Buy Gabapentin Online – Gabapentin COD

Is gabapentin addictive?

Gabapentin has been shown to lead to dependence, addiction and withdrawal in some people, although when it was first approved in 1993 this risk was thought to be minimal. Gabapentin has been increasingly associated with drug abuse, particularly in people who mix it with opioids, alcohol or other substances. Illegal diversion of gabapentin has led to its illicit availability on the streets, as well.

Using gabapentin with opioids can be dangerous. When combined with opioids or sedatives, the risk of respiratory depression (slowed or stopped breathing) and opioid-related death increases significantly. Withdrawal symptoms, especially when used at higher dosages, have also been reported.

Combined abuse of gabapentin and opioids can lead to a 4-fold higher risk of respiratory depression and opioid-related overdose and death. Serious breathing problems can also occur when gabapentin is taken with other medicines that can cause severe sleepiness or decreased awareness and by someone who already has breathing problems.

How common is gabapentin addiction?

In the general population, around 1% of people are estimated to misuse gabapentin, but in those who abuse opioids, one study has noted that 15% to 20% of people abuse the drug. In drug abuse treatment centers, up to 22% of people were reported to be misusing gabapentin. People who abuse opioids use gabapentin to further boost the euphoric “high” feeling with opioid abuse.

Gabapentin has been reported to be used by patients in substance use disorder treatment programs, as it is not typically screened for during treatment. Even though gabapentin may be used as a treatment option for alcohol and substance abuse, it is important to monitor for all drug-seeking behaviors in patients.

What are the signs of gabapentin addiction?

Signs that you may be misusing or becoming addicted to gabapentin include:

Taking larger doses or using this medicine more frequently than prescribed by your doctor.
Experiencing withdrawal symptoms when you try to stop using gabapentin.
You are having strong cravings to use gabapentin.
It is interfering with your ability at work, school or home-related activities.
Seeing multiple doctors to obtain gabapentin prescriptions.
Trying to stop use of gabapentin without success, even though you want to.
Spending too much time trying to get gabapentin

Reports note that gabapentin is often used by people abusing other medicines, such as opioid painkillers like oxycodone, muscle relaxants, and anxiety medications such as Valium and Xanax to boost the high.

What are the most common gabapentin withdrawal symptoms?

Withdrawal symptoms after abruptly stopping gabapentin may include:

agitation
anxiety
inability to remain still, restlessness (akathisia)
disorientation
headaches
dizziness
excessive sweating (diaphoresis)
confusion
trouble sleeping
nausea
fast or abnormal heart rate
seizures (possibly severe)

In general, prescription gabapentin should be withdrawn gradually to help lower the risk for significant withdrawal symptoms. If you have epilepsy, stopping gabapentin suddenly can cause serious seizures that will not stop, known as status epilepticus.

In a survey, documented cases of withdrawal symptoms were reported in people who took daily doses between 400 mg to 8000 mg for at least 3 weeks.

High doses, such as those used during substance abuse, may be associated with tolerance, addiction and even greater withdrawal symptoms.
According to the manufacturer, there are also reports of people experiencing withdrawal symptoms after stopping higher off-label doses of gabapentin.

In a survey looking at abuse of gabapentin, it was found that patients were taking on average 3,000 mg/day, ranging from 600 mg to 8,000 mg/day. Withdrawal, when reported, occurred within 12 hours to 7 days of discontinuation of the medication.

There is no approved medication to treat gabapentin withdrawal. Slow discontinuation, as directed by healthcare professional, can help to relieve symptoms. Behavioral and supportive medical care, such as treatments for nausea, anxiety or insomnia can help to support the withdrawal. Treatment for any other substance use disorder should be initiated (for example, opioid or alcohol use) if this accompanies gabapentin misuse.

Is gabapentin a controlled substance in all 50 states?

No, as of September 2022, the following states have reported reclassification of gabapentin as Schedule C-V controlled substance:

Alabama
Kentucky
Michigan
North Dakota
Tennessee
Virginia
West Virginia

The federal government does not classify gabapentin as a controlled substance, but several states have changed its status to help curb abuse.

What is gabapentin used for?

