Gabapentin capsules, tablets, and oral solution are used along with other medications to help control certain types of seizures in people who have epilepsy.
Gabapentin Neurontin
Gabapentin capsules, tablets, and oral solution are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles).
Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down).
Gabapentin is in a class of medications called anticonvulsants. Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.
Most people do not have to stay on the same brand of gabapentin as there’s very little difference between brands.
Talk to your doctor if you have been asked to switch to a different brand and are worried about that.
If your epilepsy has been hard to control in the past and the brand you’re now taking is working well for you, your doctor may recommend you stay on the same one.
Forms and strengths
Generic: Gabapentin
Form: oral capsule
Strengths: 100 mg, 300 mg, 400 mg
Brand: Neurontin
Form: oral capsule
Strengths: 100 mg, 300 mg, 400 mg
Dosage for postherpetic neuralgia
Adult dosage (ages 18–64 years)
Typical starting dosage: Day 1, 300 mg; day 2, 600 mg (300 mg two times per day, spaced evenly throughout the day); day 3, 900 mg (300 mg, three times per day, spaced evenly throughout the day). Your doctor may further increase your dosage after day 3.
Maximum dosage: 1,800 mg per day (600 mg, three times per day, spaced evenly throughout the day)
Child dosage (ages 0–17 years)
Dosage for people younger than 18 years has not been established.
Senior dosage (ages 65 years and older)
Your kidney function may decrease with age. Your body may get rid of this drug more slowly. Your doctor may start you on a lower 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. Your doctor may change your dose based on how well your kidneys are working.
Dosage for partial-onset seizures
Adult dosage (ages 18–64 years)
Typical starting dosage: 900 mg per day (300 mg, three times per day, spaced evenly throughout the day). Your doctor may increase your dose to 2,400–3,600 mg per day.
Child dosage (ages 12–17 years)
Typical starting dosage: 900 mg per day (300 mg, three times per day, spaced evenly throughout the day). The usual maintenance dose is 900–1,800 mg per day, divided into three doses daily. Your doctor may increase this dose to 2,400–3,600 mg per day.
Child dosage (ages 3–11 years)
Typical starting dosage: 10–15 mg/kg/day, divided into three doses, spaced evenly throughout the day. Your child’s doctor may increase the dosage to meet your child’s needs.
Child dosage (ages 0–2 years)
Dosage for people younger than 3 years has not been established.
Senior dosage (ages 65 years and older)
Your kidney function may decrease with age. Your body may get rid of this drug more slowly. Your doctor may start you on a lower 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. Your doctor may change your dose based on how well your kidneys are working.
Gabapentin is a prescription medicine. It’s important to take it as advised by your doctor.
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Dosage and strength
Each capsule of gabapentin contains 100mg, 300mg or 400mg of gabapentin. Each tablet contains 600mg or 800mg of gabapentin.
If you’re taking gabapentin as a liquid, 2ml is usually the same as taking a 100mg tablet or capsule. Always check the label.
Dosage for epilepsy
The usual dose for:
adults and older children (aged 12 and over) is 900mg to 3,600mg a day, split into 3 doses
younger children (aged 6 to 12) – varies depending on their weight
Dosage for nerve pain
The usual dose to treat nerve pain in adults is 900mg to 3,600mg a day, split into 3 doses.
Changes to your dose
To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few days. Once you find a dose that suits you, it will usually stay the same.
How to take Gabapentin ?
Swallow gabapentin capsules and tablets whole with a drink of water or juice. Do not chew them.
You can take gabapentin with or without food, but it’s best to do the same each day.
Try to space your doses evenly through the day. For example, you could take it first thing in the morning, early afternoon and at bedtime.
If you or your child are taking a liquid, it will come with a plastic syringe or spoon to measure your dose. If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen spoon, as it will not measure the right amount.
How long to take it for
If you have epilepsy, it’s likely that once your condition is under control you’ll still need to take gabapentin for many years.
If you have nerve pain, once your pain has gone you’ll continue to take gabapentin for several months or longer to stop it coming back.
If you forget to take it
If you forget a dose, take it as soon as you remember. If it’s within 2 hours of the next dose, it’s better to leave out the missed dose and take your next dose as normal.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you have epilepsy, it’s important to take this medicine regularly. Missing doses may trigger a seizure.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
If you take too much
Taking too much gabapentin can cause unpleasant side effects.
Urgent advice: Contact 111 for advice or go to A&E now if:
you take more than your prescribed dose of gabapentin and:
you feel dizzy or sleepy
you have double vision
you start slurring your words
you have diarrhoea
you pass out (faint)
If you need to go to A&E, take the gabapentin packet or leaflet inside it, plus any remaining medicine, with you.
Stopping gabapentin
It’s important not to stop taking gabapentin suddenly, even if you feel fine. Stopping gabapentin suddenly can cause serious problems.
