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How to taper off Gabapentin
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21 February 2016 - 2:50 pm
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Susie, my Westie (front-amp), is taking is one Gabapentin capsule (100 mg.) at night. (She has two refills left on her prescription, but I don't want to give her any med that she doesn't need, so I'm going to wait and see if the Phantom Limb Pain symptoms start up again before I refill. Her current remaining capsules last through March 1, and then she'll be off ALL meds.)

The prescribing vet did not say I needed to taper off. I only learned that was necessary from other Tripawds members.

How would I taper her off the Gabapentin if she only takes a 100mg capsule once a day? (She has been on it since her two-week post-op checkup, so it will soon be about four weeks. (I can't sprinkle part of the contents of the capsule on her food, because she still won't eat much--and will only eat if I hand feed her. She got turned off her wet food--Canine i/d--because I was putting her liquid Meloxidyl on it when she was still taking it. Now she is suspicious and gives everything a good sniff before she decides whether or not to eat it.) She is a super-sensitive--and yes, super-spoiled!--little dog.

Should I start now just giving her one every other day?

I can't ask the prescribing vet because I was the one who pushed for her to have it, and the vet gave me the prescription at my urging. The vet also is allowing two refills, if I want them, but I'd like to try to get her off after she finishes the first round, so that she's off all medication. (There were 42 capsules in the container, and now there are 10 left. The first day, I tried giving her two capsules--8 hours apart--instead of just one, as the prescription was written for her to have one capsule every 8 hours, but she slept so heavily that I then started giving them to her just once a day, in the evening.)

Do you think it's necessary for me to taper her off? If so, would that be possible when she is only getting one capsule per day?

Thanks so much!

Nancy

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23 February 2016 - 10:16 pm
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Well, I did try to be an advocate for my dog.

I called K-State and couldn't get hold of the surgeon, because she was always in surgery or with a patient. The veterinary student is doing her rotation this month at an animal shelter in the area (I live two hours away from K-State), so I couldn't reach her, either.

Finally they transferred me to a doctor who is a practicing K-State veterinarian, a pharmacy professor (head of the department) at K-State Veterinary Hospital, and the Director of Pharmacy for K-State Veterinary Clinic & Hospital. She told me I didn't need to taper off, since Susie was taking Gabapentin for pain. She said the only time it's necessary to taper off is when your dog is taking it for seizures.

I found the same answer online.

So now I guess I'm back to Square One! I don't know what to do next. Should I take Susie to a different veterinary hospital to get a second opinion? Or just try to taper off on my own--every other day for a week or so?

Thanks!

Nancy

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24 February 2016 - 8:11 am
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I'm sorry that I can't be much help because I haven't used it myself. I have a friend who takes it for pain (not for seizures) and she was warned by her doctor that she must taper it off.

I hope someone might chime in here with their experience for pets to help you out. Perhaps you could phone a human pharmacist? 

Kerren

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24 February 2016 - 9:21 am
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I am NOT a vet. I can only tell you my experience.

I also have seen it repeated here to taper dogs off Gabapentin.

My Happy Hannah was on it approximately three weeks. The Vet NEVER mentioned tapering off. Being new here at the tiime, I had not seen anything about tapering off. I stopped giving it to her and she had no issues. That was just her experience based on her particular vet.

It certainly sounds like you spoke with a very, very knowledgeable professional. Did she know the doses Susie had been on and for how long?

Kudos to you for getting to the Pharmacy Direco! I would certainly think she knows her stuff!

Sounds like Susie is really doing well and I know you're anxious to get her off the meds!

Lots of hugs!

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

The Rainbow Bridge

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24 February 2016 - 10:38 am
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Hmmm. Well I like that you got the info from that pharm prof, good for you for calling!

Honestly I never ever trust websites like that. If "Dr. Gary" won't give his last name then how can I even trust that he's a real vet? So I always ignore those sites when looking for information.

Now, I realize that the pharm prof is knowledgeable about medication however, since he isn't a pain management specialist I referred to IVAPM Pain Management Specialist Dr. Petty and his new book, Dr Petty's Pain Relief for Dog's book, which has a section all about gabapentin. On page 65 he says:

"Another cause for concern is from stopping the gapentin abruptly. Forgetting to give a few doses can cause something called rebound pain, which can be as bad or worse than the original pain you were trying to treat. Always work with your veterinarian if for some reason you need to stop giving gabapentin. he will set up a regimen for slowly stopping the drug to avoid the rebound pain."

