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Tips for tapering off Lyrica (pregabalin)

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Altostrata   
Altostrata

Lyrica is a GABA-ergic drug related to Neurontin (gabapentin) but, like Neurontin, with an action different from the benzodiazepines.

It is often prescribed for fibromyalgia and other pain syndromes. In Europe, it has been approved to treat anxiety.

One of its side effects is sleepiness or, during the day, grogginess.

Half-life is about 6 hours.

Like other drugs that act on the nervous system, long-term Lyrica may incur a withdrawal syndrome and must be tapered to protect the nervous system.

According to FDA information at http://www.drugs.com/ppa/pregabalin.html , Lyrica comes in these dosages:
- Capsules 25 mg
- Capsules 50 mg
- Capsules 75 mg
- Capsules 100 mg
- Capsules 150 mg
- Capsules 200 mg
- Capsules 225 mg
- Capsules 300 mg
- Oral solution 20 mg/mL

Reduce by 10% per month to start
The 10% rule holds for Lyrica, just like other psychiatric drugs: Reduce by 10% per month, calculated on the last dosage. (The amount of the reduction gets progressively smaller.)

See Why taper by 10% of my dosage?

Tapering by using smaller capsule dosages
It was thoughtful of Pfizer to provide a range of dosages for tapering.

You can start tapering at approximately 10% by having part of your prescription filled in 25mg capsules. (You probably will need your doctor to write a prescription for this.)

Example: If you are taking 300mg Lyrica, you can get your prescription filled at one 200mg capsule a day plus 4 25mg capsules.

To taper your dosage, you take 275mg (one 200mg capsule plus 3 25mg), decreasing by 25mg.

You can do this for the first, second, and third month of your taper (we advise holding for a month after making a 10% decrease on the existing dose).

Combine capsule dosages and liquid Lyrica
Following the example above, the third month, you will be taking 225mg. To keep to the 10% taper, your fourth monthly drop would be 22.5mg, for a dose of 202.5. For this you may wish to use capsules and liquid in combination: one 200mg capsule and 2.5mg liquid.

For the next decrease, use 150mg capsules plus the liquid for a dose of 182.25mg, and so forth.

Make your own Lyrica solution
You can mix Lyrica in lukewarm water to make your own suspension.

1) Use any small clean transparent jar with a water-tight top or an empty medicine container to make the solution.

2) Carefully open the Lyrica capsule and pour the contents into the bottom of the container.

To open a capsule, grasp each end in your fingers and gently twist. The capsule should come apart in the middle. Do this over the open container, to catch the powder.

2) Use an oral syringe to measure lukewarm water and convey it to the container. A 10mL (10cc) oral syringe is handy for this purpose.

If you wish to make 30mL of a solution, fill the 10mL syringe 3 times with water and inject it into your container.

3) To mix, put the cap on the container, tightly, and shake it gently. You will be able to see the particles swirling around in the water.

4) Use an oral syringe to take the dosage you wish.

5) Your homemade Lyrica solution will keep for 5 days, refrigerated. Keep it refrigerated, like any food, to keep it from getting mold in it.

The only tricky thing about making a Lyrica solution is creating and remembering the concentration.

For example, let's say you are tapering from 100mg Lyrica to 90mg. For 5 days, you will want roughly 450mg. You can empty 5 100mg capsules to make your solution, but you want to use a container smaller than 500mL.

You can mix 500mg Lyrica in 250mL water, making a 2:1 solution, each 1mL containing 2mg Lyrica.

If you do this, put a note on your container giving the recipe ("500mg Lyrica in 250mL water") and dosage instructions to yourself: "Take 45mL for 90mg Lyrica."

Edited by Altostrata
updated

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Skyler   
Skyler

Thanks Alto.. question? How does the appetite effect of Lyrica (almost irresistible munchies) compare with that of drugs like Zyprexa and ADs, the overall comparison. I gained 50 lbs with the help of Lyrica, now have lost 55 lbs despite still taking a large dose, but I need be ever mindful of starting to binge on carbs. I'm going to be battling this for the next year as I'm getting down to a less symptomatic dosage, yick.