If you have epilepsy, stopping gabapentin suddenly can cause seizures that will not stop.
If you’re taking it for any reason and stop suddenly, you may have a severe withdrawal syndrome. This can have unpleasant symptoms, including:
anxiety
difficulty sleeping
feeling sick
pain
sweating
It’s possible to prevent withdrawal seizures and other symptoms by gradually reducing the dose of gabapentin.
Do not stop taking gabapentin without talking to your doctor – you’ll need to reduce your dose gradually.
Gabapentin can interact with other prescription and over-the-counter medications, vitamins, and herbal supplements.
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People should be sure to give a doctor a full list of their current medications and supplements before taking gabapentin.
The results of another 2017 review suggest that the following are some of the main substances that interact with the drug:
caffeine, which is present in tea, coffee, and cola
ethacrynic acid, which is a diuretic
losartan, which is a medication for high blood pressure
magnesium oxide, which is a mineral supplement and antacid
mefloquine, which is an antimalarial drug
morphine, which is an opioid pain medication
phenytoin, which is an anti-seizure medication
If gabapentin causes sleepiness, a person should speak with a doctor before taking other medications that can also cause drowsiness, including:
antianxiety medications
antidepressants
antihistamines
cold and flu medications
muscle relaxers
narcotics, which are pain medications
sleeping pills
Presence of other health conditions
To ensure that gabapentin is safe to take, a person should tell a doctor if they also currently have or have ever had:
diabetes
dialysis treatment
drug or alcohol misuse issues
heart disease
kidney disease
liver disease
seizures (if taking gabapentin for conditions unrelated to seizures)
Gabapentin oral capsule can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.
Below is a list of medications that can interact with gabapentin. This list does not contain all drugs that may interact with gabapentin.
Before taking gabapentin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Opioids
When used with gabapentin, opioids can cause dangerous effects in the body. Some examples of these drugs include morphine, hydrocodone, and oxycodone.
Taking gabapentin with an opioid increases your risk for severe sleepiness, respiratory depression, coma, and even death.
Stomach acid drugs
When used with gabapentin, certain drugs used to treat stomach acid problems can reduce the amount of gabapentin in your body. This can make it less effective. Taking gabapentin 2 hours after taking these drugs can help prevent this problem. Examples of these drugs include:
aluminum hydroxide
magnesium hydroxide
The gabapentin dosage your doctor prescribes will depend on several factors. These include:
the type and severity of the condition you’re using gabapentin to treat
your age
the form of gabapentin you take
other medical conditions you may have
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.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.
I’m taking 800mg three times a day for anxiety. It works great. The max recommended dose is 3600mg daily, but I’ve read where some people take up to 4800mg a day. I guess it depends on the person and how they metabolize it.
Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.
This medicine comes with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.
If you are using Gralise® tablets:
These should be taken with the evening meal.
Swallow the tablet whole. Do not crush, break, or chew it.
For patients with epilepsy who take gabapentin three times per day, do not allow more than 12 hours to pass between any 2 doses. The medicine works best if a constant amount is in the blood.
Neurontin® capsules, tablets, and solution may be taken with or without food.
You may break the scored Neurontin® tablets into two pieces, but make sure you use the second half of the tablet as the next dose. Do not use the half-tablet if the whole tablet has been cut or broken after 28 days. Ask your doctor or pharmacist if you have any questions.
Swallow the capsule whole with plenty of water. Do not open, crush, or chew it.
Measure the oral liquid using a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.
If you take an antacid that contains aluminum or magnesium, wait at least 2 hours before taking gabapentin. Some examples of these antacids are Di-Gel®, Gaviscon®, Gelusil®, Maalox® and Mylanta®.
Only use the brand of this medicine that your doctor prescribed. Different brands may not work the same way.
Dosing
The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage forms (capsules, liquid, and tablets):
For epilepsy:
Adults and children 12 years of age and older—At first, 300 milligrams (mg) three times per day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 1800 mg per day (600 mg three times per day).
Children 3 to 11 years of age—Dose is based on body weight and must be determined by your doctor. The starting dose is 10 to 15 milligrams (mg) per kilogram (kg) of body weight per day and divided in 3 doses. Your doctor may adjust your dose as needed and tolerated.
Children younger than 3 years of age—Use and dose must be determined by your doctor.
For postherpetic neuralgia:
Adults— At first, 300 milligrams (mg) as a single dose in the evening. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 1800 mg per day.
Children—Use and dose must be determined by your doctor.
Missed Dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
You should store the Neurontin® oral liquid in the refrigerator. Do not freeze.
Although the FDA says 3600mg/day in most places, they have a more extensive doc about gabapentin/neurontin usage and bioavailability. First, your body can only process a certain amount taken and the rest is excreted, so large doses over their bioavailablity chart don’t give larger effects.