Gabapentin is a prescription anticonvulsant medicine approved to treat partial seizures and for the management of postherpetic neuralgia (shingles nerve pain) in adults.

Postherpetic neuralgia is pain from damaged nerves that follows healing of shingles (a painful rash that comes after a herpes zoster infection) in adults.
Partial seizures when taken together with other medicines in adults and children 3 years of age and older with seizures.

It has also been used “off-label” to treat other conditions like fibromyalgia, anxiety, alcoholism or other types of nerve pain. Gabapentin may also be used as an alternative to opioid medications to help manage pain. “Off-label” use means it may be prescribed by your doctor for a generally accepted use not specifically approved by the FDA or listed in the package labeling.

The brand name treatments Horizant and Gralise are extended-release formulations of gabapentin, but are not approved for the treatment of epilepsy.

Gabapentin enacarbil (brand name: Horizant) is the only gabapentin product approved for treatment of Restless Legs Syndrome (RLS). It is also approved to treat nerve pain (postherpetic neuralgia) caused by herpes virus or shingles (herpes zoster).
Gabapentin (brand name: Gralise) is only indicated for the management of postherpetic neuralgia. Gralise is an extended-release formulation given once a day.

Use only the brand and form of gabapentin your doctor has prescribed. Different forms and brand names of gabapentin are not interchangeable.

Gabapentin Mechanism of Action

Gabapentin works by affecting chemicals and nerves in the body that are involved in the cause of seizures and in some types of nerve pain.

It is a structural analog of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, but has no effect on GABA binding, uptake, or degradation.
Experts are not exactly sure how gabapentin works, but it is thought to bind to calcium-channels within the nerve cells, improving the response to GABA in the brain.
It is not structurally related to opioids and does not occupy opioid receptors.

Is gabapentin safe for cats?

Gabapentin is safe for cats and is commonly prescribed by veterinarians to treat pain, anxiety, and feline hyperesthesia syndrome. It has a low risk of side effects when taken at the correct dosage. Mild sedation and lethargy are the most common side effects but these tend to get better with continued dosing.

What is gabapentin used for in cats?

Gabapentin can reduce chronic pain caused by conditions such as arthritis or cancer. It may be used to treat pain associated with intervertebral disk disease.

Gabapentin is commonly used as a mild sedative to treat situational anxiety, for example, just before a vet visit, or for cats who are fearful around people or other animals.

It can help manage feline hyperesthesia syndrome. This is an area of extreme sensitivity on a cat’s skin, which is almost always on the back, typically in the area right in front of the tail.

Gabapentin can also help manage seizures in cats, in addition to other medications.

Using gabapentin in cats and other pets is considered “off-label” which means it is not an FDA-approved indication in pets.

How does gabapentin work in cats?

Experts aren’t sure exactly how gabapentin works to relieve pain, anxiety, or feline hypersensitivity syndrome but it is thought to inhibit the release of excitatory neurotransmitters. Gabapentin resembles a naturally occurring inhibitory neurotransmitter called GABA (γ-aminobutyric acid), which is involved with the transmission of nerve signals within the brain and spinal cord.

How much gabapentin should I give my cat?

Dosages of gabapentin for cats can vary depending on their age, weight, and what health issue they are suffering from. The usual dosages for pain in cats are 1.5 to 5mg per pound every 12 hours. For seizures, it is 2.5 to 5mg per pound every 8 to 12 hours. Some cats may be prescribed 10mg per pound every 6 hours.

Higher dosages may be prescribed occasionally by your vet.

Dosage Chart Gabapentin In Cats
Cat weight	Low dose (1.5mg/lb)	High dose (5mg/lb)
4lb (1.8kg)	6mg	20mg
6lb (2.7kg)	9mg	30mg
10lb (4.5kg)	15mg	50mg
15lb (6.8kg)	22.5mg	75mg
25lb (11.3kg)	37.5mg	125mg

How long does gabapentin take to work?

