What is Gabapentin and Frequent Questions About Gabapentin

What is Gabapentin?

Gabapentin is an anticonvulsant drug that acts as a mild tranquilizer and is only legally available with a prescription. It is frequently used to treat seizures and pain from nerve damage. It may also be used for medical treatment during alcohol or cocaine withdrawal, for diabetic neuropathy, restless leg syndrome, or anxiety.

The generic version of gabapentin was first introduced in 2004, so it’s still a new drug and experts aren’t exactly sure how it works. However, they do know that it affects the brain and the nervous system.

Gabapentin comes in the form of capsules, tablets, or an oral solution, and people who abuse it may crush the pills and snort the powder or take the pills with opioid drugs and benzodiazepines to enhance its effects and experience a pleasurable high. Abusing alcohol with gabapentin can cause serious dizziness or sleepiness.

Gabapentin is sold under the following brand names:

• • • Neurontin
    • Gralise
    • Gaborone
    • Fanatrex

Gabapentin warnings

Gabapentin oral capsule comes with several warnings. Call your doctor if you start having more seizures or a different kind of seizure while taking this drug.

Drowsiness warning

Gabapentin can slow your thinking and motor skills and cause drowsiness and dizziness. It’s not known how long these effects last. You should not drive or use heavy machinery while taking this drug until you know how it affects you.

Depression warning

Using this drug increases your risk of suicidal thoughts and behavior. Talk to your doctor if you feel depressed or notice any changes in your mood or behavior. Also talk to your doctor if you are having thoughts of harming yourself, including suicide.

Multiorgan hypersensitivity/DRESS warning

This medication can cause multiorgan hypersensitivity. This is also known as a drug reaction with eosinophilia and systemic symptoms (DRESS). This syndrome can be life-threatening. Call your doctor right away if you have symptoms such as a rash, a fever, or swollen lymph nodes.

Allergy warning

Gabapentin can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue
• hives
• rash

Don’t take this drug again if you have ever had an allergic reaction to it before. Taking it a second time after any allergic reaction to it could be fatal (cause death).

Alcohol interaction warning

Avoid drinking alcohol while taking gabapentin. Gabapentin can cause sleepiness, and drinking alcohol can make you even more sleepy. Alcohol can also make you more likely to feel dizzy and have trouble concentrating.

Severe breathing problems warning

Severe breathing problems can occur if you take gabapentin with opioids, such as oxycodone or hydrocodone. Taking gabapentin with an opioid increases your risk for sleepiness, breathing problems, and even death. You’re at higher risk if you already have breathing problems. Get help right away if breathing problems occur

Warnings for people with certain health conditions

For people with epilepsy: Don’t stop taking gabapentin suddenly. Doing this can increase your risk of having a condition called status epilepticus. This is a medical emergency during which short or long seizures occur for 30 minutes or more.

Gabapentin can cause problems in children aged 3–12 years who have epilepsy. It raises their risk of thought problems as well as behavioral problems, such as being hyper and acting hostile or restless.

For people with kidney problems: Your body processes this drug more slowly than normal. This may cause the drug to increase to dangerous levels in your body. Talk to your doctor about whether this drug is safe for you.

Warnings for other groups

For pregnant women: The use of gabapentin has not been studied in humans during pregnancy. Research in animals has shown negative effects to the fetus when the mother takes the drug. However, animal studies don’t always predict the way humans would respond.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus. Call your doctor if you become pregnant while taking this drug.

If your doctor prescribes gabapentin for you while you’re pregnant, ask about the NAAED Pregnancy Registry. This registry tracks the effects of anti-seizure drugs on pregnancy. Information can be found at aedpregnancyregistry.org.

For women who are breastfeeding: Gabapentin may pass into breast milk and cause serious side effects in a breastfeeding child. Tell your doctor if you are breastfeeding. You should decide together if you should stop taking this drug or stop breastfeeding.

For seniors: Kidney function may decrease with age. You may process this drug more slowly than younger people. Your doctor may start you on a lowered dose so that too much of this drug does not build up in your body. Too much of the drug in your body can be dangerous.

For children: Gabapentin has not been studied in children for the management of postherpetic neuralgia. It should not be used in people younger than 18 years. This drug should not be used to treat partial seizures in children younger than 3 years.

What Are the Signs and Symptoms of Gabapentin Addiction?

If you think a loved one is addicted to Neurontin or is abusing it for recreational purposes, he or she may display some of the following signs and symptoms of gabapentin abuse:

• • Taking extremely high doses of gabapentin.
  • Using gabapentin with other drugs (especially opioids) or alcohol.
  • Faking symptoms to get gabapentin prescriptions.
  • Doctor shopping (seeing multiple doctors to get gabapentin prescriptions).
  • Being preoccupied with using and/or obtaining gabapentin.
  • Displaying sudden changes in appearance, hygiene, or social habits.
  • Refusing to stop using gabapentin, despite financial problems, relationship issues, or legal problems.
  • Stealing, forging or selling prescriptions;
  • Taking higher doses than prescribed;
  • Excessive mood swings or hostility;
  • Increase or decrease in sleep;
  • Poor decision-making;
  • Appearing to be high, unusually energetic or revved up, or sedated;
  • Requesting early refills or continually “losing” prescriptions, so more prescriptions must be written;
  • Seeking prescriptions from more than one doctor.

