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Laregab AT (Gabapentine 300 mg + Amitriptyline 10 mg) — Therapieresistente zenuwpijn

✅ Relieves nerve pain
✅ Combats depression
✅ Manages neuropathy
✅ Improves sleep quality
✅ Reduces anxiety

Laregab AT contains Gabapentin and Amitriptyline.

Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring  · Laatst beoordeeld: mei 2026

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📦 US shipping note: We ship Laregab AT to the United States; however, due to gabapentin’s state-controlled-substance classification we cannot ship to Kentucky, Michigan, Tennessee, Virginia, or West Virginia. If you place an order with a delivery address in one of these restricted states, we will refund the relevant portion of your order or issue a coupon as compensation.
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Snelle antwoord

Laregab AT is een vaste combinatie van gabapentin 300 mg + amitriptyline 10 mg, used for refractory neuropathic pain that has not responded adequately to gabapentin or amitriptyline alone. The two molecules act on complementary pain pathways: gabapentin reduces excitatory neurotransmitter release at hyperexcitable nerve terminals, while amitriptyline boosts descending pain inhibition by raising synaptic noradrenaline and serotonin. Typical dose is one tablet at bedtime initially, increasing to twice daily. Both molecules cause drowsiness — start at night, drive cautiously, and taper slowly when stopping.

What Is Laregab AT?

Laregab AT is an Indian-manufactured combination tablet containing two well-established neuropathic-pain agents:

  • Gabapentin 300 mg — alpha-2-delta calcium-channel ligand, anticonvulsant, neuropathic-pain analgesic
  • Amitriptyline 10 mg — tricyclic antidepressant, low-dose neuropathic-pain analgesic, sleep modulator

The combination targets the multiple mechanisms underlying chronic nerve pain, often producing better symptom control than either drug alone — particularly when sleep disturbance and pain co-exist.

How the Two Molecules Complement Each Other

WerkingsmechanismeGabapentinAmitriptyline
Calcium-channel modulationBinds alpha-2-delta-1 subunit; reduces glutamate, substance P release
Descending pain modulationBoosts noradrenaline and serotonin in descending inhibitory pathways
SlaapeffectMild sedationStrong sleep-promoting effect at low dose (anticholinergic, antihistaminic)
Anxiety / mood liftModest, off-labelModest at 10–25 mg; full antidepressant effect 75–150 mg

Indicaties

  • Diabetic peripheral neuropathy
  • Post-herpetic neuralgia (shingles pain)
  • Post-traumatic and post-surgical neuropathic pain
  • Chemotherapy-induced peripheral neuropathy
  • Mixed nociceptive-neuropathic chronic low back pain with sciatica
  • Fibromyalgia (off-label combination use)

Dose & Administration

StapDoseringTiming
Week 11 tablet at bedtimeNight dose first — covers nocturnal pain and supports sleep
Week 2 onward (if tolerated)1 tablet morning + 1 tablet bedtimeTwice daily
Selected patients1 tablet three times dailyIf pain control inadequate
Ouderen1 tablet at bedtime, slow titrationAnticholinergic risk higher in age 65+
NierfunctiestoornisAvoid or use with strict cautionGabapentin component is renally cleared; alternative regimen often safer
Both components require slow tapering Stopping Laregab AT abruptly can cause withdrawal symptoms from both molecules — gabapentin withdrawal (anxiety, insomnia, sweating, rebound pain) and amitriptyline withdrawal (cholinergic rebound: nausea, dizziness, vivid dreams). Reduce by one tablet every 7–14 days if discontinuing.
Anticholinergic burden Amitriptyline contributes anticholinergic effects: dry mouth, constipation, urinary retention, blurred vision, and (in older adults) confusion. The 10 mg dose is small but the burden adds to other anticholinergic medicines. Avoid in patients with closed-angle glaucoma, prostatic hyperplasia with significant retention, or severe constipation.