Gabapentin is quick acting, and an effect should be noticed one to two hours after administration when used to relieve situational anxiety. However, when gabapentin is used to treat pain, a low dosage is started initially, which is then titrated up slowly, which means it may take longer to see an effect. While your vet is titrating up the dosage, they will be using other medications to keep your cat comfortable until the gabapentin is working. When used to treat seizures gabapentin may take a few weeks to reduce seizure frequency.

The effects of gabapentin wear off quickly unless the cat has kidney or liver disease. This is why it is usually given two to three times a day.

How long can a cat stay on gabapentin?

There is no maximum time for a cat to remain on gabapentin. Some older cats will stay on it for the rest of their life as part of a management plan for arthritis pain.

What are the side effects of gabapentin in cats?

The most common side effect of gabapentin in cats is sedation, drowsiness, and lethargy which can be managed by starting with a low dosage of gabapentin and increasing it slowly. Most cats become tolerant of this side effect with continued dosing. Other side effects may include:

When starting gabapentin your cat may also seem a little uncoordinated initially, but this should also resolve with continued dosing. Sometimes, a cat may gain weight or develop diarrhea. Rarely, a cat may be allergic to gabapentin and they may have a reaction which is a sign to avoid giving gabapentin to your cat in the future.

Xylitol is used to sweeten commercially prepared gabapentin oral suspension and while this can be toxic to dogs, cats usually tolerate it well.

How does gabapentin make a cat feel?

Gabapentin makes your cat feel a little sleepy and possibly a little uncoordinated initially. They should become tolerant to these effects within a few days, especially if the dosage is started low and titrated up slowly.

Does gabapentin make cats sleepy?

Yes, gabapentin can make your cat sleepy initially but by starting with a small dose and gradually titrating it upwards, your cat should become tolerant to this effect.

Can gabapentin cause diarrhea or constipation in cats?

Gabapentin may cause diarrhea in some cats, but it does not usually cause vomiting or constipation unless it is being used at high dosages. If your cat develops any of these side effects, call your veterinarian.

Can I overdose my cat on gabapentin?

Although gabapentin is generally well tolerated in cats, like any medication, you can give too much of it. Always follow your vet’s instructions and never try to increase the dosage yourself without their advice.

Symptoms of an overdose of gabapentin in cats include severe diarrhea, extreme sleepiness, lethargy, and incoordination; however, an overdose is not usually fatal. Seek veterinary advice immediately.

Do cats need to be weaned off gabapentin?

If gabapentin is being used to treat seizures in cats, then it should be tapered off slowly over a couple of weeks after long-term use and not abruptly discontinued because it can precipitate seizures.

Is gabapentin safe for dogs?

Gabapentin is safe for dogs and is commonly prescribed by veterinarians to treat seizures, pain, and anxiety in dogs. It has a low risk of side effects.

What is gabapentin used for in dogs?

Gabapentin can treat and reduce the frequency of seizures and is commonly used as an anticonvulsant to treat or prevent seizures in dogs.

Gabapentin may also be used to provide pain relief for dogs, particularly when other medications have proved ineffective or are not well tolerated. It may be used to treat pain associated with cancer, arthritis, or intervertebral disk disease.

Gabapentin is commonly used as a mild sedative to treat situational anxiety, for example, just before a vet visit.

Using gabapentin in pets is considered “off-label” which means it is not an FDA-approved indication in pets.

How does gabapentin work in dogs?

Experts aren’t sure exactly how gabapentin works to relieve seizures, pain, or anxiety but it is thought to inhibit the release of excitatory neurotransmitters. Gabapentin resembles a naturally occurring inhibitory neurotransmitter called GABA (γ-aminobutyric acid), which is involved with the transmission of nerve signals within the brain and spinal cord.

How much gabapentin should I give my dog?

Dosages of gabapentin for dogs can vary, but usually, gabapentin is dosed at 5 to 30 mg/kg (or 2.2 to 13.6mg/lb) up to three times daily.

