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Gabapentin is a prescription drug, marketed as Neurontin and Horizant, that’s used to treat epilepsy. Doctors can prescribe gabapentin to treat epilepsy in people older than 12, and partial seizures in children ages 3 to 12.

Gabapentin may also be prescribed to treat restless legs syndrome (RLS), to relieve numberness and tingling related todiabetes, to prevent hot flashes, and to relieve pain that can accompany shingles (known as postherpetic neuralgia).

 

Studies have also found Gabapentin to have a substantial analgesic effects on diabetic neuropathy, postherpetic neuralgia, migraine, and other neuropathic pain conditions, as well as beneficial effect on sleep and restless legs syndrome. On the basis of these findings, some doctors also prescribe gabapentin to cure fibromyalgia pain. For more information, please click here.

Gabapentin is an effective prophylactic agent for patients with migraine. In addition, gabapentin appears generally well tolerated with mild to moderate somnolence and dizziness.

Pregabalin (Lyrica), a drug similar to gabapentin, was the first medication approved by the Food and Drug Administration (FDA) to treat fibromyalgia. While gabapentin hasn’t been approved by the FDA for the treatment of fibromyalgia, some doctors may prescribe it off-label for such use.

Anticonvulsant drugs, such as gabapentin, are becoming increasingly popular for migraine prevention.

Gabapentin has mush more usages, it can cure nerve pain, prevent migraines and headaches. It is also widely used to treat Insomnia, Fibromyalgia, and Restless Legs Syndrome Pain. For more information, please check What is Gabapentin and What It Is Used For ?

A study in the Canadian Journal of Anesthesia in 2013 revealed that gabapentin may help ease moderate to high levels of anxiety among people about to have surgery. The researchers noted that doctors are increasingly using the drug to treat pain after surgery as well as a variety of psychiatric diseases, such as chronic anxiety disorders.

Gabapentin Warnings

You should know that gabapentin may increase the risk for suicide.

Suicidal thoughts or behavior occurs in about one in 500 people taking medications like gabapentin. This risk may begin within a week of starting treatment.

Let your doctor know if you experience:

  • Thoughts of suicide
  • Symptoms of depression
  • Aggression
  • Irritability
  • Panic attacks
  • Extreme worry
  • Restlessness
  • Acting without thinking
  • Abnormal excitement

You should also let friends and family members know about these symptoms.

Gabapentin Side effects

The most common side effects of gabapentin in adult patients include dizziness, fatigue, drowsiness, weight gain, and peripheral edema (swelling of extremities).[40] Gabapentin may also produce sexual dysfunctionin some patients, symptoms of which may include loss of libido, inability to reach orgasm, and erectile dysfunction. Gabapentin should be used carefully in patients with renal impairment due to possible accumulation and toxicity. What side effects can Gabapentin cause?

Gabapentin Dosage

A typical adult dose for postherpetic neuralgia usually starts at 300 milligrams (mg), and your doctor may increase the dose to up to 1,800 mg a day.

A typical adult dose for epilepsy may range from 900 to 1,800 mg a day.

Your doctor will usually start you at a low dose of gabapentin and then increase the dose gradually until you get to a level that works best for you. For More information, please check   How should Gabapentin be used?

Neurontin is used much more extensively in the medical field to treat pain than it is to treat epilepsy

Neurontin is the trade name for the generic drug gabapentin. It is useful as an anti-epileptic drug and as an analgesic, particularly for pain of the neuropathic or neurogenic type. (pain from irritation or inflammation of nerves). When used for controlling epilepsy, it is usually used in conjunction with another anti-epileptic drug. It is used much more extensively in the medical field to treat pain than it is to treat epilepsy.

NEURONTIN is a prescription medicine used to treat:

  • Pain from damaged nerves (postherpetic pain) that follows healing ofshingles (a painful rash that comes after a herpes zoster infection) in adults.
  • Partial seizures when taken together with other medicines in adults and children 3 years of age and older with seizures.

The chemical structure of gabapentin is related that of gamma-aminobutyric acid (GABA) which is a neurotransmitter in the brain. The exact mechanism as to how gabapentin controls epilepsy and relieves pain is unknown, but it probably acts like the neurotransmitter GABA.

Animal studies show that gabapentin prevents the development of allodynia (a normally non painful stimulus which is perceived as painful) and hyperalgesia (an exaggerated response to a painful stimulus).

Gabapentin can be very helpful in controlling the pain of trigeminal neuralgia (tic doloreaux), post herpetic neuralgia (the lingering pain after a bout of shingles), the pain of diabetic neuropathy and other neuritic pains such as pain from nerve irritation due spinal arthritis or disc disease and occipital neuralgia. Occasionally it seems to be helpful in controlling migraine and other headaches. It has also been reported to be helpful in controlling the pain of fibromyalgia.

Gabapentin is generally well tolerated. The main side effects are dizziness and drowsiness. Occasionally there maybe some fluid retention, unsteadiness or G.I upset, mainly diarrhea.

Gabapentin is also sometimes used to relieve the pain of diabetic neuropathy (numbness or tingling due to nerve damage in people who have diabetes), and to treat and prevent hot flashes (sudden strong feelings of heat and sweating) in women who are being treated for breast cancer or who have experienced menopause (”change of life”, the end of monthly menstrual periods).

The effective dose of gabapentin varies greatly. Some persons need only 200-300 mg a day whereas others may need 3000 mg or more a day. It may take several weeks to become effective, so it is important to stay on it for an adequate length of time.