Lyrica and other meds have different bioavailability, so use smaller dosages. Since your kidneys do much of the work with gaba/neurontin, you want to make sure you do not have any kidney problems.
A person may need lower doses or not use it due to that. Second, calcium channel meds like gabapentin are nonlinear, so side effects and benefits vary from person to person.
What works or doesn’t work for one, may be the opposite for another. That is why dosage benefits and side effects vary so much from person to person. Even a small dose might make you sleep, but not to another person.
I have heard from some people their doc may prescribe smaller doses during the day and a larger dose at the time of day more problems appear such as at night.
Gaba/neurontin has a short half life so needs doses spread out during the day. One challenging thing is that people that are on gaba are also on other meds too, so there is going to be confusion about what caused what and if there are interactions.
After a couple years, I was only on gaba. For me on maximum dose, I did sleep more, plus several other side effects. It all comes down to finding the most benefit with the least negatives including cost or as docs say, benefits outweigh the risks. Suggest reading more of this forum for a patient viewpoint.
Gabapentin may cause constipation, but it is not a common side effect. In clinical trials of adults taking gabapentin for nerve pain, only about 4% of people reported constipation.
Gabapentin belongs to a class of drugs called anticonvulsants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
It’s not fully understood how gabapentin works. For postherpetic neuralgia, it seems to prevent the increase in sensitivity to pain that occurs. For seizures, it may alter the effect of calcium (low levels of calcium may cause seizures).
Who may not be able to take gabapentin
Gabapentin is not suitable for some people.
To make sure it’s safe for you, tell your doctor if you:
have ever had an allergic reaction to gabapentin or any other medicine
have ever misused or been addicted to a medicine
are trying to get pregnant or are already pregnant
are on a controlled sodium or potassium diet, or your kidneys do not work well (gabapentin liquid contains sodium and potassium, so speak to your doctor before taking it)
Some people in these trials took an inactive medicine (placebo). About 2% of people taking a placebo also reported constipation, so the actual percentage of people with constipation while taking gabapentin is probably less than 4%.
In clinical trials of people aged 12 and over taking gabapentin for seizure disorder, about 2% reported constipation as a side effect. Out of people taking a placebo, 1% also reported constipation.
In the clinical trials of gabapentin to treat nerve pain in adults, the most common side effects were:
Dizziness
Sleepiness
Swelling in the hands or feet (peripheral edema)
In clinical trials of people older than 12 taking gabapentin to treat a seizure disorder, the most common side effects were sleepiness and clumsiness (ataxia).
Thoughts of death or suicide is another rare but important side effect of gabapentin, occurring in about 1 in 500 people. These thoughts can happen within one week of starting gabapentin. Call your doctor right away if you have any unusual changes in mood or behavior, or any of these symptoms:
Thoughts about suicide or dying
Suicide attempt
Depression, new or worsening
Anxiety, new or worsening
Panic attacks
In 2019, the U.S. Food and Drug Administration (FDA) added another important warning about gabapentin: When this drug is taken with opioid pain medication or used by a person with chronic lung disease like chronic obstructive pulmonary disease (COPD), it may cause severe and possibly fatal difficulty breathing (respiratory depression). Before starting gabapentin, let your doctor know if you are taking any opioid drug, or if you have been diagnosed with a lung disease.
Even if you have side effects from gabapentin, it is important not to stop taking it suddenly on your own. This medication must be reduced over time (tapered) by your doctor. Stopping suddenly can lead to withdrawal symptoms such as:
Anxiety
Insomnia
Nausea
Pain
If you are taking gabapentin to control seizures, stopping suddenly may increase your risk of a seizure.
Gabapentin is a prescription medication that may help you sleep. That may be why it has been prescribed for people with insomnia, even though it is not approved for that use.
Gabapentin is an anti-convulsant medication that inhibits the release of excitatory neurotransmitters, allowing for its use against pathologic neurotransmission such as that seen in neuropathic pain and seizure disorders. It has a wide therapeutic index, with doses in excess of 8000 mg/kg failing to cause a fatal reaction in rats.
Gabapentin is ineffective in absence seizures and should be used in caution in patients with mixed seizure disorders involving absence seizures. Gabapentin has been associated with drug reaction with eosinophilia and systemic symptoms (DRESS), otherwise known as multi-organ hypersensitivity. This reaction can prove fatal and early symptoms such as fever, lymphadenopathy, and rash should be promptly investigated.
Gabapentin is available on prescription. It comes as tablets, capsules and a liquid that you swallow.
Key facts
You’ll usually take gabapentin 3 times a day. You can take it with or without food.
Most people who take gabapentin do not get any side effects. But some people may feel sleepy, tired and dizzy. Common side effects are usually mild and go away by themselves.
It takes at least a few weeks for gabapentin to work.
Most people do not have to stay on the same brand of gabapentin as there’s very little difference between brands.