**Dosage Chart of Gabapentin For Dogs (Low-Dose**)
Dog’s weight	Low dose (5mg/kg)
5kg	25mg
7.5kg	37.5mg
10kg	50mg
12.5kg	62.5mg
15kg	75mg
17.5kg	87.5mg
20kg	100mg
25kg	125mg
30kg	150mg
40kg	200mg
50kg	250mg
60kg	300mg

**Dosage Chart of Gabapentin For Dogs (High-Dose)**
Dog’s weight	High-dose (30mg/kg)
5kg	150mg
7.5kg	225mg
10kg	300mg
12.5kg	375mg
15kg	450mg
17.5kg	525mg
20kg	600mg
25kg	750mg
30kg	900mg
40kg	1200mg
50kg	1500mg
60kg	1800mg

Gabapentin can also be given before an anticipated stressful event, such as a veterinary visit, at a dose of 30-60 mg/kg one to two hours before the event.

How long does gabapentin take to work?

Gabapentin is quick acting, and an effect should be noticed one to two hours after administration. However, when gabapentin is used to treat pain, a low dosage is started initially, which is then titrated up slowly, which means it may take longer to see an effect. While your vet is titrating up the dosage, they will be using other medications to keep your dog comfortable until the gabapentin is working. When used to treat seizures gabapentin may take a few weeks to reduce seizure frequency.

The effects of gabapentin wear off quickly unless the dog has kidney or liver disease. This is why it is usually given three times a day.

How long can a dog stay on gabapentin?

There is no maximum time for a dog to remain on gabapentin. Some older dogs will stay on it for the rest of their life as part of a management plan for arthritis.

What are the side effects of giving a dog gabapentin?

The most common side effect of gabapentin in dogs is drowsiness, which can be managed by starting with a low dosage of gabapentin and increasing it slowly. Most dogs become tolerant of this side effect with continued dosing.

When starting gabapentin your dog may also seem a little uncoordinated initially, but this should also resolve with continued dosing. Rarely, a dog may be allergic to gabapentin and they may have a reaction which is a sign to avoid giving gabapentin to your dog in the future.

Xylitol is used to sweeten commercially prepared gabapentin oral suspension and this can be toxic to dogs. Low-to-moderate dosages of gabapentin oral suspension are unlikely to contain enough xylitol to be problematic for dogs but higher dosages, such as those used for seizures, might. This can be avoided by having liquid formulations compounded rather than using the commercially available oral suspension.

How does gabapentin make a dog feel?

Gabapentin makes your dog feel a little sleepy and possibly a little uncoordinated initially. They should become tolerant to these effects within a few days, especially if the dosage is started low and titrated up slowly.

Does gabapentin make dogs sleepy?

Yes, gabapentin can make your dog sleepy initially but by starting with a small dose and gradually titrating it upwards, your dog should become tolerant to this effect.

Can gabapentin cause diarrhea or constipation in dogs?

Vomiting, diarrhea, or constipation is not a common side effect of gabapentin unless it is being used at high dosages. If your dog develops any of these side effects, call your veterinarian.

Can gabapentin cause hind leg weakness in dogs?

Hind leg weakness may be a sign of incoordination in dogs, usually associated with too high a dose of gabapentin. If your dog has been on gabapentin a long time and this happens, tell your veterinarian. As pets age, their bodies are not as efficient at metabolizing gabapentin and side effects, such as incoordination may reappear again, especially hind leg weakness. Usually reducing the dosage helps resolve this.

Can I overdose my dog on gabapentin?

Although gabapentin is generally well tolerated in dogs, like any medication, you can give too much of it. Always follow your vet’s instructions and never try to increase the dosage yourself without their advice.

Symptoms of an overdose of gabapentin in dogs include diarrhea, extreme sleepiness, lethargy, and incoordination; however, an overdose is not usually fatal. Seek veterinary advice immediately.

Do dogs need to be weaned off gabapentin?

If gabapentin is being used to treat seizures in dogs then it should be tapered off slowly over a couple of weeks after long-term use and not abruptly discontinued because it can precipitate seizures.

What can I give my dog instead of gabapentin?

Gabapentin is commonly used to treat nerve pain in dogs but there may be times when a dog does not tolerate it or it no longer effectively treats the pain. Other treatments that may be effective for nerve pain in dogs include:

Pregabalin (Lyrica): this works similarly to gabapentin but it lasts longer which means it only needs to be given twice a day and it is more effective at a lower dosage
Amantadine works by blocking NMDA receptors in the spinal cord and may improve your dog’s mobility when used in addition to NSAIDs

Other possible treatments that require more research include amitriptyline and venlafaxine.

