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Suggest Treatment For Diabetic Neuropathy

Posted on Thu, 16 Oct 2014

Question: Hi Doctor,
Sending this query on behalf of my father.
He has been feeling tightness and numbnes in his legs. He feels lot of heat in his foot. He says he feels as if he has taken injections in his legs and this feeling doesnt go off. He was advised to take gabapentin 300 mcg medicine with B12 vitamin. He has sugar and High BP ,though he is on medication for both of them as well.
Please advise what could be done since due to this uneasiness he is unable to sleep or relax 24/7.
Moreover his blood pressure level also increases due to this uneasiness

Answered by Dr. Rakesh Madhyastha (23 minutes later)

Brief Answer:
Diabetic neuropathy

Detailed Answer:
Hello

Thanks for the query

It looks like your father is suffering from diabetic neuropathy. He is already receiving the right treatment for it. If you are looking for a step up from here then I suggest tab Tramadol at night time. It has given good comfort in my patients. However please be careful about its addictive properties and also causes severe nausea in some patients . Approach your neurologist with my suggestion.
Another option would be tab tryptomer at night.

I hope I was of help

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (33 minutes later)

would it be right ,to have so many medicines in a day ,he is already taking sugar and BP medicince.
For how long would you suggest other two medicines? which one of them is better.

Answered by Dr. Rakesh Madhyastha (3 hours later)

Brief Answer:
Hello

Detailed Answer:
Thanks for the reply

Of the two I personally prefer Tab Tramadol given as sos basis when the pain is too much and then continue with Gabapentin and Vit b12. There is no set duration for taking tramadol, its like for example Tab paracetamol used for headaches, when the headache is severe use one.

I do not prescribe my patients with Tryptomer as it makes them drowsy.

I understand your concern of taking multiple medications, but essential medicines cannot be stopped.

Please approach your neurologist with my suggestion.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (1 hour later)

Oh does it mean on the days he takes Tramadol ,he should not be taking gapapentin.
What dose of tramadol should be taken(how many mcg)?

Answered by Dr. Rakesh Madhyastha (5 hours later)

Brief Answer:
Follow up

Detailed Answer:
Hello

Thanks for the query

He will have to continue Gabapentin when on tramadol. I usually start tramadol at 50 mg twice a day and increase it slowly to 100 mg twice a day if tolerated.
Please do not consider this as my prescription. Approach a doctor for it.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar