Hello all,
After having some issues with peripheral neuropathy (PN), I was given some samples of Lyrica (pregabalin) 75 mg that I took twice per day. It started working within a few hours and was working well while waiting for my prescription to be filled.
I received word that my insurance would not cover it until i tried another drug first. I was able to get a prescription of gabapentin (Neurontin), which is nowhere close to controlling the PN like Lyrica.
I was told by my doctor that I had to give it a few days and if it still has no effect on the PN, they would request again that my insurance fill the Lyrica. Sounds like you have to play the insurance game.
Has anyone had this issue with insurance coverage for Lyrica? I find it kind of odd because my insurance covered Revlimid with only $20 for my part. I have Express Scripts and it has been paying extremely well until now for Lyrica.
Also, I would like to know if anyone has had any success using gabapentin? My dosage is 100 mg three times per day.
Castaway
Forums
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Castaway - Name: George
- Who do you know with myeloma?: just myself
- When were you/they diagnosed?: 1/24/14
- Age at diagnosis: 62
Re: Lyrica and gabapentin for peripheral neuropathy
I had bad neuropathy three years ago when I was being treated with Velcade. It went away almost entirely over time after I stopped it.
I was prescribed Neurontin, but it did not seem to help much. I certainly did not see an effect that I could notice just a few hours after taking the medication. And Neurontin’s primary use is an anti-seizure medication, which I was not too keen on taking when I did not have a seizure problem.
I am not sure if Lyrica was on the market three years ago or it may have just been introduced. It is encouraging that you had such good success with Lyrica.
Please keep us up to date on how this works out for your. I still have some neuropathy and it has been slowly getting worse but still not as bad as when I was on Velcade.
I was prescribed Neurontin, but it did not seem to help much. I certainly did not see an effect that I could notice just a few hours after taking the medication. And Neurontin’s primary use is an anti-seizure medication, which I was not too keen on taking when I did not have a seizure problem.
I am not sure if Lyrica was on the market three years ago or it may have just been introduced. It is encouraging that you had such good success with Lyrica.
Please keep us up to date on how this works out for your. I still have some neuropathy and it has been slowly getting worse but still not as bad as when I was on Velcade.
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Eric Hofacket - Name: Eric H
- When were you/they diagnosed?: 01 April 2011
- Age at diagnosis: 44
Re: Lyrica and gabapentin for peripheral neuropathy
In the past, my insurance company flat out refused to pay for Lyrica, which worked. I tried gabapentin and it was worthless for me. So my doctor doubled the dosage. Still no relief. Finally, my neurologist doubled my Cymbalta (duloxetine), which I was already taking. That takes the pain down some notches.
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Carolee888
Re: Lyrica and gabapentin for peripheral neuropathy
I also had to use gabapentin, which I used successfully for about a year. It then began to have less and less effect, which my doctor said he had expected.
The insurance companies have rules for covering brand name prescriptions when generic drugs are available. You must follow their requests. I tried one or two more drugs without success. I was then given permission by the insurance company to receive Lyrica with coverage.
As for the Revlimid, many states have adopted legislation which requires insurance companies to provide oral chemotherapy drugs to patients with insurance coverage under the insurer's second tier of prescription coverage. This would be the first level above generic drugs. You must live in a state that has adopted this legislation, and that explains your lower-level deductible.
Good luck and be persistent. Lyrica has made a big difference in my comfort level and in my ability to maintain my employment. You have to do whatever it takes until the prescription is approved. You already know it works.
The insurance companies have rules for covering brand name prescriptions when generic drugs are available. You must follow their requests. I tried one or two more drugs without success. I was then given permission by the insurance company to receive Lyrica with coverage.
As for the Revlimid, many states have adopted legislation which requires insurance companies to provide oral chemotherapy drugs to patients with insurance coverage under the insurer's second tier of prescription coverage. This would be the first level above generic drugs. You must live in a state that has adopted this legislation, and that explains your lower-level deductible.
Good luck and be persistent. Lyrica has made a big difference in my comfort level and in my ability to maintain my employment. You have to do whatever it takes until the prescription is approved. You already know it works.
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Marcia - Name: Marcia K
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: July 2010
- Age at diagnosis: 55
Re: Lyrica and gabapentin for peripheral neuropathy
Thank you for the replies.
I just received a letter from my insurance today. They basically said that there are many other treatments. However, they also said that they consider front-line drugs and back-up drugs. The front-line drug is gabapentin, and the back-up is a brand name, in my case Lyrica.
With that said, they still mention that Lyrica is for a small amount of people, so I don't know if they will allow it anyway.
I just received a letter from my insurance today. They basically said that there are many other treatments. However, they also said that they consider front-line drugs and back-up drugs. The front-line drug is gabapentin, and the back-up is a brand name, in my case Lyrica.
With that said, they still mention that Lyrica is for a small amount of people, so I don't know if they will allow it anyway.