How does gabapentin make you feel?

Gabapentin may make you feel a little drowsy, dizzy, or clumsy when you first start taking it. You may feel like your thinking is slower. These are common side effects of gabapentin, but they usually get better as your body adjusts to the medication. These reactions are more common if you need to take a high dose. But if you do feel dizzy, unsteady, or drowsy, avoid any activities — such as driving or operating machinery — that could be dangerous.

Many people don’t feel any different when they first start taking gabapentin. Gabapentin is used to treat seizures, nerve pain, and the symptoms of restless legs syndrome. If gabapentin works for you, you may feel relief from these symptoms. Some people may also feel more anxious, irritable, depressed, angry, excited, or reckless when they first start gabapentin.

In rare cases (less than 1%), you may have feelings of death or suicide.

Gabapentin can cause other side effects that include:

Headache
Weakness
Uncontrollable shaking
Memory problems
Uncontrolled eye movement
Nausea or vomiting
Dry mouth
Increased appetite
Heartburn
Ear, back or joint pain
Flu-like symptoms.

Your doctor may warn you about these possible side effects and others that can affect the way you feel. Always let someone know right away if you have thoughts of death or suicide.

If gabapentin changes the way you feel in strange or unusual ways, or causes any side effects, do not stop gabapentin on your own. Tell your doctor.

Stopping suddenly may cause a withdrawal reaction that is uncomfortable and can include anxiety, insomnia, nausea, sweating, and pain. If you are taking gabapentin to prevent seizures, stopping gabapentin suddenly may increase your risk for a seizure.

Suicidal Behavior and Ideation of Taking Gabapentin

Antiepileptic drugs (AEDs), including NEURONTIN, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.

Pooled analyses of 199 placebo-controlled clinical trials (mono- and adjunctive therapy) of 11 different AEDs showed that patients randomized to one of the AEDs had approximately twice the risk (adjusted Relative Risk 1.8, 95% CI:1.2, 2.7) of suicidal thinking or behavior comparedto patients randomized to placebo. In these trials, which had a median treatment duration of 12 weeks, the estimated incidence rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients, representing an increase of approximately one case of suicidal thinking or behavior for every 530 patients treated. There were four suicides in drug-treated patients in the trials and none in placebo-treated patients, but the number is too small to allow any conclusion about drug effect on suicide.

The increased risk of suicidal thoughts or behavior with AEDs was observed as early as one week after starting drug treatment with AEDs and persisted for the duration of treatment
assessed. Because most trials included in the analysis did not extend beyond 24 weeks, the risk of suicidal thoughts or behavior beyond 24 weeks could not be assessed.

The risk of suicidal thoughts or behavior was generally consistent among drugs in the data analyzed. The finding of increased risk with AEDs of varying mechanisms of action and across a range of indications suggests that the risk applies to all AEDs used for any indication. The risk did not vary substantially by age (5-100 years) in the clinical trials analyzed.

Rare Side Effects of Gabapentin

Gabapentin can cause some rare but serious side effects. While these are uncommon, people should be aware of them and seek medical attention if needed.

Consult a doctor right away if you experience any of these behavioral changes:

suicidal thoughts or behavior
violent behavior, aggressiveness, or anger
anxiety that is worse or new
depression that is worse or new
irritability that is worse or new
hallucinations
mania
panic attacks

Gabapentin can also affect specific parts of the body and cause serious but rare side effects. These include:

Kidney abnormalities

A person may experience symptoms related to kidney abnormalities, such as:

a change in how much urine they produce
trouble urinating
blood in the urine
weight gain
swelling in the legs or feet from fluid retention

Other abnormalities

A person may experience:

severe fatigue, tiredness, or weakness
unexpected muscle pain
long-lasting stomach pain
skin color with a bluish tint on the lips, nail beds, toes, or fingers

Allergic reaction

Gabapentin can cause a severe allergic reaction or anaphylaxis. Symptoms of an allergic reaction to gabapentin include:

a skin rash
hives
wheezing or difficulty breathing
tightness in the chest or throat
fever
gland swelling that does not go away
swelling of the face, lips, throat, or tongue

Call your doctor right away if you experience signs of an allergic reaction to gabapentin. Call 911 if these symptoms appear life threatening.