Veelvoorkomende bijwerkingen

  • Drowsiness, sedation (additive from both components)
  • Duizeligheid, licht gevoel in het hoofd bij staan
  • Dry mouth (amitriptyline)
  • Constipation (amitriptyline)
  • Weight gain (both)
  • Mild peripheral oedema (gabapentin)
  • Blurred vision (amitriptyline)
  • Vivid dreams

Serious Side Effects

  • Severe drowsiness or breathing difficulty (especially with opioids or alcohol)
  • Cardiac conduction effects — prolonged QT, arrhythmia (amitriptyline)
  • Suicidal ideation (anticonvulsant and tricyclic class warning)
  • Urineretentie
  • Ernstige allergische reactie

Contra-indicaties

  • Recent myocardial infarction, second- or third-degree heart block, arrhythmia
  • Closed-angle glaucoma
  • Ernstige leverfunctiestoornis
  • Use of MAO inhibitors within the previous 14 days
  • Bekende overgevoeligheid voor een van de componenten

Geneesmiddelinteracties

  • Opioids — additive CNS and respiratory depression; large mortality signal in real-world data
  • Other CNS depressants (benzodiazepines, alcohol, antihistamines) — additive sedation
  • SSRIs / SNRIs — risk of serotonin syndrome with amitriptyline component
  • Tramadol — additive serotonergic and seizure-threshold-lowering effect
  • Antiarrhythmics (Class IA, III) — additive QT prolongation
  • Antacids containing aluminium / magnesium — reduce gabapentin absorption; separate by at least 2 hours

Opslag

Store below 25 °C in a dry place, away from direct sunlight. Keep in original blister packaging. Keep out of reach of children — amitriptyline overdose in children is potentially life-threatening.

Veelgestelde vragen

How is Laregab AT different from gabapentin alone?

Laregab AT pairs gabapentin 300 mg with amitriptyline 10 mg. Amitriptyline targets the descending pain-inhibitory pathway via noradrenaline and serotonin — a different mechanism from gabapentin’s calcium-channel binding. Combining the two often improves pain control when either alone has been insufficient, and the amitriptyline component also improves sleep.

Why is Laregab AT taken at night first?

Both components cause drowsiness, and the amitriptyline component has a strong sleep-promoting effect. Starting at bedtime avoids daytime sedation and lets the body adjust. Once tolerance to sedation develops, a morning dose can be added.

How long until Laregab AT works for nerve pain?

Gabapentin’s pain effect builds over 2–4 weeks. Amitriptyline’s analgesic effect (separate from its antidepressant effect) builds over 1–3 weeks. Most patients experience meaningful improvement by week 4 of regular dosing.

Can I drink alcohol with Laregab AT?

Avoid alcohol. The combination amplifies drowsiness, dizziness, and falls risk. Amitriptyline also lowers seizure threshold; combining with alcohol withdrawal can be dangerous.

Will Laregab AT make me gain weight?

Possibly — both molecules can promote weight gain. Average gain across the gabapentin + amitriptyline combination is 2–5 kg over 12 weeks. Watch portion sizes, prioritise protein, and stay active during titration.

Why can you not ship Laregab AT to certain US states?

Gabapentin is a controlled substance under state law in Kentucky, Michigan, Tennessee, Virginia, and West Virginia. We cannot ship to addresses in those states. Other US states are unaffected.

Is Laregab AT a controlled substance?

In most jurisdictions, gabapentin is not a federally controlled substance — but several US states (KY, MI, TN, VA, WV) have scheduled it. Amitriptyline is not controlled. Check local regulations before ordering.

Can I drive on Laregab AT?

Caution is essential, especially in the first 2–4 weeks. The combination causes more sedation than either drug alone. Do not drive until you know how the medication affects you, and avoid driving after the bedtime dose.

Is Laregab AT safe in pregnancy?

Both components have pregnancy concerns. Gabapentin has limited human data; amitriptyline has been linked with respiratory and feeding problems in newborns when used in late pregnancy. Discuss alternatives with your obstetrician.

How do I stop taking Laregab AT?

Always taper. Reduce by one tablet every 1–2 weeks. Sudden cessation can cause withdrawal from either molecule — anxiety, insomnia, rebound pain, vivid dreams, and (rarely) cholinergic rebound symptoms.

Does Laregab AT help with my mood?

The amitriptyline 10 mg dose is below the typical antidepressant range (75–150 mg). It will not provide a full antidepressant effect, although better sleep and reduced pain often improve mood indirectly. If depression is a primary concern, a dedicated antidepressant at therapeutic dose is more appropriate.

Medische disclaimer: This page is educational and does not replace professional medical advice. Always consult a qualified healthcare professional before starting, stopping, or changing any medication, especially if you have other medical conditions, take other prescriptions, are pregnant or breastfeeding, or are over 65.

Zie ook: Gabasign 300 / 600 mg — Cipla’s gabapentin generic — same FDA-approved molecule, full dose range from 300 mg starter to 600 mg maintenance.

Zie ook: Synaptol 150 mg — tolperisone alternative when cyclobenzaprine sedation is unacceptable — centrally acting without H1 antihistamine drowsiness.

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