 

Also, for the forgetfulness that comes about, are there recommendations for memory games around?

 

Thanks as ever, ~S

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Altostrata   
Altostrata

I don't know, sorry, Schuyler.

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Rhiannon   
Rhiannon

Schuyler, when I was taking Neurontin I never found any memory game kind of things that helped with the memory, practicing didn't help. It was weird that way. Teflon brain.

 

I used lots of tricks with notes and reminders. Also found that although I couldn't really learn stuff by being shown or told once or twice, if I did it over and over I did absorb it, and especially getting stuff into motor memory seemed to help. Mostly lots and lots of notes.

 

Can't say about weight gain, didn't have that so much myself. That is, I have no clue what my weight would be without all the various meds I'm on.

 

Good news is, the memory improved as the dose went down and seems to be improving still now that I'm all the way off.

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Rhiannon   
Rhiannon

Alto, kudos on this excellent and thorough article.

 

Although the dosages available are different with gabapentin, you can use the same method of making your own liquid to titrate.

 

I don't know about Lyrica, but with gabapentin, the powder is kind of tricky to "wet"--that is, it sort of resists dissolving at first. (Like cocoa...? kind of resists wetting at first.) One thing you can do with that is use a couple of drops of ethanol (Everclear, or vodka will work) to "wet" it and then add the water. But it will wet with water eventually.

 

Also, if you're going to make more than about 40-50 mL of solution, I'd recommend using a graduated cylinder instead of using a syringe to measure the water. They're readily available on Amazon and elsewhere on the Internet (sites that sell stuff for science fair projects are good). If you use multiple pulls on a syringe (or pipette) you're going to introduce more variation than you realize into your measurements.

 

Anyway, thanks for this excellent piece.

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Skyler   
Skyler

Thanks Rhi.. my guess is they are relatively the same. When I get the munchies it's with a vengeance. I start to compulsively eat carbs.. so until I get down on the dose, I'll probably have to watch them like the proverbial hawk.

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Skyler   
Skyler

All things being equal (and I know they never are) would it be easier for the "average person" to taper from pregabalin or duloxetine?  I need to take one of those two for nerve pain.  I have had a tough benzo taper and don't want to go anything like that again!

 

Thanks for any views.

 

Hi Riffick... I had a slowww, but smooth taper off a benzo, now I'm tapering Lyrica, which I take for nerve pain. I'm not going to taper all the way down... so far I've reduced from 300 mgs to 45 and am headed for a landing at 25 mgs Lyrica.  It has been easier for me to taper Lyrica than the benzo, I think.  I put it this way because I developed tinnitus from Lyrica which seems permanent.  At least somewhat... if I don't push the taper, or take other meds that cause it to spike, the tinnitus is relatively mild. 

 

But I get ahead of myself... I was 'jerking' the Lyrica dose around... dropping 25%... then a couple of weeks later another 25%.  This triggered off the tinnitus... which then bled thru into the very bottom of the benzo taper, and I then had tinnitus from that as well. So I've taken the Lyrica taper pretty easy..  But the other Lyrica WD Sx have not been so prominent..  and before I got stuck on the Lyrica, I was able to wean on and off for a number of years (the 25% a every couple of weeks mentioned above, got into trouble because I did not realize this needed a real taper).  So the long and short... Lyrica has been easier for me to taper, but the tinnitus has slowed me down.

 

One thing with Lyrica.. a water suspension deteriorates after 48 hours, so you need to make up fresh every 2 days

Moderator note: see Skyler's response to Riffick and primrose below

 

I want to add however, I did not find the benzo taper difficult as long as I took frequent holds and did not taper faster than 10 of the previous dose... but there was more wiggle room with Lyrica.. I'm close to 15% at present and am not worried about lag time catching up.  I held for 10 months at the bottom of my benzo taper with a good result.  I'm the hold queen, and firmly believe in erring on the side of holding too long. I think that tapering when we are symptomatic contributes to needless suffering.  I realize some people have paradoxical reactions from benzos, and need to taper in the face of WD symptoms, but they are far fewer than those who benefit from prolonged holds times... several months and more.