Some people can become addicted to gabapentin after taking it for a long time. When stopping gabapentin you’ll need to reduce your dose gradually to avoid withdrawal symptoms.
If you have epilepsy, you are entitled to free prescriptions for all the medicines you take, not just your epilepsy ones. You can get an application form from your doctor’s surgery.
However, gabapentin enacarbil (Horizant) has been approved by the Food and Drug Administration (FDA) to treat a sleep disorder called restless legs syndrome (RLS).
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One of the most common side effects of gabapentin is drowsiness.
In people taking gabapentin for its approved conditions (certain epileptic seizures and postherpetic neuralgia), 19% of patients older than 12 years of age with epilepsy and 21% of patients with postherpetic neuralgia reported drowsiness as a side effect.
Gabapentin and sleep
Most studies show that gabapentin improves slow wave sleep (“deep sleep”) and total sleep time.
Two small studies showed that gabapentin may help people with primary insomnia and occasional sleep disturbance improve total sleep time and wakefulness in the morning.
In other studies, it appears that gabapentin may improve sleep in people with other medical conditions that make it more difficult to sleep, such as alcohol dependence, hot flashes and bipolar disorder.
In a large review of 26 studies on gabapentin and sleep in patients with other medical conditions, the average dose taken daily was about 1,800 mg. Although positive sleep outcomes were reported, the researchers noted that gabapentin was not tolerated as well as placebo and some patients stopped taking it. Misuse and abuse of the drug has also been reported.
It takes about 2 to 3 hours for immediate-release gabapentin to reach its fullest effect, and it’s typically taken 3 times per day.
RLS treatment
Gabapentin may also be used to treat RLS, a disorder that makes it hard to fall asleep or stay asleep. RLS causes an uncontrollable and uncomfortable urge to move your legs, which is worse at night.
The FDA has approved gabapentin enacarbil (Horizant) — a long-acting gabapentin — as a treatment for RLS.
Side effects of gabapentin
The most common side effects with gabapentin include:
Clumsiness
Viral infection
Drowsiness
Nausea and vomiting
Speaking difficulties
Tremor
Swelling, usually involving the legs and feet
Fatigue
Fever
Movements that are jerky
Coordination difficulties
Double vision
Unusual eye movement
Serious reactions can include:
Difficulty breathing
Allergic reactions with swelling of the throat or face
Neurontin is an anti-epileptic drug, also called an anticonvulsant. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain.
Neurontin is used in adults to treat neuropathic pain (nerve pain) caused by herpes virus or shingles (herpes zoster).
Neurontin is also used to treat seizures in adults and children who are at least 3 years old.
Use only the brand and form of gabapentin your doctor has prescribed. Check your medicine each time you get a refill to make sure you receive the correct form.
To ensure that gabapentin is safe to take, a person should tell a doctor if they also currently have or have ever had:
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diabetes
dialysis treatment
drug or alcohol misuse issues
heart disease
kidney disease
liver disease
seizures (if taking gabapentin for conditions unrelated to seizures)
To make sure it’s safe for you, tell your doctor if you:
have ever had an allergic reaction to gabapentin or any other medicine
have ever misused or been addicted to a medicine
are trying to get pregnant or are already pregnant
are on a controlled sodium or potassium diet, or your kidneys do not work well (gabapentin liquid contains sodium and potassium, so speak to your doctor before taking it)
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What is gabapentin?
Gabapentin is a prescription drug. It comes as an oral capsule, an immediate-release oral tablet, an extended-release oral tablet, and an oral solution.
Gabapentin oral capsule is available as the brand-name drug Neurontin. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.
Gabapentin (Generic Neurontin ) was developed to treat epilepsy, but it is now used to treat various forms of chronic pain. It works by reducing the number of signals sent through the nerves. If the signals are reduced then the pain will be reduced. Research has shown that Gabapentin can help in treating various types of nerve pain.
Why Gabapentin is used
Gabapentin oral capsule is used to treat the following conditions:
Seizures: Gabapentin is used to treat partial (focal) seizures. It’s taken together with other seizure medications in adults and in children 3 years of age and older who have epilepsy.
Postherpetic neuralgia: This is pain from nerve damage caused by shingles, a painful rash that affects adults. Shingles appears after infection with the varicella zoster virus. This virus occurs in people who have had chicken pox.
Gabapentin may be used as part of a combination therapy. This means you may need to take it with other drugs.
How Gabapentin works
gabapentin mechanism of actions
Gabapentin belongs to a class of drugs called anticonvulsants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
It’s not fully understood how gabapentin works. For postherpetic neuralgia, it seems to prevent the increase in sensitivity to pain that occurs. For seizures, it may alter the effect of calcium (low levels of calcium may cause seizures).
Gabapentin off-label usages
Some Research Team performed searches to look for clinical trials where gabapentin was used to treat neuropathic pain or fibromyalgia. They found that 5633 participants had been involved in 37 studies of reasonable quality. They tested gabapentin against placebo for four weeks or more. Studies lasting only one or two weeks are unhelpful when pain can last for years.
