it, I think it would probably wear off at night.

        If I were a doctor (which I am NOT however) I'd probably suggest taking it every 8 hours, and increasing the dose gradually until it either worked or you had intolerable side effects. So take 100mg every 8 hours for a few weeks (preferably a month), if not good enough take 150mg every 8 hours, etc.

        I don't think hardly anyone would tolerate more than 200mg 3 times a day (I've not heard of people taking more than that - someone can contradict me if they do)

        I don't think Lyrica pills are meant to be split either - I'm not absolutely sure, but I don't think so.
        Last edited by TAM63; 23 Mar 2010, 11:36 PM. Reason: Made a mistake, maximum dose was wrong

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          #5
          Originally posted by TAM63 View Post
          The official maximum dose is 100mg 3 times per day.

          I don't think Lyrica pills are meant to be split either - I'm not absolutely sure, but I don't think so.
          I the UK the maximum is 600mg/day split into 2 or 3 doses.
          Lyrica come only in capsules filled with white powder so although splitting them is totally safe I can't see much of a benefit!
          sigpic

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            #6
            When I was in the hosp. after paral. dr's said "oh, hell we can go ALOT higher on that"was at 150 mg then, went up to 375 and all got REAL better, fast! But I weaned myself down to 2 ea 75 mg a day then off it, for weight gaining. Good luck, it was alot better than the neurontin.

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              #7
              Neo,
              I was on 150 mg. of Lyrica three times a day and my body just got used to it and the pain was always there. I have come off of slowly and really no pain difference. It is hard to figure out because we could all have the same level of injury but we are so different in the way our bodies react to drugs.
              I had a great down to earth doctor where we came off of all drugs and then tried one at a time to see what the effects were. That helped a lot. When you are taking four or five who really knows what's working. I pray you find your answers and your pain disappears.

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                #8
                Well, my doctor tells me that Lyrica does have some immediate effect once you get it built into your bloodstream, and the side effects also are higher right after you take the dose. Sometimes I take 200 every 8 hours but if I can stand it I try to take the larger dose (400) later in the evening. This helps manage the side effects and also lets me sleep a little better. I didn't realize 600 mg was the max dose, so sorry. Now I don't know what I will do if my neuropathic/central pain gets worse....
                2012 SCINetUSA Clinical Trial Support Squad Member
                Please join me and donate a dollar a day at http://justadollarplease.org and copy and paste this message to the bottom of your signature.

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                  #9
                  Sorry, I don't mean to worry you. The max dose is the max dose on the label. That's the "official" maximum dose. When I know it, I try to mention it because it is a guideline.

                  That doesn't mean doctors cannot prescribe more than that. They can, and often do. Please don't worry yet

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                    #10
                    Originally posted by TAM63 View Post
                    Sorry, I don't mean to worry you. The max dose is the max dose on the label. That's the "official" maximum dose. When I know it, I try to mention it because it is a guideline.

                    That doesn't mean doctors cannot prescribe more than that. They can, and often do. Please don't worry yet
                    Well worry was too strong a word. I guess I already know the pain meds will have to be adjusted and changed from time to time the rest of my life.

                    Thank you!
                    2012 SCINetUSA Clinical Trial Support Squad Member
                    Please join me and donate a dollar a day at http://justadollarplease.org and copy and paste this message to the bottom of your signature.

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                      #11
                      Originally posted by Neo View Post
                      Doctors have no experience with SCI-related neuro pain here.
                      It is really hard to find doctors who are experienced with sci related neuro pain, it is very different than other neuro pain.

                      I take 400-500mg a day, I take 200mg in the morning, and another 200mg in the late afternoon. If needed I take the last 100mg in the evening. Luckily for me, my doctor IS experienced in sci pain, and under his advice I have experimented with the dosing. I started on a lower dose, and we slowly increased it, and played around as to when the doses were taken. This is what works best for me. But I definitely find that it works as a rescue or breakthrough drug as well as one that has to be taken all the time. I also, understand from my doctor that I am not at the maximum dose possible for SCI related neuro pain.

