In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of gabapentin for treating partial seizures in children 3 years of age and older. However, safety and efficacy have not been established in children younger than 3 years of age.
Appropriate studies have not been performed on the relationship of age to the effects of gabapentin for treating postherpetic neuralgia in children. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of gabapentin in the elderly. However, elderly patients are more likely to have unwanted effects (eg, problems with balance or walking, swelling in the feet or legs) and age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving gabapentin.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using Gabapentin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Calcium Oxybate
- Chloral Hydrate
- Gabapentin Enacarbil
- Magnesium Oxybate
- Methylene Blue
- Morphine Sulfate Liposome
- Nitrous Oxide
- Opium Alkaloids
- Potassium Oxybate
- Sodium Oxybate
- Tolonium Chloride
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aluminum Carbonate, Basic
- Aluminum Hydroxide
- Aluminum Phosphate
- Dihydroxyaluminum Aminoacetate
- Dihydroxyaluminum Sodium Carbonate
- Magnesium Carbonate
- Magnesium Hydroxide
- Magnesium Oxide
- Magnesium Trisilicate
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Depression, history of or
- Lung or breathing problems (eg, respiratory depression) or
- Mood or mental changes, history of—Use with caution. May make these conditions worse.
- Kidney disease (eg, patients receiving dialysis)—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
Gabapentin and pregabalin—are they safe whilst breastfeeding?
This UKMi Medicines Q & A reviews the evidence available, and makes recommendations, for the use of gabapentin and pregabalin during breastfeeding.
- Limited data indicate that gabapentin passes into breast milk, with low or negligible concentrations measured in the breastfed infant’s serum.
- The infant dose of gabapentin via breast milk has been estimated to be 1.3–3.8% of the maternal weight-adjusted dosage.
- Gabapentin use during breastfeeding can therefore proceed, with adequate infant monitoring.
- Evidence for the use of pregabalin during breastfeeding is limited, A single study reported extensive passage of pregabalin (dose not specified) into breast milk but low levels in the infant serum. However, a slightly larger study has estimated the infant dose of pregabalin to be 7% of the maternal weight-adjusted dosage.
- Therefore, due to limited data for pregabalin, alternative agents for which more data exists should be used preferentially, especially in a newborn infant. However, this may not always be therapeutically possible.
- No adverse effects have been attributed to infant exposure to gabapentin or pregabalin through the breast milk.
- If gabapentin or pregabalin is used by a breastfeeding mother, monitor the infant for gastrointestinal adverse effects, appetite changes, adequate weight gain, drowsiness and normal developmental milestones. If the infant becomes unwell then consider withholding breastfeeding until a cause can be identified.
- Gabapentin and pregabalin are almost entirely renally excreted; therefore, where possible, use should be avoided in infants with impaired renal function and premature infants.
- Long-term data on the developmental effects of exposure to gabapentin through breast milk is limited, although a meta-analysis does not associate gabapentin with cognitive or psychomotor development delay. There is no available long-term data for pregabalin.