Neuropathic pain is pain coming from damaged nerves. It differs from pain messages carried along healthy nerves from damaged tissue (a fall, cut, or arthritic knee).
Neuropathic pain is treated by different medicines than pain from damagedtissue. Medicines like paracetamol or ibuprofen are not effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain.
Our understanding of fibromyalgia (a condition of persistent, widespread pain and tenderness, sleep problems, and fatigue) is poor, but fibromyalgia can respond to the same medicines as neuropathic pain.
Gabapentin is helpful for some people with chronic neuropathic pain or fibromyalgia. Gabapentin comes as a capsule, tablet, or solution. You take it by mouth. Gabapentin is available as the brand-name drugs Neurontin, Gralise, and Horizant. It’s also available as a generic drug.
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This is different for different people. In general, Gabapentin will have to be taken for as long as you are requiring pain relief for nerve pain. Do not stop taking your Gabapentin suddenly if you have been taking it for a while. Your body will be used to the Gabapentin and stopping it suddenly may cause withdrawal symptoms. Reducing the dose slowly as advised by your pain specialist or GP will help stop withdrawal symptoms happening. You may wish to reduce the dose every so often, to check nerve pain is still a problem.
How to take Gabapentin ?
The dose of gabapentin required varies from person to person. To avoid side effects we build up to the dose gradually. The tables in this leaflet show you how this can be done. Some patients can put their dose up faster than others. We call this faster way the FAST TRACK (see table 1).
If you find you are getting side effects with the fast track way of putting your dose up, you can switch to the SLOWER METHOD. ( see table 2).ther people will need to put their dose up less quickly over a number of weeks. This is THE SLOWER METHOD .
As with any medication it is important to check how well it works. With gabapentin this can be in a few days but for most patients may take 4-8 weeks to assess the full benefit. If you feel you are getting no benefit from this medication please discuss this with your GP or pain specialist.
Gabapentin other Off-label usages
Gabapentin is one drug that researchers have studied for preventing migraines. It has a high safety profile and few side effects. This makes it a good option for Migraine prevention. Results from some clinical trials have shown a modest benefit from the use of gabapentin for migraine prevention.
However, the American Academy of Neurology (AAN), the organization that provides guidance for the use of drugs to prevent migraines, has stated that there is not enough evidence at this time to support the use of gabapentin for migraine prevention. Healthcare professionals can choose to prescribe gabapentin when other prevention therapies have not worked, however.
Gabapentin has been proven to be effective for people who have hard-to-treat depression or other mood disorders. Neurontin is not your traditional anxiety drug. It’s a drug primarily described to those with bipolar disorder, not anxiety. Bipolar disorder is a complicated mental health problem.
Gabapentin was successful in helping with rapid cycling and mixed bipolar states in people who have not received relief from valproate or carbamazepine. It appeared that Gabapentin helped more with anxiety and agitation than the other two drugs.
It has also been shown that Gabapentin could aid people with certain types of tardive dyskinesia. That’s why anyone that has been prescribed Neurontin should strongly consider taking it, despite the side effects above and questions about its effectiveness. Bipolar disorder is not something that should be left to chance.
The total number of patients treated with NEURONTIN in controlled clinical trials in patients with postherpetic neuralgia was 336, of which 102 (30%) were 65 to 74 years of age, and 168 (50%) were 75 years of age and older. There was a larger treatment effect in patients 75 years of age and older compared with younger patients who received the same dosage. Since gabapentin is almost exclusively eliminated by renal excretion, the larger treatment effect observed in patients ≥ 75 years may be a consequence of increased gabapentin exposure for a given dose that results from an age-related decrease in renal function.
However, other factors cannot be excluded. The types and incidence of adverse reactions were similar across age groups except for peripheral edema and ataxia, which tended to increase in incidence with age.
Clinical studies of NEURONTIN in epilepsy did not include sufficient numbers of subjects aged 65 and over to determine whether they responded differently from younger subjects.
Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and dose should be adjusted based on creatinine clearance values in these patients.
What form(s) does this medication come in?
Capsules
100 mg – Each hard gelatin Coni-Snap capsule, with white opaque body and cap printed with “PD” on one side and “Neurontin/100 mg” on the other, contains gabapentin 100 mg.
300 mg – Each hard gelatin Coni-Snap capsule, with yellow opaque body and cap printed with “PD” on one side and “Neurontin/300 mg” on the other, contains gabapentin 300 mg.
400 mg – Each hard gelatin Coni-Snap capsule, with orange opaque body and cap printed with “PD” on one side and “Neurontin/400 mg” on the other, contains gabapentin 400 mg.
Tablets
600 mg – Each white, elliptical, film-coated tablet with “Neurontin 600” printed on one side contains gabapentin 600 mg.