Edited by scallywag
incorrect information

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cymbaltawithdrawal5600   
cymbaltawithdrawal5600

All things being equal (and I know they never are) would it be easier for the "average person" to taper from pregabalin or duloxetine?  I need to take one of those two for nerve pain.  I have had a tough benzo taper and don't want to go anything like that again!

 

Thanks for any views.

 

Riffick, I thought about this and how to reply all morning, not just because I want to warn everyone I can off taking such a horrible drug but because I tried to research its effectiveness in treating 'nerve pain'. I believe that its use is a move by the pharma companies to get their drugs used to treat 'off label' conditions. How it passed FDA approval is beyond me.

 

So instead of that (and because I have no idea how one does manage to treat nerve pain without drugs) I'll just link to what people have said about using duloxetine (cymbalta).

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Skyler   
Skyler

Just to add.... given cw's research.  I have fibromyalgia, and Lyrica is the only thing I've found to help in 30 years of looking.  It does not take away the pain completely, but it does make me less vulnerable to flares, which for me have lasted for 2 years or so (I'm a marathoner in this regard. :( ).   So Lyrica makes me less vulnerable to the horrific flares that put me on methadone, and other opioids.   Subjectively speaking, what I've found, when the pain is triggered, it does not get as reactive.. does not kindle with as much intensity, and once kindled, it's easier to put the 'fire out'.

 

Alto found that medications marketed for pain often do not have much effect, if any.. and my experience with ADs prescribed for this bears this out..  She also told me meds are often prescribed at much higher doses than necessary... 300 mgs in my case, when doses of 25 to 50 mgs may do just as well.. less many of the side effects.  This info is the reason I'm tapering down, and so far, so good.

 

My experience with Lyrica suggests it may not be as difficult to taper off as benzos.   I was able to stop taking it 2 or 3 times by weaning off in a few weeks. (I stopped after the flares ended, as opposed to circumvent flares, which I'm doing now (heh, before I got stuck on high dose)... so you might be able to give it a try and get off without a taper should you find there is no to minimal effect.  I'm not doing that this time because it did catch up with me...  but as you know all too well... we all respond differently.  I also found over time that I'm not as likely to go into the catastrophic flares I used to have.. it seems to down regulate the pain. 

 

So the clinical response I had... it helped down regulate the pain, making everyday pain more manageable.  And when I went into flares.. which are still possible, it made them easier to extinguish.  But keep to a low dose are there are too many side effects.

 

All the best....

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Altostrata   
Altostrata

Thank you for that information, Skyler. I'm glad a lower dose is working for you.

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degen12   
degen12

It was thoughtful of Pfizer to provide a range of dosages for tapering.

 

First time I've truly LOLed in days.

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mac   
mac

Hi,

 

This has been really useful to me and explained a few things the doctor couldn't. I am curious what the usual last dose of the tapering is with Lyrica please?

 

Also can anyone confirm if the worst symptoms for me are due to the drug itself or lack of?

 

- really bad pins and needles, sweaty palms, numbness - especially left hand and fingers but feeling it in both arms at the moment and hair loss - thinning and receding fast. I can take the depression and crying but the physical side effects are really worrying me, they are worse than what lyrica was supposed to help me with and now I feel I am stuck taking it. It is important I work this out to gauge how much to cut by!

 

Are they permanent or will the nerves settle and hair grow back?

 

To help I have stopped drinking, I haven't smoked in over a year, gave up coffee and just drink tea now, take organic supplements filled with dried cold pressed super foods, I am vegetarian and eat salad every lunch time, I exercise every night and walk during day. What else can I do?

