Gabapentin, a prescription medication primarily used to treat seizures and neuropathic pain associated with herpes zoster, or shingles, is showing up in more drug overdoses. It’s a trend that’s worrying doctors and lawmakers.
Since the drug was first approved for use in the United States in 1993, it’s largely been considered safe with little or no potential for misuse.
But the opioid epidemic could be changing that.
Gabapentin is now so common among overdose deaths in Kentucky that lawmakers have included it as a controlled substance.
abapentin is used to help control partial seizures (convulsions) in the treatment of epilepsy. This medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to take it.
Gabapentin is also used to manage a condition called postherpetic neuralgia, which is pain that occurs after shingles. Gabapentin works in the brain to prevent seizures and relieve pain for certain conditions in the nervous system. It is not used for routine pain caused by minor injuries or arthritis. Gabapentin is an anticonvulsant.
This medicine is available only with your doctor’s prescription.
This product is available in the following dosage forms:
According to data from the Louisville coroner’s office, gabapentin was found in nearly one-fourth of all overdoses. Across the state, the drug is now showing up in about 1 in every 3 overdose deaths.
The drug has been dubbed an “emerging threat” in the opioid epidemic in a national bulletin provided to narcotics officers.
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Even though you buy this medication from apt sources and you have surety of quality, some side effects with this medication are always there.
This happens with almost all the medications that are available in the market. Some people face less number of side effects while some patients have more side effects with some medications. Thus like every other medication even generic Neurontin comes with this package.
Gabapentin is a commonly used drug
Gabapentin remains a widespread and popular drug.
In 2016, it was the 10th most prescribed medication in the United States, with 64 million prescriptions.
As use of a drug grows, so does the unpredictability of side effects and potential for misuse.
“Once released as an approved drug, the number of people being prescribed the drug jumps substantially (tens of thousands to millions), and there is much more variability in the patient population and less control on how the drug is actually being taken,” said Bilsky.
A study from 2016 found that gabapentin misuse was low among the general population at just 1 percent. But that jumped to between 15 and 22 percent among people who misuse opioids.
“With decreasing availability of commonly abused prescription opioids, it has been suggested that nonmedical users of prescription opioids are substituting other licit and illicit drugs for abuse,” wrote the authors of a 2015 article on gabapentin misuse.
Gabapentin isn’t the only “safe” pain medication to show up on the radar of doctors and lawmakers in recent months, either.
As Healthline previously reported, Imodium — an over-the-counter anti-diarrheal drug — has also seen a surge in misuse. So much so that the U.S. Food and Drug Administration announced a plan to help cut down on its misuse potential.
Neither gabapentin nor Imodium is particularly good at getting someone high, so reasons for misuse are likely associated with cost and availability.
“It is hard to say what drives the person who suffers from a substance use disorder to switch between drugs and drug classes,” said Bilsky. “The current misuse of gabapentin may be another version of combining drugs to try and maximize the high.”
Before taking this medicine
You should not use gabapentin if you are allergic to it.
To make sure this medicine is safe for you, tell your doctor if you have ever had:
- kidney disease (or if you are on dialysis);
- depression, a mood disorder, or suicidal thoughts or actions;
- a seizure (unless you take gabapentin to treat seizures);
- liver disease;
- heart disease; or
- are taking an anti-depressant or sedating medication; or
- (for patients with RLS) if you are a day sleeper or work a night shift.
Some people have thoughts about suicide while taking this medicine. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Seizure control is very important during pregnancy, and having a seizure could harm both mother and baby. Do not start or stop taking gabapentin for seizures without your doctor’s advice, and tell your doctor right away if you become pregnant.
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Gabapentin Pregnancy Warnings
Animal studies have revealed evidence of fetotoxicity involving delayed ossification in several bones of the skull, vertebrae, forelimbs, and hindlimbs. Hydroureter and hydronephrosis have also been reported in animal studies. There are no controlled data in human pregnancy.
To provide information regarding the effects of in utero exposure to this drug, physicians are advised to recommend that pregnant patients enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. This can be done by calling the toll free number 1-888-233-2334, and must be done by patients themselves. Information on the registry can also be found at the website http://www.aedpregnancyregistry.org/.
AU TGA pregnancy category B1: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have not shown evidence of an increased occurrence of fetal damage.
US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
This drug should be used during pregnancy only if the benefit outweighs the risk.
AU TGA pregnancy category: B1
US FDA pregnancy category: C
-Women on antiepileptic drugs (AEDs) should receive prepregnancy counseling with regard to the risk of fetal abnormalities.
-AEDs should be continued during pregnancy and monotherapy should be used if possible at the lowest effective dose as the risk of abnormality is greater in women taking combined medication.
-Folic acid supplementation (5 mg) should be started 4 weeks prior to and continued for 12 weeks after conception.
-Specialized prenatal diagnosis including detailed mid-trimester ultrasound should be offered.
-The risk of having a child with a congenital defect as a result of antiepileptic medication is far outweighed by the dangers to the mother and fetus of uncontrolled epilepsy.
Gabapentin Breastfeeding Warnings
Benefit should outweigh risk.
Excreted into human milk: Yes
-The effects in the nursing infant are unknown.
-Limited information indicates that maternal doses up to 2.1 g daily produce relatively low levels in infant serum.
-Breastfed infants should be monitored for drowsiness, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants and when using combinations of anticonvulsant or psychotropic drugs.