Neurontin can be used to treat Fibromyalgia, Migraine, sleep and restless legs syndrome

 

Studies have also found the drug to have a substantial analgesic effects on diabetic neuropathy, postherpetic neuralgia, migraine, and other neuropathic pain conditions, as well as beneficial effect on sleep and restless legs syndrome. On the basis of these findings, the researchers suspected that gabapentin might also ease fibromyalgia pain. 

For treating the chronic pain and other symptoms of fibromyalgia, the anticonvulsant gabapentin (Neurontin) proved safe and effective, researchers here reported.

In a 12-week randomized, double-blind clinical trial, patients taking gabapentin displayed significantly less pain, better sleep, and less fatigue than placebo controls, Lesley M. Arnold, M.D., of the University of Cincinnati, and colleagues reported in the April issue of Arthritis and Rheumatism.

However, the drug had no effect on acute pain points or depression, the researchers reported.

Although gabapentin, which was used off-label for fibromyalgia, has little, if any, effect on acute pain, it has shown a robust effect on pain caused by a heightened response to stimuli related to inflammation or nerve injury in animal models of chronic pain syndromes, Dr. Arnold said.

Studies have also found the drug to have a substantial analgesic effects on diabetic neuropathy, postherpetic neuralgia, migraine, and other neuropathic pain conditions, as well as beneficial effect on sleep and restless legs syndrome. On the basis of these findings, the researchers suspected that gabapentin might also ease fibromyalgia pain.

The study, supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, included 150 mainly white fibromyalgia patients (90% women). Of these, 75 took gabapentin at dosages of 1,200 to 2,400 mg daily for 12 weeks, while there were 75 placebo controls.

The study was conducted at three outpatient research centers in the U.S., from September 2003 to January 2006.

The mean pain severity scores, measured by the Brief Pain Inventory (BPI), decreased in both groups but more so among the gabapentin patients (P = 0.015). The estimated difference between groups at week 12 was – 0.92 (95% confidence interval -1.75, -0.71).

Of the gabapentin-treated patients, 51% achieved a response at the endpoint compared with 31% of the placebo patients (P=0.014).

gabapentin overviewGabapentin compared with placebo also significantly improved the BPI average pain interference score, as well as a series of other scores. These included the Fibromyalgia Impact Questionnaire total score, the Clinical Global Impression of Severity Improvement, the Patient Global Impression of Improvement, the Medical Outcomes Study (MOS), the Sleep Problems Index, and the MOS Short Form 36 vitality score.

However, the drug had no effect on acute pressure-point pain or depression (the Montgomery Asberg Depression Rating Scale), the researchers reported.

Overall, the drug was well-tolerated. Of the 150 patients, 19 dropped out due to adverse events, with no significant difference between the treatment groups.

The gabapentin patients reported dizziness, sedation, lightheadedness, and weight gain significantly more often that did the placebo-treated patients. Notably, the researchers said, there was no significant difference in weight change in the two groups as measured in the clinic, although edema may have explained some of the patients’ perceptions. Most treatment adverse events, they reported, were mild to moderate in severity.

The pathophysiology of fibromyagia is unknown, but evidence suggests that it is associated with aberrant central nervous system pain processing, the researchers said.

The drug appears to be effective in reducing abnormal hypersensitivity induced by inflammatory responses or nerve injury. Yet unlike many other pain syndromes, there is no physical evidence of inflammation or CNS damage.

One possible explanation, Dr. Arnold said, is that gabapentin’s effects involve binding to a specific subunit of voltage-gated calcium channels on neurons. This binding, she said, reduces calcium flow into the nerve cell, which reduces the release of some signaling molecules involved in pain processing.

In discussing the study’s limitations, the researchers said that because the study was short, the results may not generalize to longer treatment periods, and long-term efficacy should be studied in future clinical trials.

Also, because the study was relatively small, they said it may have lacked the power to detect potentially relevant differences between the groups. Finally, they wrote that the results may not apply to patients with some comorbid psychiatric disorders, such as bipolar disorder, or to patients with other painful musculoskeletal disorders.

“In this, the first randomized, placebo-controlled study to evaluate gabapentin in the treatment of fibromyalgia, the results demonstrated that gabapentin, taken for up to 12 weeks, is effective and safe in the treatment of pain and other symptoms associated with fibromyalgia,” Dr. Arnold concluded.

Gabapentin may be useful in the treatment of comorbid anxiety in bipolar patients, (however not the bipolar state itself). Gabapentin may be effective in acquired pendular nystagmus and infantile nystagmus, (but not periodic alternating nystagmus). It is effective in hot flashes. It may be effective in reducing pain and spasticity in multiple sclerosis. Gabapentin may reduce symptoms of alcohol withdrawal (but it does not prevent the associated seizures). Use for smoking cessation has had mixed results. Gabapentin is effective in alleviating itching in renal failure (uremic pruritus)  and itching of other etiologies. It is well-established in the treatment of restless leg syndrome. (A prodrug form, gabapentin enacarbil, is also effective.)  Gabapentin is effective in insomnia.

Primary Source

Arthritis and Rheumatism

Source Reference: Arnold LM, et al”Gabapentin in the Treatment of Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial”Arthritis Rheum 2007; 56: 1336-1344.

https://en.wikipedia.org/wiki/Gabapentin