 

Thanks for any help in advance.

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mac   
mac

I think some of the symptoms, including paresthesia and depression could be alleviated with the use of natural GABA enhancing foods and supplements. This gives me hope, however I worry about the hair loss, I feel this has worsened as I reduced the dose but cannot be sure.

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Petunia   
Petunia

Welcome to SA mac,

Symptoms can be side effects of the drugs you are taking or they could be withdrawal symptoms if you are tapering or have stopped. If you would start a topic for yourself here:  Introductions and updates  giving a few more details about your situation, we will be able to answer your questions and also help you with a tapering plan.

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MNgal1960   
MNgal1960

I have a question. How many times a day does a person typically dose gabapentin? And can a person have interdose withdrawal from not dosing it often enough? Thanks.

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Buffy   
Buffy

I did lyria twice a day as thats what the hosptial said.

 

It also helped my pain some, but I felt drunk all of the time. For the first few days at 150 it completely cured my anxiety, I was excited. But it took less than a week to turn on me. So they put it up to 300... Then the rest started. Hair falling out, blurry eyes, itchy cracked skin. I was so unwell they dropped the dose before discharge. The next time I saw the pain specialist, he recommended I return to hospital because my anxiety was visibly so severe.

 

Chiropractic treatment gave me more relief than any pain drug ever has.

 

I didnt have much of a problem coming off lyrica. I did it as pdoc suggested - half the dose a week or two and then drop it. I didnt have too many new physical issues but the ones started with lyrica are ongoing.

 

Most annoying being itchy dry cracked hands, feet and scalp. It comes and goes.

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Mccauley   
Mccauley

I did not know the dry skin could be a side effect. Mine has gone just terribly thick and dry.

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Buffy   
Buffy

I did not know the dry skin could be a side effect. Mine has gone just terribly thick and dry.

Nor did my pain specialist!

 

Its mostly my hands, feet and scalp. But I do get dry patches all over. I had never had dry skin before, oily was my problem :P I dont react well to some creams (sensitive soul i seem to be!) but Alto recommened oils which I may try tomorrow.

 

For my face (even before lyrica) I use rosehip oil. Only about 3 drops, its easy to put too much on, but for me it has been has kept my face comfortable. I havent used it other areas due to the price. There is only one brand that I works best - kosmea.

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Altostrata   
Altostrata

I have a question. How many times a day does a person typically dose gabapentin? And can a person have interdose withdrawal from not dosing it often enough? Thanks.

 

Please read http://www.drugs.com/dosage/lyrica.html

 

Buffy, I like rosehip oil myself. Swanson Vitamins and iHerb have very good prices online.

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MNgal1960   
MNgal1960

Buffy, I'm so sorry about your reaction to the Lyrica. I've not had that problem with Neurontin. But I'm at an age that dry skin is typical anyway. I'll have to check out rosehip oil. :)

 

Thanks, Alostra. Seems 3 times/day should be often enough.

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Mccauley   
Mccauley

Buffy, I just ordered rose hip oil. Thanks for that information. My face is covered with dry skin and I just thought it was my Retin A finally working. The rest of me especially the front side of my thighs went from just dry to leathery. I douse myself with Vaseline constantly literally from head to toe. I too thought it was age related. Anxious to try the oil to see if anything improves.

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MNgal1960   
MNgal1960

Seems we have started a rose hip oil fan club due to our meds. Yes, we'll blame it on the meds, not aging! :D

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Mccauley   
Mccauley

Mngal1960

I like the way you think.

I'm going to look so young and hydrated when I'm off this.

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Riffick   
Riffick

Has anyone had interdose withdrawal from taking Lyrica 3 times a day (8 hourly)?

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Skyler   
Skyler

TID was optimal for me... I went to four times a day because of tinnitus.. but I'm not sure it helped...  I'd go for three times.

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Riffick   
Riffick

TID was optimal for me... I went to four times a day because of tinnitus.. but I'm not sure it helped...  I'd go for three times.