                      There is a thread here about using it for breakthrough pain.


                      Originally posted by TAM63 View Post
                      The official maximum dose is 100mg 3 times per day. But as the previous poster said, it is prescribed in higher doses. You just have to watch out for side effects.

                      The thing is, it sounds like you're treating Lyrica like a "rescue" medication - taking it every four hours, and hoping it has an immediate effect on your pain. While some people say that does work for them, the "official" take on it is that it is to be taken regularly, and have the effects build up. The schedule you're taking it on may contribute to the nights being worse.

                      Generally it's taken 3 times per day - i.e. every 8 hours. The way you're dosing it, I think it would probably wear off at night.

                      If I were a doctor (which I am NOT however) I'd probably suggest taking it every 8 hours, and increasing the dose gradually until it either worked or you had intolerable side effects. So take 100mg every 8 hours for a few weeks (preferably a month), if not good enough take 150mg every 8 hours, etc.

                      I don't think hardly anyone would tolerate more than 200mg 3 times a day (I've not heard of people taking more than that - someone can contradict me if they do)

                      I don't think Lyrica pills are meant to be split either - I'm not absolutely sure, but I don't think so.
                      Tam, I have to point out to you, that the use of Lyrica for SCI related pain is different than typically prescribed. If I am correct you don;t have any experience with this type of pain? I am not trying to downplay you husbands pain, just pointing out that your advice is coming from the same
                      no experience with SCI-related neuro pain
                      place that the op has questioned. Not saying that it is worse, just that it is different.
                      T7-8 since Feb 2005

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                        #12
                        I understand it seems to work as a rescue/breakthrough med for some people (can't open that thread just now for some reason, but that was what I was remembering). I believe some people on the forum also take it regularly (3x per day also). Several on this thread have said so.

                        However, the op has been using it split up in doses during the day, and is having a lot of pain at night. So it isn't working for him at the moment. So trying something different might work better for him. Or it might not.

                        But if he has a lot of pain at night, and there's no Lyrica dose at night (which is what I think I make of his schedule), whether it's considered more of a rescue med or building up a level, it would seem to make sense to try to take it in a way that would cover the night. Perhaps even take a higher dose at bedtime.

                        It would obviously be much better if he had a good pain management doc there to figure it out - but as he doesn't, seems his best option is to experiment unfortunatly.

                        Up to him and his doctor of course, it's just a thought.

                        My husband doesn't take Lyrica btw. Whether or not his cord may be injured is undetermined at this point.

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                          #13
                          Dave takes 150 3X a day. When he increased form 100mg it made a huge difference.
                          I think it would be hard to split the capsules.

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                            #14
                            Neo, is there a reason you are currently taking Lyrica 4 times per day?

                            I mean - when you were taking it 3 times per day did you get pain before it was time for your next dose, and decided to take it more often?

                            Or did you have pain all the time, and going to 4 times just the easiest way to increase the total amount?

                            If you were taking it 3 times per day (I'm saying every 8 hours here, for discussion) and it seemed to "wear off" before the next dose then it may be working better for you to take it more often (although I understand not well enough).

                            But, a higher dose, even back at 3 times per day might work better - hard to say.

                            Do you think your pain is worse at night because the Lyrica is "wearing off" - or has it just always been that way? Obviously waking up in the middle of the night to take another dose would not be fun.

                            I saw you said you are coming to the US - that's great. I hope you have a great vacation if that's what you're doing, or rehab, and/or meet up with some good docs. If you're looking for a pain management doc in the US, I'd really suggest you try to get some suggestions from people - some are far better than others. Some won't even prescribe pain meds to anyone. There are some very good ones, but you have to choose carefully.

                            Comment


                              #15
                              I edited my earlier post. I misread and made a mistake - for some indications the maximum label dose is 300mg per day. For others, the maximum label dose is 600mg per day.

                              Regardless of what they're prescribing it for, docs could certainly go up to the 600 per day, if the person tolerates it.

                              I apologize for causing any confusion.

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