What Is the Treatment for Gabapentin Addiction?

Since most Neurontin abusers use other drugs to enhance its effects and achieve a recreational high, people addicted to gabapentin will most likely be addicted to other substances like opioids or cocaine.

Therefore, treatment for gabapentin addiction should address polydrug abuse as well as the physical, mental, and social effects that come with it.

After completing gabapentin detox, continuing your addiction treatment by enrolling in a rehab program is an essential part of maintaining your sobriety and preventing relapse. In rehab, you’ll learn the essential life skills to sustain sobriety and address the social, behavioral, and psychological issues associated with addiction.

According to the National Institute on Drug Abuse, long-term addiction treatment of at least 90 days is most effective for people who want to sustain their sobriety for good. Anything less is of limited effectiveness. A 90-day drug rehab program is considered a “long-term program” and is typically comprised of the following things:

• • • Behavioral therapy
    • Individual counseling and group counseling
    • 12-step work
    • Gender-specific programming
    • Chemical dependency education
    • Relapse prevention strategies
    • Life skills development
    • Other alternative therapies (music therapy, animal-assisted therapy, art therapy, etc.)

What are Gabapentin dosages forms and strengths ?

Gabapentin is taken by mouth as a tablet, capsule, or oral solution.

• • • Tablets: 600 or 800 mg per tablet
    • Capsules: 100, 300, or 400 mg per capsule
    • Liquid: 250 mg per 5 milliliters (ml) oral liquid

What are Gabapentin dosages for adults

For adults, the gabapentin dosage can vary widely depending on the condition being treated. Upon starting treatment with gabapentin, the starting dose may be 100 to 300 mg per day and steadily increase until an effective dose is reached. The maximum dosage will depend on the condition being treated.

• • Standard gabapentin dosage for adults: 300-600 mg taken three times per day.
  • Maximum gabapentin dosage for adults: 1200 mg taken three times per day for a maximum daily dose of 3600 mg.

What are Gabapentin dosages for children

Gabapentin is FDA approved as a secondary treatment for partial seizures in children 3 years or older with epilepsy. The use of gabapentin in children for any other medical condition is not FDA-approved. Dosing will be determined by both the child’s age and weight.

What are Gabapentin dosages for partial seizures

Gabapentin is FDA approved as adjunctive therapy for partial seizures in adults and children 3 years of age or older.

• Standard gabapentin dosage for adults: 300 to 600 mg taken three times per day by mouth.
• Maximum gabapentin dosage for adults: 3600 mg daily in three divided doses.
• Renally impaired patients (kidney disease)—dose amount and dose frequency adjustment:
• 1. Creatinine clearance of 30-59 ml/min: 200 to 700 mg twice per day
  2. Creatinine clearance of 16-29 ml/min: 200 to 700 mg once per day
  3. Creatinine clearance of 15 ml/min or less: 100 to 300 mg once per day decreased proportionately (1/15 per whole number value) for each decrease in creatinine clearance
  4. Hemodialysis: dose is dependent on estimated creatinine clearance; a supplemental dose of 125 to 350 mg is given after dialysis

What are Gabapentin dosages for nerve pain due to shingles (postherpetic neuralgia)

Gabapentin is FDA approved to treat postherpetic neuralgia, that is, neuropathic pain due to shingles (herpes zoster).

• • • Standard gabapentin dosage for adults: 300 to 600 mg taken three times per day by mouth.
    • Maximum gabapentin dosage for adults: 1800 mg daily in three divided doses.
    • Renally impaired patients (kidney disease): See dosage for renal impaired patients above

What are Gabapentin dosages for neuropathic pain

Gabapentin is most frequently prescribed off-label to treat nerve pain (neuralgia) due to nerve damage (neuropathy), compression, or irritation.

• • Standard gabapentin dosage for adults: 300 to 1200 mg taken three times per day by mouth.
  • Maximum gabapentin dosage for adults: 3600 mg daily in three divided doses.
  • Renally impaired patients (kidney disease): See dosage for renal impaired patients above

What are Gabapentin dosages for fibromyalgia

Gabapentin is used off-label to reduce fatigue, provide pain relief, and improve sleep in patients with fibromyalgia.