Dosage of Taking Gabapentin

The right dosage of gabapentin for an individual depends on several factors, including:

the type and brand of gabapentin they use
the strength of the product
the condition they have
their kidney function
their weight, age, and general health

The number of daily doses, the hours that pass between those doses, and how long a person takes gabapentin will vary among individuals.

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

A person should take some forms of gabapentin with food, but for other forms, this is not necessary. Anyone who receives a prescription for the Horizant brand of gabapentin for RLS should take it only during the evening or at night.

Some brands and dosages require a person to break the tablets in half. Always use the other half with the next dose or as soon as possible. Never break or chew extended-release gabapentin tablets. People should always swallow these whole.

It is vital to take only the recommended dosage of gabapentin and not to continue using it for longer than a doctor prescribes. If a person misses a dose, they should follow the instructions on the label or call a pharmacist for advice.

What to do if you miss a dose

If a person misses a dose of gabapentin, they should take their required dose as soon as they remember. The only exception is if it is already time to take the next dose. In this case, the person should simply skip the missed dose and take the next dose at the usual time.

A person should never take two doses of gabapentin together.

Safety and Risks of Taking Gabapentin

Individuals taking gabapentin should talk with a doctor about any problems they experience while doing so, especially if they are severe, ongoing, or getting worse.

People taking gabapentin should be aware of the following serious safety concerns.

Breathing problems

In 2019, the Food and Drug Administration (FDA)Trusted Source issued a warning that people with respiratory risk factors who take the different brands of gabapentin may experience serious breathing difficulties.

People who have conditions such as chronic obstructive pulmonary disease or asthma should speak with a doctor before taking gabapentin.

Risk of suicidal thoughts or behaviors

Studies suggest that some people may experience thoughts of suicide or exhibit suicidal behaviors when taking gabapentin or other anticonvulsants.

If a person or their loved one notices any changes in their mood or behavior, they should contact a doctor immediately.

Risk of overdose

Despite research in this area, it is not always clear whether suicidal behaviors in people who take gabapentin are a result of the drug itself or related to an existing mental health condition.

It is clear, however, that the risk of overdose from the drug is higher if a person also has a mental health condition such as depression.

In addition, when taking gabapentin, a person should monitor themselves carefully to make sure that they are not accidentally taking the wrong dosage.

People should also check on loved ones and minors taking this medication and seek help if there is any concern that they may have suicidal thoughts or behaviors.

Data from U.S. poison centers show that between 2012 and 2017, the number of suspected intentional suicide attempts from a gabapentin overdose grew by 80.5%.

According to the FDA, there have been reports of oral overdoses from taking up to 49 grams of the drug.

Symptoms of an overdose may include:

sleepiness
lethargy
double vision
slurred speech
diarrhea
coma, in cases when someone has chronic renal failure and has received treatment with Neurontin

Interactions with other medications and substances

Gabapentin can interact with other prescription and over-the-counter medications, vitamins, and herbal supplements.

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 reviewTrusted Source 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)

Risks during pregnancy and when breastfeeding

People who are pregnant and those who intend to become pregnant should tell a doctor before taking gabapentin.

Research from 2020 suggests that taking this drug during pregnancy may be associated with a higher risk of cardiac malformations in the fetus, a condition called small for gestational age, and preterm birth.

However, it is also essential to control seizures during pregnancy, so pregnant people should only take the drug if it is absolutely necessary.

People should never start or stop taking gabapentin for seizure control before talking with a doctor. They will assess the potential risks and benefits.

After childbirth, gabapentin passes into breast milk. At low levels, it may not affect the infant. However, it is best to discuss this issue with a doctor before breastfeeding.

Potential for allergies

People with gabapentin allergies should not take this drug.

Also, the medication may contain other ingredients that can trigger allergy symptoms in some people. For this reason, people should discuss all drug and food allergies with a doctor before taking gabapentin.