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Castaway - Name: George
- Who do you know with myeloma?: just myself
- When were you/they diagnosed?: 1/24/14
- Age at diagnosis: 62
Re: Lyrica and gabapentin for peripheral neuropathy
After getting Grade 4 peripheral neuropathy after Velcade, I was on 3600 mg of gabapentin and 300 mg of a fentanyl patch. I was like a zombie. The cramping stopped after 2 months, but I still have pain in my feet and legs.
I weaned myself off the patch and am down to 300 mg of gabapentin at night to help with sleep. I also take 12 mg of hydromorphone each day (I was on 32 mg). My brain has developed a mental callous to the pain during the day, but at night I need the gaba¡pentin and hydromorphone to help with sleep because, at night, my mind concentrates on the pain when all is quiet and calm.
I found that none of the above mentioned takes away all the pain, they only help ease it somewhat. I haven't tried Lyrica yet, but based on these comments, I will give it a try. God Bless.
I weaned myself off the patch and am down to 300 mg of gabapentin at night to help with sleep. I also take 12 mg of hydromorphone each day (I was on 32 mg). My brain has developed a mental callous to the pain during the day, but at night I need the gaba¡pentin and hydromorphone to help with sleep because, at night, my mind concentrates on the pain when all is quiet and calm.
I found that none of the above mentioned takes away all the pain, they only help ease it somewhat. I haven't tried Lyrica yet, but based on these comments, I will give it a try. God Bless.
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GeorgeLJurak - Name: George Jurak
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Jan. 2011
- Age at diagnosis: 59
Re: Lyrica and gabapentin for peripheral neuropathy
I had really bad PN after Velcade and was given Lyrica. It has taken over a year to go, although I can still feel it in my feet if I walk too much.
I think Lyrica is a wonder drug. I am completely off it now. I have tried nothing else, but I would just say it worked for me.
I think Lyrica is a wonder drug. I am completely off it now. I have tried nothing else, but I would just say it worked for me.
Re: Lyrica and gabapentin for peripheral neuropathy
Castaway, I am sorry you are having to go through this. Peripheral neuropathy can be a huge challenge for patients, as described in the responses to your post.
Unfortunately, we do not have great treatments that work for everyone. Gabapentin is approved for neuropathy pain after shingles as well as for treatment of seizures. It can be helpful in patients with Velcade-associated neuropathy when used at higher doses.
In my experience, the minimal effective dose of gabapentin is 900 mg per day, which is usually taken as 300 mg three times per day. You will need to take about a week to get to that dose to avoid side effects like dizziness and diarrhea. I've used up to 900 mg three times a day, but my experience is that most people don't tolerate that high of a dose. And you have to know that it takes a couple of weeks to work. I wouldn't anticipate immediate relief.
You could try that and, if it works, great. If not, then maybe the insurance company will cover Lyrica. It is good news that Lyrica was effective for you. It's not effective in everyone. We will often use a combination of Lyrica and Cymbalta.
Best wishes,
Jlk
Unfortunately, we do not have great treatments that work for everyone. Gabapentin is approved for neuropathy pain after shingles as well as for treatment of seizures. It can be helpful in patients with Velcade-associated neuropathy when used at higher doses.
In my experience, the minimal effective dose of gabapentin is 900 mg per day, which is usually taken as 300 mg three times per day. You will need to take about a week to get to that dose to avoid side effects like dizziness and diarrhea. I've used up to 900 mg three times a day, but my experience is that most people don't tolerate that high of a dose. And you have to know that it takes a couple of weeks to work. I wouldn't anticipate immediate relief.
You could try that and, if it works, great. If not, then maybe the insurance company will cover Lyrica. It is good news that Lyrica was effective for you. It's not effective in everyone. We will often use a combination of Lyrica and Cymbalta.
Best wishes,
Jlk
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Dr. Jonathan Kaufman - Name: Jonathan Kaufman, M.D.
Beacon Medical Advisor
Re: Lyrica and gabapentin for peripheral neuropathy
Thanks to everyone for your replies.
Dr. Kaufman,
Great information. My pain is mostly on the tops and sides of my feet, not a lot of numbness. The Lyrica started to ease the pain after only 4 or 5 hours, and I was about 90% pain free the next day.
I am only getting 100 mg three times per day of the gabapentin, so maybe if I cannot get the Lyrica, my dose needs to be upped for the gabapentin. I had a complete sensitivity test and exam for my feet and legs by my podiatrist / surgeon. He found that I basically passed all the testing.
Thank you very much,
Castaway
Dr. Kaufman,
Great information. My pain is mostly on the tops and sides of my feet, not a lot of numbness. The Lyrica started to ease the pain after only 4 or 5 hours, and I was about 90% pain free the next day.
I am only getting 100 mg three times per day of the gabapentin, so maybe if I cannot get the Lyrica, my dose needs to be upped for the gabapentin. I had a complete sensitivity test and exam for my feet and legs by my podiatrist / surgeon. He found that I basically passed all the testing.
Thank you very much,
Castaway
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Castaway - Name: George
- Who do you know with myeloma?: just myself
- When were you/they diagnosed?: 1/24/14
- Age at diagnosis: 62
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