Nov 16, 2005
My doctor hasn't paid much attention to it, and perhaps feels that my peripheral neuropathy (PN) will be fought when I build up from my very low T-cell counts. I'm using combo-therapy meds Emtriva, Tenofovir (Viread), Rizonavir (Norvir), and Atazanavir (Reyataz). He did prescribe Gababentin (generic Neurotin - 300 mg 1 per day at bedtime) for the PN (feet). From what I read I am confused as to whether Gababentin is just killing the pain (covering up the PN) or actually treating the PN as well.
But the PN is getting worse. It's a daily cyle. In the morning it feels like the PN is close going away, but by mid-evening I can feel it 'moving up' from almost white, swollen feet, into now swelling ankles and further. I think it developed from some already recently numbed toes and then started after meds.
I wonder if any of my meds are likely to cause or worsen PN?
Should I ask my doctor to change any meds, or change the Gababentin. Would increased dosages of Gababentin be advised (2 * 300-mg per day)? I do want to walk again after this is over.
Response from Dr. Henry
That is a low dose of gabepentin (I have used 3600 mg/day in some patients to obtain relief). It doesn't reverse the neuropathy but merely makes it more tolerable in some patients. A neurologic evaluation may be useful to pin down if there are other factors contributing (vitamin deficiencies, other infections, etc). Your HIV regimen can sometimes (though fairly rarely) aggravate your neuropathy though HIV itself is more likely in the setting of a low CD4 count. Vascular problems, cryoglobulins, and other conditions can cause some of the symptoms you describe so a neuro evaluation can be quite useful to sort out. KH
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