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Suggest Treatment For Peripheral Neuropathy While Undergoing Chemotherapy
Question: My husband has neuropathy in his feet cause by chemo treatments. he is 81 and has Parkinson's Disease Also on blood thinners so most pain killers are off limits. what can he do and what type of Dr. should he be looking for?
Brief Answer:
Take Gabapentin, consult neurologist.
Detailed Answer:
I read your question carefully and I understand your concern.
Peripheral neuropathy is a common complication of chemotherapy. Fortunately not all the medication which is used for peripheral neuropathy symptoms interacts with blood thinners.
The class of medication which is the first choice for neuropathy, the anticonvulsant class includes Gabapentin and Pregabalin. None of those medications interacts with blood thinners (at least not with the commonly used ones like aspirin, warfarin or new oral anticoagulants). So they can be safely used with blood thinners. Actually they would have been my first choice anyway, blood thinners or not.
As for what type of doctor to look for, apart from the treating oncologist the most appropriate specialist for a peripheral nervous system would be a neurologist.
I remain at your disposal for other questions.
Take Gabapentin, consult neurologist.
Detailed Answer:
I read your question carefully and I understand your concern.
Peripheral neuropathy is a common complication of chemotherapy. Fortunately not all the medication which is used for peripheral neuropathy symptoms interacts with blood thinners.
The class of medication which is the first choice for neuropathy, the anticonvulsant class includes Gabapentin and Pregabalin. None of those medications interacts with blood thinners (at least not with the commonly used ones like aspirin, warfarin or new oral anticoagulants). So they can be safely used with blood thinners. Actually they would have been my first choice anyway, blood thinners or not.
As for what type of doctor to look for, apart from the treating oncologist the most appropriate specialist for a peripheral nervous system would be a neurologist.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Actually he is taking Gabapentin (300mg) his PCP just had him increase to 300..3 time a day. total 900 mg.. but it has been only 1 week . if he does not see any relief what would be the XXXXXXX mg that is safe (I wold not without his pcp's ok.) He started the med for restless leg syndrome. He has so many issues but everything except the neuropathy is under control (for now)
Brief Answer:
Read below.
Detailed Answer:
Hello again!
The dosage of Gabapentin can be increased but that should be done gradually. The maximum dosage depends on whether it is tolerated by the patient. The maximum dosage is 2400 mg/day but of course if it is not well tolerated it shouldn't be increased. Generally in someone over 80 I do not go beyond 1800 mg/d.
The other class of medications for neuropathy, antidepressants, I am afraid interacts with blood thinners, so Gabapentin or Pregabalin are the main options. Using local anesthetics like Capsaicin cream may also have some additional benefit and no risks.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Hello again!
The dosage of Gabapentin can be increased but that should be done gradually. The maximum dosage depends on whether it is tolerated by the patient. The maximum dosage is 2400 mg/day but of course if it is not well tolerated it shouldn't be increased. Generally in someone over 80 I do not go beyond 1800 mg/d.
The other class of medications for neuropathy, antidepressants, I am afraid interacts with blood thinners, so Gabapentin or Pregabalin are the main options. Using local anesthetics like Capsaicin cream may also have some additional benefit and no risks.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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