Neurontin is a prescription-only oral medication used to treat seizures and nerve pain. It belongs to a class of medications called anticonvulsants.
Neurontin works by decreasing the number of seizures you have. It also helps reduce the pain you feel from damaged nerves.
The drug is available in the following formats:
Tablet: 600mg, 800mg
Capsule: 100mg, 300mg, 400mg
Oral solution: 250mg/5ml
Gabapentin is the generic form of Neurontin.
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Neurontin is a seizure medication prescribed to treat epilepsy. You can also take Neurontin to treat restless legs syndrome (RLS).
Doctors may also prescribe Neurontin to treat postherpetic neuralgia (PHN) — nerve pain that sometimes affects people who have had shingles.
The drug appears to work by altering electrical activity in the brain. It also affects the activity of neurotransmitters, which transmit signals between nerve cells.
Your doctor will prescribe a dose of Neurontin based on several factors, including:
Your condition and its severity
Your age
Whether you are taking the capsule, tablet, or oral solution
Other medical conditions you may have
Other medications you are taking
Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.
Take this medication with or without meals.
The following information describes dosages that are commonly used or recommended.
Typical adult dose for epilepsy:
Initial dose: 100 to 300mg three times a day
Maintenance dose: 300 to 600mg three times a day
Maximum dose: 3,600mg daily taken orally, in three divided doses
The maximum interval between three daily doses should not exceed 12 hours.
Typical dose for children aged three to four with epilepsy:
Initial dose: 10 to 15mg/kg daily in three split doses
Maintenance dose: 40mg/kg daily in three split doses
Typical dose for children over five years of age with epilepsy:
Initial dose: 10 to 15mg/kg daily in three split doses
Maintenance dose: 25 to 35mg/kg daily in three split doses. This dose should be built up gradually over roughly three days, with the medication being taken in three split doses.
Twelve hours is the maximum time between doses.
This medication is not recommended for children under the age of three years.
Typical dose for children over 12 years of age with epilepsy:
Initial dose: 300mg three times a day
Maintenance dosage: 900 to 1,800mg orally in three split doses
Maximum daily dose: 2,400mg
In a three-a-day regimen, the maximum interval between doses should not exceed 12 hours.
Typical adult dose for postherpetic neuralgia:
Initial dose:
Day 1: one 300mg dose
Day 2: two 300mg doses
Day 3: three 300mg doses
Maximum daily dose:
1,800mg (600mg taken by mouth, three times a day)
Measure your dose carefully using a specially marked spoon or dropper. Do not use a household spoon, as you may get an inaccurate measurement. You can ask your pharmacist for a measuring device if you do not have one.
It may take some time to find the right dosage for you and for the medication to start working.
Some people experience relief from their symptoms almost immediately,² while others may need to wait a few weeks.
Neurontin can cause mild side effects, such as:
Dizziness
Drowsiness
Blurred vision
Dry mouth
Constipation or diarrhea
Nausea or vomiting
If you experience any of these side effects and they worsen or continue, talk to your doctor. They may adjust your dosage or prescribe a different medication that will help alleviate your symptoms.
Call your doctor right away if you develop serious side effects when taking Neurontin, such as:
Changes in mood or anxiety — symptoms can include:
Thoughts of suicide or dying
Attempts to commit suicide
Anxiety that is new or gets worse
Crankiness that is new or gets worse
Restlessness
Trouble sleeping
Anger
Aggressive or violent behavior
Extreme increase in activity and talking
Changes in behavior and thinking, especially in children aged three to 12 years of age — symptoms can include:
Emotional changes
Aggressiveness
Trouble concentrating
Restlessness
Changes in school performance
Hyper behavior
Neurontin can also cause an allergic reaction (see below).
Long-term use of Neurontin among older people may result in dizziness, drowsiness, and renal impairment,³ which can cause adverse events and hospital stays.
Long-term clinical trials have found that Neurontin treatment is well-tolerated¹ when taken to treat seizures.
Take a missed dose as soon as you remember. If it’s nearly time to take your next dose of Neurontin, skip the missed dose and resume your regular dosing schedule. Don’t take two doses at once to make up for the one you missed.
The US Food and Drug Administration (FDA) reports that up to 49g¹ of Neurontin may be fatal if taken by mouth.
Symptoms of a Neurontin overdose may include:
Sleepiness
Lethargy
Double vision
Slurred speech
Diarrhea
Coma
Neurontin is thought to increase suicidal thoughts or behavior. Between 2012 and 2017, the number of suspected intentional suicide attempts linked to Neurontin toxicity rose by 80.5%⁴ in the US. It is listed by the US Drug Enforcement Administration (the DEA) as a Schedule III⁵ drug.
Monitor your or a dependent’s use of Neurontin closely. Never take more than your doctor prescribed.
Before taking Neurontin, tell your doctor about any other medications you are taking, as well as any preexisting medical conditions you have. You must also disclose information about any nutritional supplements or herbal medications you are taking or plan to take.
You should not take Neurontin if you’re allergic to it or any of its ingredients. Discuss any previous allergic reactions with your doctor, and let them know if you’re allergic to any other medications.