It is important to seek emergency medical treatment if symptoms of a severe allergic reaction occur. These may includeTrusted Source:

breathing difficulties
extreme dizziness
fever
hives
rash
severe weakness
swelling of the face, lips, tongue, or throat
yellowing of the skin or eyes, otherwise known as jaundice

People can report adverse drug reactions to the FDA at 800-FDA-1088 or through MedWatch.

Other safety considerations

Because gabapentin can cause drowsiness, anyone taking this drug should exercise caution while driving or using machinery.

Also, people should not take antacids within 2 hours of taking gabapentin, as antacids reduce the body’s ability to absorb the drug.

People should also avoid alcohol or limit their intake of alcohol while taking gabapentin, as there is a risk of adverse reactions.

Does gabapentin help treat nerve pain?

Gabapentin can help relieve nerve pain in some people with postherpetic neuralgia (nerve pain after shingles) and peripheral diabetic neuropathy (nerve pain in the feet in people with diabetes). A Cochrane review reported that 3 to 4 patients out of every 10 with either of these conditions experienced at least a 50% reduction in pain intensity when prescribed gabapentin at dosages of 1800mg-3600 mg/day (gabapentin encarbil: 1200mg-3600 mg/day). This compared with only 1 or 2 out of every 10 given a placebo (an inactive treatment). People who had an improvement in pain relief with gabapentin are also expected to experience an improvement in sleep, fatigue, and in their mood.

This same Cochrane review reported that over half of those treated with gabapentin did not experience any worthwhile pain relief, but did experience side effects.

What type of nerve pain is gabapentin approved to treat?

Gabapentin is approved to treat nerve pain (neuralgia) that results from nerve damage. Gabapentin may be used to treat:

Nerve pain caused by a herpes zoster viral infection, also known as shingles. This pain is called post-herpetic neuralgia (PHN), and it can be severe and chronic
Nerve pain as a result of diabetic neuropathy, which happens when nerves in the feet damaged by diabetes cause chronic burning pain.

How does gabapentin work in nerve pain?

The exact way that gabapentin works to relieve pain is not known. It may change the way the body senses and reacts to pain. Gabapentin is used to manage long-term (chronic) pain, not to be taken for pain as needed. Chronic pain can interfere with sleep and work, and lead to depression.

How quickly does gabapentin work?

Studies show that pain relief may start within one week and reach a maximum effect in about 4 weeks. It can take this long because gabapentin is usually started at a low dose and gradually increased over time until it works.

For treating neuralgia, gabapentin is often started at 300 mg per day and gradually raised by 300 mg per day. One 2017 review of 37 studies found that pain relief usually occurs at a dose of 1,200 mg or more.

The same review compared gabapentin to an inactive medicine (placebo) in almost 6,000 adults with chronic pain from PHN or diabetic neuropathy. Study participants were given either gabapentin or a placebo for 4 to at least 12 weeks. The results showed that 30-40% of people taking gabapentin were able to reduce their pain by half or more, compared to 10-20% of people taking the placebo.

Although some people may get significant relief, others may have side effects without relief of pain. More than half of people taking gabapentin did not get significant relief and had side effects from the drug.

According to the review, about 60% of people taking gabapentin had side effects, including:

Dizziness
Sleepiness
Water retention (edema)
Clumsiness while walking (ataxia)

It does not typically make pain worse: In trials comparing gabapentin side effects to placebo side effects, only 1% of people reported increased pain, and this was the same for gabapentin and placebo.

Once you find the dose that relieves neuralgia for you, it is important not to stop taking it suddenly. Stopping suddenly can lead to withdrawal symptoms such as:

Anxiety
Insomnia
Nausea
Pain
Sweating

Is Gabapentin Considered a Painkiller?

Gabapentin is commonly used to treat some types of nerve pain but is classified as an anticonvulsant medicine, not as an opioid or painkiller.

