What is gabapentin used for?
Gabapentin is commonly used to treat and prevent seizures in people with epilepsy or to treat nerve pain (postherpetic neuralgia) that can occur after a viral infection called shingles.
Gabapentin may also be used for other conditions as determined by your healthcare provider.
How does Gabapentin work (mechanism of action)?
Gabapentin is a prescription medication initially developed to treat epilepsy. It is also widely used for managing certain types of nerve pain (neuropathic pain). Gabapentin belongs to a class of drugs called anticonvulsants, which work by calming overactive nerve signals in the brain and nervous system.
The exact way that gabapentin works for nerve pain or seizures is unknown. Gabapentin may block certain signals from nerves. Seizures are caused by electrical activity in the brain that is not normal. Gabapentin may interfere with the abnormal electrical activity of the brain.
Gabapentin mimics the neurotransmitter gamma-aminobutyric acid (GABA), although it does not directly affect GABA receptors. Instead, it binds to calcium channels on nerve cells, which helps to reduce the transmission of pain signals.

Why Gabapentin is Effective for Pain Relief
- Targets Nerve Pain:
- Traditional pain relievers often fail to alleviate nerve pain. Gabapentin specifically addresses the overactive nerve signals that cause this discomfort.
- Lower Risk of Addiction:
- Compared to opioids, gabapentin has a significantly lower potential for abuse and addiction, making it a safer long-term option for some patients.
- Well-Tolerated:
- Many people tolerate gabapentin well, though some may experience side effects like drowsiness, dizziness, or fatigue.
Uses of Gabapentin for Pain Relief
- Neuropathic Pain:
- Gabapentin is particularly effective in treating nerve-related pain, such as:
- Diabetic neuropathy
- Postherpetic neuralgia (pain following shingles)
- Sciatica
- It is often prescribed when pain is not well-managed by standard painkillers like acetaminophen or NSAIDs.
- Gabapentin is particularly effective in treating nerve-related pain, such as:
- Chronic Pain Conditions:
- It may be used in certain cases of fibromyalgia or chronic lower back pain where nerve dysfunction is suspected.
- Adjunctive Therapy:
- Gabapentin can complement other pain management therapies, offering additional relief without the risks associated with stronger opioids.
How long does Gabapentin take to work?
The time it takes for gabapentin to work depends on the condition being treated and individual factors such as dosage and metabolism.
It depends on what you’re treating. For example, you may feel the effects of gabapentin for nerve pain within a week of taking it. But it can take several weeks to see significant improvement. If you’re taking gabapentin for anxiety, full effects may also take several weeks.
It can take time to find the right gabapentin dose, which is why the medication might not be as effective at first. Gabapentin doses vary significantly from person to person. Most people start taking lower doses and then their dose is increased slowly to give their body time to adapt to gabapentin. Your healthcare professional will give you specific instructions if they want you to increase your dose.
If your symptoms don’t improve after a couple weeks of taking gabapentin, talk to your prescriber. They might consider increasing your dose. But don’t make any changes without talking to them first. Taking too much gabapentin can be dangerous.
Here’s a breakdown:
1. Neuropathic Pain
- Onset: Pain relief may start within 1 to 2 weeks after beginning treatment, but full effectiveness can take up to 4 to 6 weeks.
- Titration: Gabapentin doses are often gradually increased to minimize side effects, which can delay its maximum effect.
2. Seizure Control
- Onset: It can take several days to a week for gabapentin to reduce seizure frequency, depending on the dose and how quickly it’s adjusted.
3. Anxiety or Off-Label Uses
- Onset: Some people notice a calming effect within a few days, but it may take 2 to 4 weeks for noticeable benefits in conditions like anxiety or fibromyalgia.
Factors Influencing Onset
- Dose Timing: Gabapentin is usually taken 2-3 times daily because it has a short half-life (5-7 hours).
- Consistency: Regular dosing is crucial for the medication to build up to therapeutic levels.
- Individual Response: Metabolism, age, and the severity of the condition can affect how quickly the medication takes effect.
Are there factors that can affect how long gabapentin takes to work?
Yes, several factors can affect how long it takes for gabapentin to work. They include:
- How quickly you reach your ideal dose: Your gabapentin dosage may be increased every few days. But if you have side effects from gabapentin, your prescriber may wait longer between dosage increases. This allows your body to get used to the medication. If your dose is increased more slowly, it may take longer to feel the medication’s full benefits.