And regarding sleepiness from gaba, he says

"Side effects from gabapentin are uncommon: the most reported ones being sleepiness and diarrhea. Both of these side effects will often, but not always, dissipate over time. I try to avoid the sleepiness by prescribing it for the first week at bedtime only; then I increase the dose when the dog has gotten somewhat used to it. If your dog just seems too sleepy, ask your veterinarian if you can give a lower dose or reduce the frequency until he is more used to it. Then work with your veterinarian to move back up to the original dose."

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The Rainbow Bridge

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24 February 2016 - 10:39 am
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kazann said
I'm sorry that I can't be much help because I haven't used it myself. I have a friend who takes it for pain (not for seizures) and she was warned by her doctor that she must taper it off.

This is exactly what Dr. Petty is talking about. I'm assuming your friend's doc is also a pain management specialist.

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24 February 2016 - 10:48 am
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Oops! Just noticed this was under the Ask A Vet.

Sounds like Jerry has given you a good resource.

I guess the real wuestiin now for you, is exactly how do you specifically taper off if she's only taking one a day now anyway. Hmmmm....interesting.

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

The Rainbow Bridge

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24 February 2016 - 10:50 am
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Yeah that's where the vet would come in but I would "assume" a half tablet? You know what they say about ASSuming though. Always good to check with a vet who is knowledgeable about pain management.

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24 February 2016 - 11:00 am
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The reason I asked the question in "Ask a Vet" is because it's a capsule. I can't sprinkle it on food, because she already won't eat canned food now, since that's what I used to mix the Meloxidyl in.

There isn't a pain management vet in my town. But I do think going off any pain med poses the risk of rebound pain. (Susie had been on Meloxidyl for four months, and I noticed a difference in her attitude and energy level the first two days after stopping it without tapering.)

Virginia
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24 February 2016 - 11:20 am
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Can't remember what form the Gaba was in for Happy Hannah. Wonder if you could get it in pill form for smaller doses. Can't wait to see what Dr. Pam suggests.

And you posted exactly in the right place!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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24 February 2016 - 12:09 pm
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Sally, the Director of Pharmacy did know the doses Susie had been on and how long she'd been on Gabapentin, because she needed to get all Susie's records in front of her and review them all before she would take the call.

I had talked with her before, to make sure that the Gabapentin Susie was taking didn't contain xylitol, as that's toxic to dogs (and it's in the human form of liquid Gabapentin--Neurontin Solution). So she remembered Susie, as she was the one who directed the filling of the original prescription, and had talked with me before.

The capsules that Susie takes are the human form of Gabapentin, so the pharmacist said she could send my two refills to a pharmacy here in my own town. (But I'm hoping I don't need to order refills.)

Because I can see that there are different opinions among veterinarians on whether or not it's necessary to taper off Gabapentin, I think I should err on the side of caution and try "every other day" dosing for maybe about a week before stopping, unless Pam weighs in with something different.

The main reason I want her off all meds (except for possibly the famotidine) is that she has never gotten her appetite back since the surgery. She has never been a hearty eater (unlike every other dog I've ever had), and now she turns her nose up at just about everything. (I asked the pharmacist/veterinarian about that, and she said that possibly the Gabapentin could cause loss of appetite, since different meds certainly affect different dogs in different ways.) The secondary reason I want her off all meds is because I have to take a two-week business trip starting March 12 (out of the country), and she'll be home by herself during the day. Also, I don't want to be giving her any drug (they all have some side effects) unless it's directly benefiting her.

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24 February 2016 - 1:38 pm
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lyriclemon said
The reason I asked the question in "Ask a Vet" is because it's a capsule.

Ohhh! I wish I had an icon for "Slaps hand on forehead"! I don't know how I missed that.

The every other day sounds reasonable to me but I'm not a vet. If you withdraw and she does have rebound pain you will know it, and can give the pharm prof a call to let them know. Hopefully that won't happen though.

When it comes to her appetite, what kinds of things are you trying? Hop over to Eating Healthy and the Tripawds Nutrition blog for some appetite tips.

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25 February 2016 - 5:43 pm
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There is no reason to taper off if she has been on it short-term other than to see if the phantom pain comes back at lower doses.  I would give 1 every other day for 4 doses then stop if no pain is noted.

Pam

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25 February 2016 - 10:24 pm
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Thanks so much, Pam! I really appreciate it. That's basically what the Director of Pharmacy at the veterinary hospital said, too--that there was no need to taper off and I could stop cold turkey if I wanted, but that if I wanted to taper off (in order to see if her pain came back so I could quickly order a refill before I left the country), I could do that, too.

I'll give her the four capsules every other day before I stop (unless she has symptoms of Phantom Limb Pain with the every-other-day dosage), and that way, she'll (most likely) still be off it soon.

Thanks again!

Nancy

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26 February 2016 - 10:00 am
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Pam you ROCK! Thank you so very much! We will point people here in the future.superstar

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