 

Hi Skyer.  I once read elsewhere that you mentioned a solution of Lyrica doesn't keep for more than about 48 hours.  Pfizer now make a liquid form of Lyrica which seems to keep for a very long time although it is not available in all countries.  The ingredients are:

 

Methyl parahydroxybenzoate (E218)

Propyl parahydroxybenzoate (E216)

Sodium dihydrogen phosphate, anhydrous

Disodium phosphate, anhydrous (E339)

Sucralose (E955)

Artificial strawberry flavour

 

See https://www.medicines.org.uk/emc/medicine/26524#EXCIPIENTS

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Skyler   
Skyler

Riffick... I was wrong on the length of time... it was Requip that would not keep more than 48 hours.  I thought it was the Lyrica that was giving me problems.. it was heavier hitter.  BUT it was the Requip.  I did not realize this until I went off Lyrica entirely...   and took Requip alone.. THEN the real villain raised it's head.  Go figure.. I thought it was Lyrica for something like 3 years.   I always mixed the two at the same time... go figure.

 

Be well...

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primrose   
primrose

hi skyler, im now on 240mg lyrica, good eh!

was on 600mg @ xmas, and started with 5mg cuts, and my symptoms faded as I tapered.

I reduced the cuts when signature headache came and now on 2mg cuts.

I'm back on valium though but tapering, just at the stage of finding my 'best cut"

 

what i am posting is cos you said your lyrica deterorated after 2 days even if refrigerated.

Well, I have got amber jars, and although I am using alll my water and lyrica liquid mix now, when i get to the lower doses i dont wanna chuck out loads of lyrica water after two days

 

what colour jars did you use to keep your lyrica-water mix in.

 

Congrats on getting off stuff.

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Skyler   
Skyler

I sure did Primrose... and would have sworn by it, but I was wrong. 

Edited by scallywag
topics merged

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Riffick   
Riffick

I sure did Primrose... and would have sworn by it, but I was wrong. 

 

Hey Skyler, I wonder if there's a way for the mods to go back and tweak that 48 hour post because I believe you're no longer able to edit it for yourself.

 

My own experience of Lyrica is that it is one of the most forgiving of meds when it comes to handling.  It dissolves readily in water, is mostly tasteless, it keeps well.  Compared to meds which need fancy solvents, it's much easier to handle.  Meds like diazepam or clonazepam can be a real hassle by comparison.

 

However I found I got bad interdose withdrawal symptoms even if I took Lyrica 3 times a day every 8 hours.  For me, these kicked in after 5 or 6 hours and disappeared 30 to 60 minutes after taking a dose.  I figured that yo-yo-ing up and down like that was further sensitising me and caused a heightening of symptoms, so I went to 6 doses a day (every 4 hours) which helped a lot although it was a nuisance getting up in the night to take a dose.

 

In the final days, I was taking 12.5mg split over six doses.  Yup, that's a tiny 2mg Lyrica per dose but I still felt withdrawals and taking the next 2mg dose still gave me relief.  I had to fully come off Lyrica to see real improvement.

 

My case is unusual and my experience may not apply to everyone because I have an underlying metabolic disease affecting my mitochondria which, even without any meds or withdrawals being present, gives me symptoms of a very acute med withdrawal.  These epilepsy-like states occur every day and will feel better or worse depending on how any med withdrawal is going but the primary cause is not the meds.  The meds just modulate the strength of the underlying symptoms.

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primrose   
primrose

Hi

 

I've tapered successfully since xmas from 600mg pregabalin to 230mg, emptying the capsule contents in luke warm water and then letting it dissolve as its water soluble.

 

I heard that pregabalin water mix deteriorates after two days, why is this?

I buy my own pills and I cannot afford to throw the liquid out after two days.

 

I dose five times a day and take 2mg off and its been successful, no withdrawal headache but very bad weepiness, feelinigs of doom etc.

