Gabapentin

Generic Name: gabapentin (GA ba PEN tin)
Brand Names: Gabarone, Neurontin

What is gabapentin?

Gabapentin is an anti-epileptic medication, 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.

Gabapentin is used alone or in combination with other medications to treat seizures caused by epilepsy in adults and children who are at least 12 years old. Gabapentin is also used with other medications to treat partial seizures in children who are 3 to 12 years old.

Gabapentin is also used to treat nerve pain caused by herpes virus or shingles (herpes zoster).

Gabapentin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about gabapentin?

You should not use this medication if you are allergic to gabapentin.

Before taking gabapentin, tell your doctor if you have kidney, liver, or heart disease.

You may have thoughts about suicide while taking gabapentin. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Do not stop taking gabapentin for seizures without first talking to your doctor, even if you feel better. You may have increased seizures if you stop taking gabapentin suddenly. You will need to use less and less before you stop the medication completely.

Contact your doctor if your seizures get worse or you have them more often while taking gabapentin.

Carry an ID card or wear a medical alert bracelet stating that you are taking gabapentin, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking a seizure medication.

What should I discuss with my healthcare provider before taking gabapentin?

You should not use this medication if you are allergic to gabapentin.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take this medication.

• kidney disease;

• liver disease; or

• heart disease.

You may have thoughts about suicide while taking this medication. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

FDA pregnancy category C. It is not known whether gabapentin is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. Gabapentin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take gabapentin?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Gabapentin can be taken with or without food.

If you break a tablet and take one half of it, take the other half at your next dose. Any tablet that has been broken should be used as soon as possible or within a few days.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Gabapentin can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using gabapentin.

Do not stop taking gabapentin for seizures without first talking to your doctor, even if you feel better. You may have increased seizures if you stop taking gabapentin suddenly. You will need to use less and less before you stop the medication completely. Contact your doctor if your seizures get worse or you have them more often while taking gabapentin.

Carry an ID card or wear a medical alert bracelet stating that you are taking gabapentin, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are taking a seizure medication.

It is important to use gabapentin regularly for best seizure control. Get your prescription refilled before you run out of medicine completely.

Store gabapentin tablets and capsules at room temperature away from light and moisture. Store the liquid medicine in the refrigerator. Do not freeze.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include blurred vision, drowsiness, weakness, slurred speech, or diarrhea.

What should I avoid while taking gabapentin?

Gabapentin can cause side effects that may impair your vision or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid taking an antacid within 2 hours before or after you take gabapentin. Antacids can make it harder for your body to absorb gabapentin.

Gabapentin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; fever; swollen glands; painful sores in or around your eyes or mouth; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

• increased seizures;

• fever, chills, body aches, flu symptoms;

• swelling of your ankles or feet;

• confusion;

• rapid back and forth movement of your eyes;

• tremor; or

• easy bruising.

Some side effects are more likely in children taking gabapentin. Contact your doctor if the child taking this medication has any of the following side effects:

• changes in behavior;

• memory problems;

• trouble concentrating; or

• acting restless, hostile, or aggressive.

Less serious side effects may include:

• dizziness, drowsiness, weakness, tired feeling;

• lack of coordination;

• blurred vision;

• nausea, vomiting, stomach pain, loss of appetite;

• diarrhea, constipation;

• dry mouth;

• runny or stuffy nose, sore throat;

• headache;

• sleep problems (insomnia), unusual dreams; or

• acne, mild skin rash.

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.

Gabapentin Dosing Information

Usual Adult Dose for Epilepsy:

Initial dose: 300 mg orally on day one, 300 mg orally twice 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. If necessary, the dose may be increased using 300 mg or 400 mg capsules three times a day 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.

Usual Adult Dose for Postherpetic Neuralgia:

Initial dose: 300 mg orally on day one, 300 mg orally twice a day on day two, then 300 mg orally 3 times a day on day three.

The dose may be titrated up as needed for pain relief to a daily dose of 1800 mg.
Maintenance dose: 900 to 1800 mg orally in 3 divided doses.

Efficacy was demonstrated in clinical studies over a range of 1800 mg/day to 3600 mg/day. However, no additional benefit was demonstrated from the use of doses over 1800 mg/day.

Usual Pediatric Dose for Epilepsy:

<3 years: Effectiveness has not been established.

>=3 <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 of gabapentin in patients 5 years of age and older is 25 to 35 mg/kg/day and given in divided doses (three times a day). The effective dose in pediatric patients ages 3 and 4 years is 40 mg/kg/day and given in divided doses (three 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.

>12 years:
Initial dose: 300 mg orally on day one, 300 mg orally twice 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. If necessary, the dose may be increased using 300 mg or 400 mg capsules three times a day 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.

What other drugs will affect gabapentin?

The following drugs can interact with gabapentin. Tell your doctor if you are using any of these:

• hydrocodone (Lortab, Vicodin, Vicoprofen, and others);

• morphine (Kadian, MS Contin, Oramorph, and others); or

• naproxen (Naprosyn, Aleve, Anaprox, and others).

This list is not complete and there may be other drugs that can interact with gabapentin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about gabapentin.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Where can I buy gabapentin?

You can buy gabapentin by any brand name such as Neurotin at any reputable online pharmacy.