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What is gabapentin?

Gabapentin is an anti-epileptic and anticonvulsant drug used by people with epilepsy to deal with seizures. The medicine affects the chemicals, neurons, and brain cells that play a crucial part in seizures and pain signals.

For patients three years and older, gabapentin also can be used for neuropathic pain, including postherpetic neuralgia.

What is gabapentin's generic name?

Gabapentin is available in its generic form and as brand name. These include Gralise®, Neurontin®, and the extended-release form Horizant®.

What does gabapentin treat?

Doctors prescribe gabapentin for seizures in people with epilepsy.

People with diabetic peripheral neuropathy (pins and needles in the hands and feet) and postherpetic neuralgia (pain after shingles) use it to deal with nerve pain.

People with restless legs syndrome and fibromyalgia could also use gabapentin to alleviate their symptoms.

How do you take gabapentin?

Gabapentin is available as tablets, oral solutions, capsules, and extended-release tablets (ER). 

You must follow the directions for your specific medication as different brands are for particular conditions:

  • Horizant treats restless leg syndrome and postherpetic neuralgia.

  • Gralise treats neuropathic pain.

  • Neurontin and generic gabapentin treat neuropathic pain and epileptic seizures.

How you should take gabapentin:

The following dosage information is general, and the dose you take will depend on your doctor’s advice for your specific circumstances.

For partial seizures

Neurontin

Doctors usually prescribe a low dosage of 300mg every eight hours, and then an increase of up to 600mg per eight hours may follow. Your doctor can increase your daily dosage to 2,400mg or even 3,600mg, depending on how you respond to treatment.

For children 3-12, the dose is around 10-15mg/kg per day in three doses to start, then your doctor will adjust it according to your child’s age. The effective dose is 30-40mg/kg per day in three divided doses and 25-35mg/kg per day in the same divided doses for 5-12 years old. 

For post-herpetic neuralgia

Neurontin

Take 300mg on the first day, 300mg every 12 hours on the second day, and 300 mg every eight hours on the third day. Depending on the response, your doctor can titrate your dose to a maximum of 1,800mg per day (usually 600mg three times per day). 

Gralise

You will usually take Gralise as a once-daily evening meal dose. Your doctor will titrate it over several weeks to an effective dose to relieve neuralgia. This can be up to 1,800mg daily.

Horizant

For restless legs syndrome

Take 300mg once a day in the evening. Your doctor may prescribe 600mg if necessary.

Seeing results

It will take a few weeks before you see the full effects of gabapentin for postherpetic neuralgia and seizures. Even then, the pain and seizures may still occur. If you respond well to the treatment, your doctor will prescribe it for you to take regularly.

Potential side effects of gabapentin

Common side effects of gabapentin include:

  • Fatigue and tiredness

  • Headache

  • Nausea

  • Dizziness

  • Vomiting

  • Coordination problems

  • Tremors and shakiness

  • Weight gain

  • Memory loss

  • Fever

  • Eye problems

  • Erectile dysfunction

Potentially serious side effects include: 

  • Liver and kidney problems

  • Severe stomach pains

  • Changes in mood and behavior

  • Feeling suicidal or thinking of harming yourself

Long-term use of gabapentin

You must take gabapentin regularly for it to be truly effective, and your doctor will increase your dosage for maximum effectiveness. In the case of side effects, especially severe ones, inform your physician immediately. You may need to stop taking the drug.

Gabapentin can become a habit-forming drug if it’s not used for approved medical conditions or under medical guidance.

Missed doses

Take gabapentin immediately if you miss a dose, but do not take it if it is almost time for your next one. 

For Horizant, which you can only take once a day, skip your missed dose and take your regular dose the next day. Never double dose.

Overdoses

Various symptoms may occur if you overdose on gabapentin, including: 

  • Loose stools

  • Fatigue

  • Double vision

  • Slurred speech

If you overdose and you’re experiencing severe symptoms or side effects, go to the nearest hospital, or call the Poison Control helpline on 1-800-222-1222 for instructions.