Gabapentin was first approved in 1993 and is used to treat:

postherpetic neuralgia, a nerve pain caused by the shingles virus (herpes zoster),
restless legs syndrome (RLS), a painful movement disorder in the legs
partial seizures in adults and children at least 3 years old who have epilepsy

Gabapentin works by affecting chemicals and nerves in the body that are involved in the cause of seizures and in some types of nerve pain.

Gabapentin is not a federally-controlled drug substance and does not contain an opioid (narcotic) medication. However, gabapentin misuse and abuse has been reported, and it may be restricted in some states through their state drug-monitoring program. Gabapentin abuse can boost the high a person gets from opioid painkillers, muscle relaxants, and anxiety medications. This can be dangerous and potentially life-threatening.

In 2019, the FDA issued an alert that serious breathing problems have been reported with gabapentin and other related drugs, like Lyrica (pregabalin) in people at risk of slowed breathing.

This includes people who use opioid pain medicine or CNS depressants, people with chronic obstructive pulmonary disease (COPD, and the elderly.
These serious breathing problems may be fatal.
Read more about this serious FDA warning here.

Avoid or limit the use of alcohol (in beverages or medicines) with gabapentin as it can worsen drowsiness or dizziness. Ask you doctor about drinking alcohol while you are taking gabapentin.

What type of pain does gabapentin treat?

Gabapentin is approved by the FDA to treat:

Postherpetic neuralgia: nerve pain that can occur due to an outbreak of shingles. Shingles, also known as herpes zoster, occurs when the chicken pox virus deep-seated in your nerve activates again later in life and causes a serious skin rash. Not everyone gets postherpetic neuralgia from shingles, but it can be painful if you do. It causes a burning nerve pain that lasts for months, or even years, after the rash and blisters have cleared up.

Restless legs syndrome (RLS): an uncontrollable urge to move your legs around, often at night. This is usually due to leg discomfort. It may occur most often when you are sitting, laying down, or during bedtime. It can be disruptful to sleep and travel. It is thought RLS may occur due to an imbalance of the chemical dopamine in the brain.

Gabapentin has also been used off-label for the treatment of other types of neuropathic (nerve) pain like peripheral diabetic neuropathy, fibromyalgia and trigeminal neuralgia. “Off-label” uses of gabapentin are uses that have not been approved by the FDA and are not found in the package insert, but may have been accepted for use by healthcare providers based on clinical use.

How does gabapentin come?

There are several brand names of gabapentin including Gralise, Horizant, and Neurontin. Use only the brand and form of gabapentin your doctor has prescribed.

Gralise (gabapentin) is indicated for the management of postherpetic neuralgia only. It is not used for epilepsy. Gralise comes as a 300 and 600 milligram (mg) extended-release (ER) tablet and in a 30-day starter pack of 78 tablets. A generic option is not yet available.

Horizant (gabapentin enacarbil) is used in adults to treat either nerve pain due to postherpetic neuralgia (PHN) or restless legs syndrome (RLS). Horizont is also an extended-release 300 mg or 600 mg tablet and is not interchangeable with other gabapentin products. A generic option is not yet available.

Neurontin (gabapentin) is an immediate-release form used to treat seizures in adults and children who are at least 3 years old, in addition to nerve pain due to shingles. It comes as 100, 300, or 400 mg oral capsules; 600 mg and 800 mg oral tablets, and as a 250 mg per 5 mL oral solution. It is also available as a generic option.

Some brands are only used for certain conditions, and these products may not be interchangeable. Check your medicine each time you get a refill to make sure you have received the correct form.

Some of these medicines may be expensive. Ask your healthcare provider if you are able to use a generic form of gabapentin for your condition (this may not always be possible). Generic options could save you hundreds of dollars each month, or may be less expensive than your insurance copay.

Also, check with the manufacturer who may offer copay cards or patient assistance programs to lessen your overall costs, if you qualify. Be sure to check for online coupons, too, that can save you money on both generics and brands.

To learn more about gabapentin, join the Drugs.com gabapentin Support Group and Q&A Section where you can ask questions, share experiences and keep up with the latest news.

This is not all the information you need to know about gabapentin for safe and effective use and does not take the place of talking to your doctor about your treatment. Review the full gabapentin information here, and discuss this information and any questions you have with your doctor or other health care provider.