- Other medications you take: Certain medications can interact with gabapentin, and some interactions may lead to lower levels of gabapentin in the body. For example, medications containing aluminum or magnesium can lower gabapentin absorption. Examples include magnesium oxide and Rolaids (calcium carbonate / magnesium hydroxide). It’s best to avoid taking gabapentin within 2 hours of taking these medications so gabapentin can achieve its full effect.
- Foods you eat: Taking gabapentin with high-protein foods may increase the amount of gabapentin your body absorbs. This may also affect how quickly gabapentin starts to work. You can take gabapentin IR with or without food. But you should take Horizant and Gralise with food for maximum absorption.
How is gabapentin supplied (dosage forms)?
Gabapentin is available as Gralise, Neurontin, and generic gabapentin in the following dosage forms that are taken by mouth. Gabapentin is available in several dosage forms to accommodate different medical needs and patient preferences. Below are the common forms in which gabapentin is supplied:
1. Capsules
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- Strengths: Commonly available in 100 mg, 300 mg, and 400 mg.
- Description: These are gelatin capsules filled with powdered gabapentin.
- Use: Swallowed whole with water, typically prescribed for adults or children who can handle capsules.
2. Tablets
- Immediate-Release Tablets:
- Strengths: 100 mg, 300 mg, 400 mg, 600 mg, and 800 mg.
- Use: Taken by mouth, often prescribed for regular pain management or seizure control.
- Extended-Release Tablets (e.g., Gralise, Horizant):
- Strengths: 300 mg and 600 mg.
- Use: Designed for slow, steady release into the bloodstream, often used for postherpetic neuralgia or restless leg syndrome.
- Note: Extended-release tablets should not be cut, chewed, or crushed.
3. Oral Solution
- Strengths: Commonly supplied as 250 mg per 5 mL (50 mg/mL).
- Use: Ideal for individuals who have difficulty swallowing pills, such as children or elderly patients.
- Flavoring: Typically flavored to make it more palatable.
4. Compounded Formulations
- Some pharmacies prepare customized formulations, such as gabapentin cream or gel for topical use, though these are not standard FDA-approved products.
- Use: Applied directly to the skin for localized nerve pain relief (off-label use).
5. Chewable Tablets
- Strengths: Vary by manufacturer but often in 100 mg increments.
- Use: Less common but available for patients who need chewable options.
How should I store gabapentin?
Oral Tablet and Oral Capsule. Gabapentin oral tablets and oral capsules should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place. Keep in a tightly closed container.
Gabapentin is sold under the brand name Neurontin and is available as a generic product as well. (Generic medications are chemically the same as brand-name drugs but may cost less.) Gabapentin is also available as an extended-release tablet that works for a longer length of time; this is the only formulation that is approved for restless legs syndrome.
Gabapentin is taken by mouth and comes in capsule, tablet, and liquid form.
- Gabapentin should be stored at room temperature (20°C to 25°C or 68°F to 77°F) and kept in a dry place away from direct light.
- Keep the medication out of reach of children.
Conditions treated with Gabapentin
Gabapentin is FDA-approved as Neurontin to treat partial seizures in adults and children with epilepsy. Partial seizures are convulsions that originate from a single location in the brain.
Neurontin is also approved to treat a type of nerve pain called postherpetic neuralgia, or PHN. PHN can happen after a person has had shingles, an infection from the same virus as chickenpox that causes a painful rash or blisters. Nerve pain from PHN can last for months, or even longer, after the rash has gone away.
An extended-release form of gabapentin is also FDA-approved to treat PHN.
Another extended-release form of gabapentin is FDA-approved to treat restless legs syndrome. This condition causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them around, especially at night, which disrupts sleep.
Off-label uses for gabapentin
Doctors often prescribe gabapentin off-label to treat conditions such as:
- pain from diabetic neuropathy, which is numbness or uncomfortable tingling caused by nerve damage from diabetes
- nerve pain in the neck and back from conditions such as sciatica, a painful compression of the sciatic nerve
- hot flashes, which are sudden feelings of heat and sweating that can happen in women after menopause and in those being treated for breast cancer
- mood disorders such as anxiety
- alcohol addiction.
Common Off-Label Uses of Gabapentin
1. Anxiety Disorders
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- Gabapentin is sometimes prescribed for generalized anxiety disorder (GAD), social anxiety, and other forms of anxiety.
- It can have a calming effect, potentially reducing symptoms like restlessness and excessive worry.
