Gabapentin

Generic name: Gabapentin
Drug class: Gamma-aminobutyric acid analogs

Usage of Gabapentin

Gabapentin (Neurontin, Gralise, Horizant) is a medicine used to treat partial seizures, nerve pain from shingles and restless leg syndrome. It works on the chemical messengers in your brain and nerves. Gabapentin is from a group of medicines called anticonvulsants.

Different brands of gabapentin are not interchangeable and they are FDA approved for different conditions. 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.

Neurontin (gabapentin) is used to treat pain you may have from shingles (postherpetic nerve pain). It is also used with other seizure medicines for partial onset seizures in patients 3 years and older.

Gralise (gabapentin) is only used for pain after having shingles (postherpetic nerve pain). It should not be used for any other medical condition.

Horizant (NACarbil" href="/drugs/gabapentin-enacarbil-6032/">Gabapentin enacarbil) is an extended release tablet used to treat restless legs syndrome and for the pain from having shingles (postherpetic nerve pain).

Generic brands of gabapentin capsules, USP are used for postherpetic nerve pain and for add on therapy for partial onset seizures in patients 3 years and older

Gabapentin side effects

Get emergency medical help if you have signs of an allergic Reaction to gabapentin: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.

Gabapentin can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Some side effects are more likely in children taking gabapentin. Call your doctor if the child has any of the following side effects: behavior changes, memory problems, trouble concentrating, or acting restless, hostile, or aggressive.

Gabapentin may cause serious side effects. Call your doctor at once if you have:

drowsiness, dizziness, weakness;

problems with balance or muscle movement; or

increased seizures.

Common gabapentin side effects may include:

fever, chills, sore throat, body aches, tiredness;

headache;

swelling of your legs and feet;

trouble speaking;

vision problems, dizziness, drowsiness;

tremors, problems with balance or muscle movement; or

nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before taking Gabapentin

You should not take gabapentin if you are allergic to it.

To make sure this medicine is safe for you, tell your doctor if you have ever HAD:

breathing problems;

diabetes;

depression, a mood disorder, or suicidal thoughts or actions;

drink alcohol;

a history of drug addiction;

a seizure;

(patients with RLS) if you are a day sleeper or work a night shift; or

kidney disease (or if you are on dialysis).

Some people have thoughts about suicide while taking seizure medicine. Children taking gabapentin may have behavior changes. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.

It is not known if gabapentin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Do not start or stop seizure medication during pregnancy without your doctor's advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of gabapentin on the baby.

Ask a doctor if it is safe to breastfeed while using gabapentin.

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How to use Gabapentin

Usual Adult Dose for Epilepsy:

Initial dose: 300 mg orally on day one, 300 mg orally 2 times day on day two, then 300 mg orally 3 times a day on day three Maintenance dose: 300 to 600 mg orally 3 times a day Maximum dose: 3600 mg orally daily (in 3 divided doses) -Maximum time between doses in the 3 times a day schedule should not exceed 12 hours -The safety and effectiveness of gabapentin available under the trade name Gralise or Horizant in patients with epilepsy has not been studied. Use: Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization

Usual Adult Dose for Postherpetic Neuralgia:

-Initial dose: 300 mg orally on day one, 300 mg orally 2 times day on day two, then 300 mg orally 3 times a day on day three -Titrate up as needed for pain relief -Maximum dose: 1800 mg per day (600 mg orally 3 times a day) Gabapentin available under the trade name Gralise: -Maintenance dose: Gralise should be titrated to 1800 mg orally once daily with the evening meal. -Recommended titration schedule: Day 1: 300 mg orally with the evening meal Day 2: 600 mg orally with the evening meal Days 3 through 6: 900 mg orally with the evening meal Days 7 through 10: 1200 mg orally with the evening meal Days 11 through 14: 1500 mg orally with the evening meal Day 15: 1800 mg orally with the evening meal COMMENT: -Gralise is not interchangeable with other gabapentin products because of differing pharmacokinetic profiles that affect the frequency of administration. Gabapentin enacarbil extended release tablets are available under the trade name Horizant: -The recommended doSage is 600 mg orally 2 times a day. Therapy should be initiated at a dose of 600 mg orally in the morning for 3 days of therapy, then increased to 600 mg 2 times a day (1200 mg/day) on day four. COMMENT: Gabapentin enacarbil extended release tablets available under the trade name Horizant and gabapentin are not interchangeable. Use: Postherpetic neuralgia

Usual Adult Dose for Restless Legs Syndrome:

Gabapentin enacarbil available under the trade name Horizant: 600 mg orally once daily with food at about 5 PM Use: For the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS) in adults

Usual Pediatric Dose for Epilepsy:

Less than 3 years: Not recommended Greater than or equal to 3 and less than 12 years: Starting Dose: Ranges from 10 to 15 mg/kg/day in 3 divided doses Effective Dose: Reached by upward titration over a period of approximately 3 days; the effective dose in patients 5 years of age and older is 25 to 35 mg/kg/day in divided doses (3 times a day). The effective dose in pediatric patients ages 3 and 4 years is 40 mg/kg/day and given in divided doses (3 times a day). Gabapentin may be administered as the oral solution, capsule, or tablet, or using combinations of these formulations. Dosages up to 50 mg/kg/day have been well tolerated in a long term clinical study. The maximum time interval between doses should not exceed 12 hours. Greater than 12 years: -Initial dose: 300 mg orally on day one, 300 mg orally 2 times a day on day two, then 300 mg orally 3 times a day on day three -Maintenance dose: 900 to 1800 mg orally in 3 divided doses; the dose may be increased up to 1800 mg/day. Dosages up to 2400 mg/day have been well tolerated in long term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated. The maximum time between doses in the three times a day schedule should not exceed 12 hours. Use: Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization in patients 3 years of age and older<

Warnings

Gabapentin can cause life-threatening breathing problems, especially if you already have a breathing disorder or if you use other medicines that can make you drowsy or slow your breathing. Seek emergency medical attention if you have very slow breathing.

Some people have thoughts about suicide while taking seizure medicine. Stay alert to changes in your mood or symptoms. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.

Seizures may increase if you stop using gabapentin suddenly. Ask your doctor before stopping the medicine.

Avoid driving or hazardous activity until you know how gabapentin will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Do not stop using gabapentin suddenly, even if you feel fine.

What other drugs will affect Gabapentin

Taking gabapentin with other drugs that make you drowsy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your current medicines. Many drugs can affect gabapentin, especially:

Naproxen;

opioid medicine - hydrocodone, oxycodone, morphine, Buprenorphine;

zolpidem;

lorazepam; or

cimetidine.

This list is not complete and many other drugs may affect gabapentin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

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