Multiple Myeloma Neuropathy Treatments
A lot of multiple myeloma patients will experience neuropathy. Peripheral neuropathy (peripheral just means at the extremities like your hands and feet) is caused by chemotherapy for myeloma patients.
Velcade is one of the main neuropathy culprits for myeloma patients. Another is the melphalan used for stem cell transplants in treading multiple myeloma.
If you are in pain, or the numbness has gotten out of hand, do not stay silent. There are neuropathy prescriptions your doctor can give you.
The catch is that not everyone has the same neuropathy, and not everyone responds the same to each medicine. That means that you might have to try a few different neuropathy medicines and doses before you find the right combination for you.
Unfortunately, there is no cure for neuropathy, and the treatments can be iffy. That doesn’t mean that there is nothing that can be done.
Originally, I was prescribed Gabapentin. Keep your doctor up to date on how you are feeling. As it turns out, you can go up to pretty high doses of gabapentin, so long as your body will tolerate it. So, if you are still in pain, tell your doctor. If they don’t offer, specifically ask about increasing your dosage.
Your oncologist’s job is to keep you alive. You are responsible for the quality of that life.
Over time, I seem to have gotten all of the relief I could from gabapentin. It felt like the gabapentin stopped working for me, although I’m sure the reality is that I would have been much worse off without any. Either way, I wanted to get more improvement.
Pregabalin is the generic name for Lyrica. Unfortunately, Lyrica is still under patent. That means it is expensive. For this reason, your doctor will likely look to this as a treatment last, even though it may work better for many myeloma patients.
Your oncologist will have you step up your dosage over time for two reasons. One, is to ensure that you tolerate the medication. You don’t want pills making you worse. Myeloma already gives you plenty to worry about.
The second reason is to get an idea of what the minimum dose is that works for you. For me, the best dosage seems to be 400 mg per day.
Neuropathy Medication Costs
Gabapentin is generic, so your insurance should cover it. If not, it shouldn’t be too crazy.
Pregabalin is another story. Lyrica is still under patent. That means it is pricey. I have pretty good insurance and most of my medications are actually free because I hit my annual out-of-pocket-maximum already. That does not mean I get to go around the insurance policy limits though.
My insurance plan only covers 300 mg per day of pregabalin. My doc tried to get them to allow me to have 400 mg per day because that is what works form. This is successful more often than you might think, but in this case, apparently that is not what is says on the medication’s “label” and it also is not in some book, or prescribing manual, so they will only pay for 300 mg per day.
Unfortunately, that leaves me short 30, 100mg pills per month. At my usual CVS pharmacy that costs an extra $111. I’m not looking to get into another $1200 per year of medical expenses.
I have a plan to try and get around it. We’ll have to see how it works out.
GoodRx Myeloma and Cancer
I have seen ads for GoodRx and my research makes it seem as though GoodRx is legit. According to the website, I could get the extra pregabalin I need at another pharmacy with a GoodRx coupon for a very reasonable cost. So, theoretically, all I need a prescription with no insurance information and the GoodRx app coupon, and I could get it for like $20.
I am having my doc’s office crank out the extra prescription and I will keep you posted about how it works out.