Tell your doctor if you are pregnant, breastfeeding, or plan to become pregnant while taking Neurontin.
Discuss any potential side effects with your doctor before taking the drug.
If you have been taking Neurontin for a while and your doctor decides that it is time to stop the medication, they will probably wean you off of it slowly. This is done to avoid any potential side effects from stopping the drug.
If you are taking Neurontin for seizures, your doctor may tell you to stop taking the medication gradually over a period of weeks or months.
If you are taking Neurontin for pain relief, your doctor may tell you to reduce your dose gradually over a period of days or weeks. Some people who take Neurontin for long periods may experience withdrawal symptoms if they stop taking the drug abruptly.
Pregnant women and those planning to get pregnant should discuss the potential risks of using Neurontin before taking it.
Research⁶ suggests gabapentin may increase the chance of fetal heart abnormalities when used in the first trimester. Use during late pregnancy was found to increase the risk of small for gestational age (SGA), preterm birth, and admission to neonatal intensive care units.
Seizure management is critical during pregnancy, but pregnant women should only use the medicine if absolutely required.
Neurontin is excreted in breast milk at very low concentrations, and it may have no effect on the newborn. However, it is recommended that you discuss this with your doctor prior to nursing.
Neurontin may interact with drugs, vitamins, and herbal supplements, both prescription and over-the-counter.
Before using Neurontin, provide information about your use of drugs and supplements to your doctor.
The following are some of the most common medications that interact with the Neurontin:
Caffeine
Ethacrynic acid (Edecrin), a diuretic
Losartan (Cozaar), a medication for high blood pressure
Magnesium oxide (Mag-Ox, Maox, and others), a mineral supplement and antacid
Mefloquine, an antimalarial drug
Morphine (Kadian, MS Contin, and others), an opioid pain medication
Phenytoin (Phenytek or Dilantin), an anti-seizure medication
Taking other drugs that may induce drowsiness while taking Neurontin may cause adverse effects. Ask your doctor before taking these medications with Neurontin:
Anti-anxiety medications
Antidepressants
Antihistamines
Cold and flu medications
Muscle relaxers
Narcotics
Sleeping pills
People who are allergic to Neurontin or any of its ingredients should not take this drug.
Symptoms¹ of an allergic reaction may include:
Hives
Skin rash
Persistently swollen glands
Trouble breathing
Severe weakness or fatigue
Muscle pain
Swollen face, lips, throat, or tongue
Fever
Jaundice (yellowing of the skin or eyes)
Seek urgent medical care and stop taking Neurontin if you develop any of these symptoms.
Neurontin was evaluated for the management of postherpetic neuralgia in two multicenter, randomized, double-blind, placebo-controlled studies.
The studies included 563 participants who had experienced pain for more than three months after their herpes zoster skin rash had healed. Patients recorded their pain in a daily diary using an 11-point numeric pain rating scale.
In the first study, researchers administered 3,600mg daily doses of Neurontin over eight weeks. In the second study, participants were given 1,800mg and 2,400 daily doses of Neurontin over seven weeks. In total, 336 patients received Neurontin, while 227 received a placebo.
Both studies demonstrated Neurontin’s efficacy compared to placebo at all doses tested.
In study one, 29% of participants taking 3,600mg of Neurontin reported a 50% pain reduction. In study two, 32% of participants taking 1,800mg of Neurontin and 34% of patients taking 2,400mg of Neurontin reported a 50% pain reduction.
Follow these tips to help you take Neurontin safely and get the best results:
Remember there are several things your doctor should be aware of before you take Neurontin, including other diagnosed health conditions, allergies, and medications. Being honest and upfront with your doctor can help prevent harmful complications.
If you have trouble consuming tablets or capsules, speak to your doctor about taking the oral solution.
Keep the oral solution refrigerated between 2°C to 8°C (36°F to 46°F).
Neurontin can cause drowsiness, so avoid driving or operating heavy machinery until you know how the drug affects you.
Consuming alcohol is not recommended while taking Neurontin as the two substances can cause drowsiness and dizziness.
Do not stop taking the medication without your doctor’s guidance, as this could result in withdrawal symptoms.
Bear in mind that Neurontin causes side effects in some people, including behavioral changes, depression/anxiety, dizziness, headache, and nausea. Tell your doctor if your side effects worsen or don’t go away on their own.
Only ever take Neurontin as prescribed by your doctor.
Remember that Neurontin is unsuitable for children under the age of three.
Sources
Neurontin (gabapentin) (2017)
20% of older patients prescribed gabapentin after surgery use it long term (2021)
Trends in gabapentin and baclofen exposures reported to U.S. poison centers (2019)
Other sources:
CDC guideline for prescribing opioids for chronic pain — United States, 2016 | Center for Disease Control and Prevention
Information for adult patients prescribed gabapentin for the treatment of pain | British Pain Society
MedWatch: The FDA safety information and adverse event reporting program | U.S. Food and Drug Administration
Review about gabapentin misuse, interactions, contraindications and side effects (2017)
Neurontin and its off-label use in bipolar disorder | Verywell Mind
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Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.
However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.
It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.
Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.
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