800 mg – Each white, elliptical, film-coated tablet with “Neurontin 800” printed on one side contains gabapentin 800 mg.
How to take gabapentin
The gabapentin dosage your doctor prescribes will depend on several factors. These include:
the type and severity of the condition you’re using gabapentin to treat
your age
the form of gabapentin you take
other medical conditions you may have
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.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.
We do not sell Gabapentin to all patients!
Normally Gabapentin is suitable for all adult and children bigger than six years old. But you are not allowed to order Gabapentin online especially in our online pharmacies if you have any of following health conditions (But you are OK to order in your local street pharmacies):
You are younger than 18 years old;
You have kidney disease;
Alcohol – you are addictive to alcohol, gabapentin may cause alcohol intolerance;
diabetes – Gabapentin may affect blood sugar levels, you must find a local doctor to prescribe you Gabapentin.
kidney disease,liver disease and heart diseases;
a history of depression, mood disorder, drug abuse, or suicidal thoughts or actions;
(for patients with RLS) if you are a day sleeper or work a night shift;
You are breastfeeding mother or you are pregnant;
have thoughts about suicide.
If you are allergy to Gabapentin
Stop immediately if you have any thoughts about suicide.
Donot order Gabapentin online if you have suicide thoughts. Please go to your doctor to have you completely checked.
We hope you can refill your Gabapentin online using our online pharmacy. You have already checked by your local doctors and they have prescribed you Gabapentin. After your first prescription, you can order in our websites. Our doctors and pharmacists will review your health conditions too and it is much easier for you to understand the gabapentin prescription you are taking.
Gabapentin may interact with other medications
Gabapentin oral capsule can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.
Below is a list of medications that can interact with gabapentin. This list does not contain all drugs that may interact with gabapentin.
Before taking gabapentin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Pain drugs
When used with gabapentin, certain pain drugs can increase its side effects, such as tiredness. Examples of these drugs include:
morphine
Stomach acid drugs
When used with gabapentin, certain drugs used to treat stomach acid problems can reduce the amount of gabapentin in your body. This can make it less effective. Taking gabapentin 2 hours after taking these drugs can help prevent this problem. Examples of these drugs include:
Fibromyalgia is a muscular condition that affects many people. It refers to muscle fatigue and pain felt across different muscle groups in the body, not just on isolated areas.
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues.
The term fibromyalgia directly means pain that is embedded in the tissues of the muscles, specifically the fibrous tissues. This very acute pain starts from the ligaments, the tendons, and other such connective muscle tissues that are present all over the muscular system of the body. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.
Fibromyalgia Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.
Women are more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.
There are however some controversial theories regarding Fibromyalgia that propose that this condition is a psychosomatic illness, that is, it is a disorder brought about by psychological factors and not necessarily physical factors. This reasoning is mainly brought about by the strong evidence available that relates Fibromyalgia to major depression.
An in-depth review regarding the association of major depression disorders with Fibromyalgia brought out significant similarities between the two in terms of psychological characteristics and neuroendoctrine abnormalities in the patients.
Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain’s pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals.
Medications designed to treat epilepsy are often useful in reducing certain types of nerve pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms. Gabapentin is a medicine used to treat pain caused by nerves that are not working properly. Gabapentin changes the way that the nerves send messages to the brain. It can be taken in a tablet or a liquid, with or without food. Doses are usually 1200 mg to 2400 mg each day. At the start of treatment low doses are used to minimise side effects, but the dose is usually increased after a few weeks.
At the reviews of gabapentin for fibromyalgia in drugs.com , almost 70% Fibromyalgia Patients think Gabapentin can cure their fiobromyalgia disease. But almost 20% fiobromyalgia Patients think it doesnot work. ( Rating 1 -2 %), another 15% patients think it do work but the effect is not that good ( Rating 3 – 5 ).
One of the patient said:
“I have had fibro for 7 years, finally have a doctor that prescribed me Gabapentin. It’s amazing I feel like a normal person again. I sleep through the night, with no pain anymore. My anxiety is gone also, which is awesome. I know everyone is different, but it works for me. I have had little to no side effects yet. First few doses was a bit of an air head other than that no complaints. Being able to function pain free and agitation free is a blessing.”
Another Fiobro patient said:
“I had the best results, in relieving the pain, with gabapentin. I was able to work through the other symptoms. The etodolac helped with the inflammation. I was doing well, until the muscle spasms started, again. I suspect the mould allergies exasperated the symptoms. So, cyclobenzeprine was added. I don’t know what happened, but I was jobless, homeless, and very sick by the time a CVS pharmacist recognized the V.A. had put me on another toxic, prescription drug cocktail. When I brought it to the V.A.s attention, as usual, it was ignored. The medications that help, are the ones the V.A. will not prescribe to veterans like myself. They say speak up, if you do, expect to be classified as mentally ill, violent, aggressive, involuntarily committed”
NatalieW555 Said:
“I was suffering from fibromyalgia pain most of my adult life, I’m 52 by the way, not realizing there was this wonderful medication available to me…I started it about 2 years ago and it really makes a HUGE difference in how my body feels. I take 300 mg 3X daily. I hope it never quits working for me…you should give it a try….It has no side effects on me.”