 

I thought it was because maybe pregabain hated UV light so i bought some amber jars and used those, but the cardboard lining in the lids have all falllen out leaving the jars non airtight, rendering these jars useless.

 

Is it possible to keep the pregabalin liquid for longer than two days, cos when i get to the lower doses, im going to be wasting loads of pills bought by my precious money if i have to dispose of the liquid ater two days.

 

Skyler told me this, but she mustn't have got the pm i sent her last week.

 

thanks

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Skyler   
Skyler

I heard that pregabalin water mix deteriorates after two days, why is this?

I buy my own pills and I cannot afford to throw the liquid out after two days.

 

Primrose.. I responded to you on this when you made the last post.  Your post was added to the Lyrica thread.  I was incorrect about the length of time Lyrica can be kept.  I was taking requip at the same time I took Lyrica.. and thought of Lyrica as the more problematic of the two... not the requip.  I always mixed the two up at the same time.. 

 

When I completed the Lyrica taper, I was still on requip, and the problem I'd attributed to Lyrica was still there... it was the requip, which goes to show how difficult it can be to find why we are symptomatic at times, though I'm rather embarrassed not to have thought about the requip possibility. 

 

I'm going to ask the mods to merge this message with the Lyrica thread, as they did the last time.. but not to merge until you have responded here.  The Lyrica thread is only a few messages under yours in this forum... http://survivingantidepressants.org/index.php?/topic/2381-tips-for-tapering-off-lyrica-pregabalin/ Please make a note of it for future reference.  Thanks

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primrose   
primrose

I am tapering lyrica using water.

I only have access to 75mg caps as they are not presribed.

I cannot get less.

I was told by skyler that pregabalin dissolved in water only lasts 2 days and then deteriorates, even if refrigerated.

Can anyone tell me why this is?

Does lyrica hate uv light?

I cannot find adequate amber containers, i was using aromatherapy jars but once the cardboard inside the lid got all soggy, the container was useless.

 

My supply of these drugs is limited, so when I get below 75mg, I am going to have to make the water-with-lyrica-dissolved-in-it last more than two days. Also, the UK is talking about making them illegal so I wont be able to get any if they do.

I don't fancy going onto gabapentin, when further down as i have heard these are worse to come off and if lyrica is being made illegal, so will gabap

I would like to hear from others who are tapering or have tapered lyrica please.

thank you

Edited by KarenB
Moved post to correct thread

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Skyler   
Skyler

I am tapering lyrica using water.

I only have access to 75mg caps as they are not presribed.

I cannot get less.

I was told by skyler that pregabalin dissolved in water only lasts 2 days and then deteriorates, even if refrigerated.

Can anyone tell me why this is?

Does lyrica hate uv light?

I cannot find adequate amber containers, i was using aromatherapy jars but once the cardboard inside the lid got all soggy, the container was useless.

 

My supply of these drugs is limited, so when I get below 75mg, I am going to have to make the water-with-lyrica-dissolved-in-it last more than two days. Also, the UK is talking about making them illegal so I wont be able to get any if they do.

I don't fancy going onto gabapentin, when further down as i have heard these are worse to come off and if lyrica is being made illegal, so will gabap

I would like to hear from others who are tapering or have tapered lyrica please.

thank you

 

Primrose... this is the third time I'm answering this question, and each time you have asked again, you started a different thread!  Do you read my answers?  Click to follow in the upper right hand corner, and you can be notified when you get a reply.

 

I was mistaken.. it was another medication that was deteriorating in 2 days that I was taking at the same time. Lyrica is more stable than I thought..you can keep it at least 3 days.

 

By the way.. do you have any idea why the UK is thinking of making Lyrica illegal? It really did help me with fibro pain. 

 

Thanks

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Altostrata   
Altostrata

I made a suspension of Lyrica with water and kept it in the refrigerator for 5 days with no problems.

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MNgal1960   
MNgal1960

Altostrata, will that work with gabapentin, too?

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