Gabapentin and Mounjaro

[Nevertriedcaviar]

I am currently taking Gabapentin for my restless legs, which are caused by my poor kidneys function. (I am at stage 4 with an egfr of 23)

Sadly, the average weight gain on Gabapentin is 2 stone 11 lbs, and I have put on at least that.

I am considering Mounjaro. My question is, which one will win - will it be the Gabapentin increasing my weight, or the Mounjaro decreasing it?

Or will they balance themselves out so that my weight stays the same?

I would love to hear from anyone who has had this dilemma.

I'm on both.
I've been on gabapentin for several years. I take 900mg three times a day.

I've been on MJ for 25 months and I've lost 9st 7lb. I'm almost at my goal weight.

Oh wow, thank you! That has really encouraged me to start the Mounjaro.

Patients with stage 4 kidney disease need specialist advice before taking Mounjaro. Have your kidney team advised on it? It doesn't normally need any dose adjustments for low eGFR but it is possible they might want regular checks if you were to go on it
I suspect most providers (private pharmacies) would not prescribe it due to their lack of expertise in renal disease so you would probably need a doctor-led prescriber or go via the NHS (if you are heavy enough and tick enough boxes)
Good luck

But you do need specialist medical advice as you have renal disease.

I hope you get the MJ prescribed.

Thank you. I have a doctor's appointment scheduled for next week, so I will take advice.

gabapentin has been associated with an increased risk of dementia so you shouldn’t be on it for an extended period of time. For chronic pains or other symptoms, ask for a review.

There is a 29% risk of developing dementia over a 10 year period.
Therefore there must be a 71% chance of not developing it.

100% needs specialist input with stage 4 renal disease - deffo do not be tempted to try sourcing it 'off the record'. Mounjaro can interfere with the balance of acids in the blood and also cause other issues due to the way it affects gastric emptying (including reducing the effectiveness of the gabapentin/other drugs). Hope they're able to help work something out with you.

Yes also been on gabapentin for years, goal weight on Mounjaro for a year. Inflammation totally gone, had blood tests. Literally none detectable

The manufactures SPC for Mounjaro says:
No dose adjustment is required for patients with renal impairment including end stage renal disease (ESRD). Experience with the use of tirzepatide in patients with severe renal impairment and ESRD is limited. Caution should be exercised when treating these patients with tirzepatide.
so technically no reason why not. But I would think most prescribers working for companies that supply Mounjaro privately do not have enough experiencing of prescribing in renal impairment to do so in your case.

THIS study showed no increased likelihood of developing dementia in patients who take gabapentin.

The study quoted earlier in the thread did not suggest that 29% of patients taking gabapentin would develop dementia! That would be a ridiculously high percentage and an unacceptable risk.

That's a flawed interpretation of the data, and that study has been discredited anyway.

Actually, papers published in 2025 confirm the dementia risk
https://pubmed.ncbi.nlm.nih.gov/40639955/

No. A great many experts have urged caution in interpreting the results of this study.
Too few variables were considered.

The jury is very much still out.