What is the right dose of Pregabalin in fibromyalgia?

Question

Hello doctor,

My sister is taking Pregabalin 225 mg at 7 PM for fibromyalgia, but it is not providing adequate pain relief. She has severe back pain. When we added another 150 mg at 10 PM, her pain reduced significantly.

What is the appropriate dose and timing for Pregabalin in her case? I am attaching her current medication list for reference. Her vitamin D level is 22 ng/mL.

Please advise.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Well, if that much dose is not effective in fibromyalgia, you ought to change it. I understand she is on Quetiapine and also on Effexor (Venlafaxine). I understand that they started it for depression or bipolar disorder. Well, the other drugs you can consider for fibromyalgia are Duloxetine (Cymbalta), Amitriptyline, and Mirtazapine. But, only after consulting your psychiatrist, as all of them together can have some side effects.

Pregabalin beyond 225 mg may not have any effect now. Also, she needs to start with meditation and yoga. All these medicines are for pain; eventually reach a saturation point after which you do not feel any effect. So, one needs to try other ways to peace out as well. Yoga, along with meditation, helps a lot. Also, she can spend some time on a hobby.

I hope this helps.

Kindly revert in case of further queries.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I read your query and understand your concern.

Well, that is quite a high dose of Pregabalin to be taken. Since it is a long-acting drug, there will not be much point in taking it three times a day. Better, she can take 200 mg in the morning and 400 mg in the evening, so she gets good sleep also at night.

Nevertheless, she needs to go for alternative therapies along with it before she reaches the saturation of this dose as well. So, if both go hand in hand, we can relieve her pain, as this is a chronic problem that can linger on.

I hope this helps.

Please revert in case of further queries.

Thank you.