• • Standard gabapentin dosage for adults: 600 mg twice daily and 1200 mg at bedtime.
  • Maximum gabapentin dosage for adults: 2400 mg daily.
  • Renally impaired patients (kidney disease): See dosage for renal impaired patients above

What are Gabapentin dosages for alcohol dependence

Gabapentin is widely used off-label to reduce insomnia and cravings in people with alcohol use disorder, particularly those in the maintenance phase of alcohol abstinence.

• • Standard gabapentin dosage for adults: 300 to 600 mg taken three times per day by mouth.
  • Maximum gabapentin dosage for adults: 1800 mg daily in three divided doses.
  • Renally impaired patients (kidney disease): See dosage for renal impaired patients above

What are Gabapentin dosages for pets

You should not give gabapentin to animals unless a veterinarian has given the animal a prescription for gabapentin. Veterinarians frequently prescribe gabapentin to treat seizures or chronic nerve pain in pets and large animals. The recommended dose is 5-10 mg per kilogram of body weight (2.3-4.5 mg/lb) every 12 hours, but dosing will vary between veterinarians. Gabapentin dosages can vary from 3 to 11 mg per kilogram (1.4 to 5 mg per pound) as an analgesic to 10 to 30 mg mg per kilogram (4.5 to 13.6 per pound) as an anticonvulsant. As with people, the dose may start small and steadily increase until an effective dose is reached.

How long does it take gabapentin to work?

The starting dose of gabapentin will be low. The dose amount and frequency will be steadily increased each day until an effective dose is reached, a process called titration. For most conditions, it typically takes one to two weeks after the starting dose to notice the effects of gabapentin.

How long does gabapentin stay in your system?

For people with healthy kidneys, gabapentin is typically taken every eight hours. Each dose reaches its maximum concentration in the body in two to three hours.

The kidneys rapidly clear gabapentin from the body. The rate at which the body clears gabapentin is measured by its half-life, which is the amount of time it takes for the body to clear half the gabapentin in the body. The half-life of gabapentin in children is about five hours. In adults, gabapentin’s half-life is five to seven hours.

Because gabapentin is cleared by the kidneys, the drug stays in the system longer in patients with impaired renal function. Both the dose amount and dose frequency may need to be adjusted by the prescribing physician.

What happens if I miss a dose of gabapentin?

If you miss a dose of gabapentin, take the missed dose as soon as you remember. Take the next dose at its scheduled time. If it is almost time for the next dose, skip the missed dose and take the next dose at its scheduled time. Do not take extra medicine to make up for a missed dose. If you are taking gabapentin for seizures, ask your doctor, pharmacist, or other healthcare professional for instructions for handling a missed dose. In patients with epilepsy, missing a dose for longer than 12 hours increases the risk of seizures.

How do I stop taking gabapentin?

Gabapentin should not be stopped unless directed by a physician. Patients may experience withdrawal symptoms, such as agitation, anxiety, restlessness, nausea, and flu-like symptoms, if gabapentin is abruptly discontinued after taking it for longer than six weeks. If gabapentin is being taken to prevent seizures, abrupt discontinuation of the drug may cause severe seizures. When it’s time to stop taking gabapentin, your doctor may gradually taper your dose across seven days.

Seek immediate medical attention if you experience serious side effects such as mood or behavioral changes, suicidal thoughts, breathing problems, or signs of a hypersensitivity reaction such as hives, difficulty breathing, swollen glands, or fever.

What can be used instead of gabapentin?

Because of side effects, medical conditions, or other reasons, gabapentin may not be right for everyone. The good news is that there are alternative and effective medications for most conditions treated by gabapentin. These medications include anticonvulsants, analgesics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs) such as Cymbalta (duloxetine), and selective serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Savella (milnacipran).

What is the maximum dosage for gabapentin?

The maximum dosage for gabapentin depends on the condition being treated. For most conditions, this maximum ranges between 2,400 mg and 3,600 mg per day.

What interacts with gabapentin?

Foods do not affect the bioavailability or effectiveness of gabapentin. However, if gabapentin is causing side effects such as upset stomach, constipation, or diarrhea, changes in the diet may be required.

Because gabapentin slows activity in the brain, it may cause certain side effects, such as drowsiness, dizziness, sedation, somnolence, and impaired coordination (ataxia). Gabapentin may interact with similar substances or drugs that depress the central nervous system, such as alcohol, cannabinoids, sedatives, antihistamines, anxiety medications, opioids, and other antiepileptic drugs. Not all of these drugs are to be avoided outright, but their use may be modified by your physician. When gabapentin is taken with any of these drugs, patients need to avoid the medication or be cautious while driving, operating machinery, or engaging in potentially dangerous activities.

Patients should also exercise caution when taking antacids that contain aluminum or magnesium salts. Aluminum and magnesium can decrease the concentration of gabapentin in the body, which can reduce the effectiveness of the medication. As a general rule, wait at least two hours after taking an antacid before taking a dose of gabapentin.

Is gabapentin a controlled medicine?