Member Annabqnm Said:
“Pretty much saved my life. 13 years ago fibromyalgia symptoms (severe pain especially legs and shoulders), started. My father was taking high doses of gabapentin for chronic guillaune barre. He urged me to try it–and it was the first real sleep I had in months! My rheumatologist had me on 1600mg. 3x, gradually lowered to 1600 mg. 2x. Studies at Mayo Clinic and Johns Hopkins show very few (and very mild) side effects, even at high doses. The only problem I have is if I forget to take them. Then I get flu like symptoms. I was able to continue my career (elementary school teacher) with no problems. Retired this year age 66 and very active. BTW my memory seems better than most friends my age.”
But 30% Fibro customers think Gabapentin is not effective for their Fibro disease. I looked the reviews they have wrote, I found most of them are just back pain or leg pain but not Fiobromyalgia. But some Fibro patients do think it has some side effects, especially thought problems such as depression.
One of the Fibro patient said:
“I have “fibromyalgia,” severe muscle pain from a twisted spine/congenitally deformed vertebrae. I was getting better with yoga, but hurt my back/rib muscles overdoing. I developed depression on gabapentin after a few weeks. At first it dulled the pain and made me feel lightheaded, and I had memory problems. Then my anxiety increased and the pain continued, and hit a real low. I spent two weeks in a psych ward until a brilliant psych nurse who believed in treating muscle pain. I am now recovering on a mix of robaxin, a muscle relaxer, a low dose of valium for rib spasms, and prozac and remeron (for sleep) and hope to get off all of them once I can exercise again. Similar reaction to Lyrica four years ago.”
Gabapentin is effective for Fibro. But you need consider whether you can endure the side effects of gabapentin. Please check our website for the Gabapentin Side Effects.
First, we must consider the different neuropathic pain types. Neuropathic pain can be diverse in nature, encompassing a wide range of pain types, including post-herpetic neuralgia (PHN), painful diabetic peripheral neuropathy (DPN), and painful cancer-related neuropathies.
Gabapentin has been shown to be beneficial in treating several types of neuropathic pain; however, the mechanism of action by which gabapentin exerts its analgesic effect is still unknown.
It is suggested that gabapentin may block the calcium channel alpha(2)delta (a2d)-1 receptor in the brain. This protein-modulated receptor is involved in excitatory synapse formation. Therefore, the therapeutic effects of gabapentin may be attributed to prevention of new synapse formations.
Gabapentin was shown to offer substantial improvement in neuropathic pain with side effects that were similar to those on placebo.
Even with sufficient data supporting the use of gabapentin in the treatment of various neuropathic pain conditions, gabapentin only has Food and Drug Administration (FDA) approval for PHN. Dosing recommendations for off-label use of gabapentin can be somewhat ambiguous, if a recommendation exists at all. Therefore, several studies further investigate dosing regimens specific to other neuropathic pain syndromes.
Gabapentin Dosing Considerations
Three gabapentin products are FDA approved to treat PHN. The different formulations cannot be interchanged and each has its own dosing schedule.
For immediate-release gabapentin (Neurontin), dosing may be initiated with 300 mg on day 1, doubled on day 2 (300 mg twice a day), and tripled on day 3 (300 mg 3 times a day). The dose can then be titrated up as needed for pain relief to a maximum dose of 1,800 mg daily (divided into 3 daily doses). Clinical studies referenced in the package insert state that efficacy for a range of doses from 1,800 mg/day to 3,600 mg/day were observed; however, there was no additional benefit seen with doses greater than 1,800 mg/d.
Gralise is an extended-release gabapentin formulation that also is FDA approved for PHN with a titration schedule that begins with 300 mg on day 1; 600 mg on day 2; 900 mg on days 3 to 6; 1,200 mg on days 7 to 10; 1,500 mg on days 11 to 14; and 1,800 mg on day 15 and thereafter.
The third gabapentin formulation for PHN treatment is another extended-release product, Horizant. The starting dose is 600 mg in the morning for 3 days, increased to 600 mg twice daily on day 4 and thereafter. A daily dose of Horizant greater than 1,200 mg provided no additional benefit at the expense of side effects.
Several studies have evaluated off-label use of gabapentin in the treatment of other neuropathic pain conditions. A randomized, double-blind trial compared gabapentin to placebo in 135 patients with DPN over 8 weeks. The results showed a statistical benefit of gabapentin compared to placebo, at all end points, for pain improvement.
