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Jon Siegel's Multiple Myeloma Blog

This is the updated Dana-Farber Neuropathy Regimen,
Received October 2006 and Posted with Permission
Also see the accompanying Comment Sheet
For a printable pdf of this page, click here
For a printable pdf of the comment sheet, click here

DANA-FARBER CANCER INSTITUTE

THE JEROME LIPPER MULTIPLE MYELOMA CENTER

Institutional approach for Neuropathy with Multiple Myeloma patients

NEUROPATHY TREATMENTS

Always consult with your physician before taking any

supplements or medications

VITAMINS – Always take with food

Hi –DOSE MULTI-B COMPLEX VITAMINS

with B1, B6, B12, folic acid and other B-vitamins

Folic acid should be 1 to 2 mg

VITAMIN E

400 IU daily

FISH OILS - OMEGA-3 FATTY ACIDS (EPA and DHA)

EVENING PRIMROSE OIL Capsules

FLAX SEED OIL

AMINO ACIDS – can be obtained at Health Food Stores

or some supermarkets. Take both if possible.

Take 1 to 2 hours before or after meals

ACETYL L- CARNITINE

500mg twice a day with food

Can take up to 2000mg a day.

ALPHA-LIPOIC ACID

200mg to 1000mg a day with food

COMBINATION PILL - take ONE twice a day

Alpha lipoic acid 200mg

Acetyl-L-Carnitine 500mg

For Cramping

MAGNESIUM

250mg twice a day

May cause diarrhea in large doses

POTASSIUM

2 teaspoons Apple Cider Vinegar

Bananas, Oranges

TONIC WATER (has Quinine in it)

Drink one glass in evening and any other time cramping occurs

MEDICATIONS – Prescription needed

NEURONTIN (gabapentin)

Start with 100mg three times a day.

Gradually work up to 600mg three times a day.

Can dose as high as 2700mg total dose with Physician permission.

Neurontin comes in 100mg and 300mg pills.

Not to be used in high doses with kidney dysfunction

ELAVIL (Amitriptyline)

25-50mg at bedtime

CYMBALTA (Duloxetine)

Start at 20mg, work up to 60mg at bedtime

CELEBREX 100-200mg

(Cox II prostaglandin inhibitors)

Take only with physician supervision

LYRICA (Pregabalin)

75-150mg twice a day

LIDODERM PATCH 5%

1 ½ patches to each area of pain. Change every 12 hours

MISCELLANEOUS

COCOA BUTTER (rich in Vitamin E and other emollients)

Apply to affected area twice a day with gentle massage

STEROID SYMPTOMS

RITALIN

5 to 10mg twice a day

ATIVAN

.5 – 1mg before bedtime and

every 4 hours if needed for anxiety