What to discuss with your doctor before taking gabapentin

Talk about these with your doctor before taking gabapentin:

  • All allergies you have, including any allergy to gabapentin 

  • How to use gabapentin. Every brand is for a specific condition, and each one has precise dosing instructions

  • All the medicines and supplements you are taking, prescribed and non-prescribed

  • If you are taking antacids, as they may interact with gabapentin

  • Any other medical conditions, particularly lung and kidney diseases

  • If you are going to have surgery

  • If you are pregnant, planning to have a baby, or already breastfeeding

  • If you regularly drink alcohol

  • Your sleeping patterns

  • If you have mental health conditions and receive medical treatment or therapy

  • Your dietary habits

Discussing these with your doctor ensures the maximum effectiveness of gabapentin and minimizes all possible side effects.

Stopping gabapentin

There could be adverse effects if you suddenly stop taking gabapentin. Possible withdrawal symptoms include:

  • Psychological symptoms: Anxiety, extreme agitation, and irritability

  • Headaches

  • Nausea

  • Dizziness

  • Irregular heartbeat

If you take gabapentin for seizures and stop it suddenly, you’re at greater risk of relapse. On stopping the medication, withdrawal symptoms usually appear within twelve hours to a few days.

Ask your doctor about how to stop taking gabapentin. Usually, your doctor will administer smaller doses for a period, depending on your response and other factors, like age.

Gabapentin and pregnancy

No conclusive studies prove that gabapentin is harmful to an unborn baby. In the absence of evidence, the rule of thumb is that you can take the drug as long as the benefits clearly outweigh the risks. Your doctor will be able to advise you if there’s a safer medication.

Since you can pass gabapentin on to your child in small amounts if you’re breastfeeding, consult your doctor about the risks of taking it while nursing.

Interactions with other drugs

Antacids interact with gabapentin, rendering it ineffective by reducing the amount in your body. Take the antacid at least two hours before you take gabapentin.

Painkillers could increase the side effects of gabapentin, especially if you are already suffering from fatigue or tiredness due to the medicine.

Anti-psychotic drugs, some anti-depressants, other drugs for seizures, and even over-the-counter drugs like those for coughs and colds could interact with gabapentin.

Anesthesia and other muscle relaxants may result in dangerous side effects if you combine them with gabapentin.

Consult your doctor about the medicines you take before taking gabapentin.

Allergy information

In extreme cases, a severe allergic reaction called anaphylaxis could occur.

Symptoms include: 

  • Breathing difficulties

  • Rash

  • Itching/swelling (especially of the face/tongue/throat)

  • Severe dizziness

  • Faster heartbeat 

If you’re having an allergic reaction, seek emergency medical care.  

Clinical Trial History

Two studies¹ found gabapentin to be safe and effective when used alone for partial seizures.

Gabapentin is a common drug for treating hot flashes and neuropathic pain in breast cancer survivors, but its use as an anxiety remedy has limited clinical trial evidence.

A study found that gabapentin is a low-cost alternative treatment for breast cancer survivors with anxiety symptoms in primary care practices. Gabapentin’s effects are beneficial for hot flashes² and provide relief from the discomfort brought by anxiety without fear of addiction risk.

Tips and advice for taking gabapentin

Here are some important reminders for taking gabapentin:

  • Do not chew or break the drug, as this can affect how your body absorbs it, leading to more side effects. Swallow it whole.

  • As gabapentin is available as generic or branded, and they treat different things, you must take the specific brand of gabapentin prescribed by your doctor.

  • Take Gralise at dinner. You should not take Gralise or Horizant on an empty stomach.

  • You can split Neurontin and some forms of generic gabapentin. If you split it, ensure that you take the other half at the next dose.

  • If it is an oral solution, carefully measure it with an accurate, medically approved measuring device, not a kitchen spoon. Ask your doctor or pharmacist for instructions.

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Disclaimer

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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