The gabapentin dosing regimen used in this study was 900 mg/d for week 1; 1,800 mg/d for week 2; 2,400 mg/d for week 3; and 3,600 mg/d for week 4. All the patients were titrated up to a dose of 3,600 mg/d, regardless of efficacy at lower doses. Patients who could not tolerate this dose were titrated down to the greatest tolerable dose.
Of the 84 patients randomized to the gabapentin group, 56 (67%) were able to tolerate 3,600 mg/d.During the first week, gabapentin resulted in improvement in sleep interference compared to placebo.
By the second week, gabapentin resulted in improvement in all pain rating scales compared to placebo. Of the 84 patients in the gabapentin group, 70 completed the study, and 7 patients withdrew due to adverse drug events (ADEs). Most ADEs reported in the gabapentin group were of mild or moderate intensity, and the most frequently reported effects were dizziness (23.8%), somnolence (22.6%), headache (10.7%), diarrhea (10.7%), confusion (8.3%), and nausea (8.3%).
A double-blind crossover study (n=40) assessed gabapentin for the treatment of DPN. The dose of gabapentin used in this trial was much lower, with patients titrated up every 3 days to a maximum dose of 900 mg/d. The end points evaluated in this study included level of pain on a visual analog pain scale (VAS), and scores on the present pain intensity scale, the McGill pain questionnaire (MPQ), and the global assessment of pain relief.
Statistical improvement between gabapentin and placebo was noted in only 1 end point, the MPQ score, with a mean reduction of 8.9 points for gabapentin compared to 2.2 points with placebo (P=0.03). No serious ADEs were noted, and the most common ADEs of gabapentin were drowsiness, fatigue, and imbalance. The results of this study suggest that gabapentin is not effective or is only minimally effective in treating painful DPN at a dose of 900 mg/d.5
A search in the Cochrane Database of Systematic Reviews was conducted to further examine dosing regimens for neuropathic pain. In a review analyzing 37 studies for gabapentin treatment in chronic neuropathic pain, the main outcome was Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) definitions for moderate and substantial benefit in chronic pain studies.6 These were defined as follows:
30% reduction in pain over baseline (moderate)
50% reduction in pain over baseline (substantial)
Much or very much improved on Patient Global Impression of Change (PGIC) (moderate)
Very much improved on PGIC (substantial)
Gabapentin was shown to be better than placebo across all studies for IMMPACT outcomes. The review concentrated on gabapentin doses of 1,200 mg/d or greater and reported that doses at or above this threshold were reasonably effective for treatment of various neuropathic pain types.
The upper threshold for maximum effective gabapentin doses ranged from 2,400 mg/d to 3,600 mg/d in the majority of studies reviewed.
ADEs and withdrawal rates for patients taking gabapentin doses of 1,200 mg/d or greater were compared to those for patients taking placebo in 20 studies with 4,125 participants. Common ADEs seen were somnolence, drowsiness, and sedation.
These occurred in 14% of participants in the gabapentin group versus 5% of those taking placebo. Data also showed gabapentin was associated with a higher incidence of dizziness (19% vs 5%), peripheral edema (7% vs 2.2%), and ataxia or gait disturbances (8.8% vs 1.1%).
The rate of serious events was similar between gabapentin and placebo groups. Twenty-two studies involving 4,448 patients reported on participant withdrawals due to ADEs, which occurred in 11% of patients taking gabapentin compared to 7.9% of those taking placebo.6
Postmarketing Abuse
Postmarketing reports have described symptoms of agitation, confusion, and disorientation upon abrupt withdrawal of gabapentin. Cases usually involve other potentiating factors, such as the use of higher than recommended doses for unapproved indications, a history of poly-substance abuse, or the use of gabapentin to relieve symptoms of withdrawal from other substances.1 In a study of postmortem toxicology, cases that tested positive for gabapentin or pregabalin were included to determine if abuse of these drugs contributed to the fatalities. Of the 13,766 cases investigated, 0.31% were positive for gabapentin. Of the gabapentin cases, 18.6% were considered abuse, and 4.7% were poisonings. An overwhelming majority of abuse cases (87.5%) also involved opioid intoxication, and 100% involved alcohol and/or opioids. In addition, a greater number of pregabalin cases were designated as abuse cases than gabapentin cases (48.1% vs 18.6%, respectively).7
Conclusion
Gabapentin has sufficient evidence showing its efficacy and safety in treating neuropathic pain. Effective treatment doses of gabapentin for neuropathic pain tend to be higher compared to effective treatment doses for other conditions. Gabapentin is a relatively safe medication. The most prevalent effects seen are drowsiness, somnolence, and sedation. It is necessary to start at lower doses of gabapentin and titrate up to a therapeutic dose. Ataxia and somnolence appear to exhibit a positive dose-response relationship; therefore, titrating the dose of gabapentin may help manage possible ADEs.