2. Insomnia
-
- Its sedative effects can help improve sleep quality, particularly in people who struggle with anxiety or chronic pain that interferes with sleep.
3. Migraine Prevention
-
- Gabapentin may be used to reduce the frequency and severity of migraines, though it is not a first-line treatment.
4. Fibromyalgia
-
- It is sometimes used to manage chronic pain and improve sleep in people with fibromyalgia, a condition characterized by widespread musculoskeletal pain.
5. Alcohol and Substance Use Disorders
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- Gabapentin can help reduce cravings and withdrawal symptoms associated with alcohol dependence or opioid use disorder.
- It may also help prevent relapse in recovering addicts.
6. Restless Leg Syndrome (RLS)
-
- Gabapentin is occasionally prescribed to alleviate the uncomfortable sensations and urge to move associated with RLS.
7. Chronic Pain Conditions
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- Non-neuropathic pain: Gabapentin is sometimes used for conditions like chronic low back pain or arthritis, though its efficacy is less established.
- Pelvic pain syndromes: It may also help with pain associated with endometriosis or interstitial cystitis.
8. Hot Flashes
-
- It has been used to manage hot flashes in menopausal women or those undergoing treatments like chemotherapy.
9. Pruritus (Chronic Itching)
-
-
- Gabapentin has shown effectiveness in treating severe itching associated with conditions like chronic kidney disease, liver disease, or post-burn recovery.
-
What is the Off-Label Usages of Gabapentin ?
- Gabapentin is in the drug class gamma-aminobutyric acid analogs.
- Gabapentin is used to treat the following conditions:
- Alcohol Withdrawal
- Anxiety
- Benign Essential Tremor
- Bipolar Disorder
- Burning Mouth Syndrome
- Carpal Tunnel Syndrome
- Cluster-Tic Syndrome
- Cough
- Diabetic Peripheral Neuropathy
- Epilepsy
- Erythromelalgia
- Fibromyalgia
- Hiccups
- Hot Flashes
- Hyperhidrosis
- Insomnia
- Lhermitte’s Sign
- Migraine
- Nausea/Vomiting, Chemotherapy Induced
- Neuropathic Pain
- Occipital Neuralgia
- Pain
- Periodic Limb Movement Disorder
- Peripheral Neuropathy
- Postherpetic Neuralgia
- Postmenopausal Symptoms
- Primary Orthostatic Tremor
- Pruritus
- Pudendal Neuralgia
- Reflex Sympathetic Dystrophy Syndrome
- Restless Legs Syndrome
- Small Fiber Neuropathy
- Spondylolisthesis
- Syringomyelia
- Transverse Myelitis
- Trigeminal Neuralgia
- Vulvodynia
Gabapentin Side Effects
What are the most common side effects of gabapentin?
The most common side effects of gabapentin are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Dizziness
- Sleepiness and tiredness
- Swelling of hands, legs, or feet
- Trouble with balance or coordination
- Uncontrollable eye movements
- Infection and fever
- Nausea and vomiting
- Aggressive behavior
There may be other side effects of gabapentin that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of gabapentin?
While less common, the most serious side effects of gabapentin are described below, along with what to do if they happen.
Severe Allergic Reactions. Gabapentin can cause allergic reactions, including DRESS, which can be serious. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking gabapentin and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Swelling of the face, lips, mouth, tongue, or throat
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
- Swelling in your feet, ankles, or legs
- Dark-colored urine
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Breathing Problems. Gabapentin may cause slow and shallow breathing, especially if you have breathing problems from another condition or take other medicines that can slow your breathing. See the Interactions section for more details. Tell your healthcare provider if you develop severe sleepiness, especially when you start gabapentin or when your dose is increased. Get emergency help if you have any of the following symptoms.
- Changes in the color of your skin, including bluish color to your lips and fingernails
- Confusion
- Shortness of breath
- Feeling dizzy, lightheaded, or fainting
- Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
- Fast breathing or very slow breathing
Sleepiness, Dizziness, and Driving Impairment. Gabapentin may cause dizziness and sleepiness and can impair your ability to safely drive. Do not drive or do other activities that require alertness or coordination like operating heavy machinery until you know how gabapentin affects you. How long gabapentin may impair your ability to drive is unknown. Ask your healthcare provider when you can drive or do other activities.
Suicidal Thoughts and Actions. Gabapentin may cause suicidal thoughts or actions in a small number of people. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.
- New or increased thoughts of suicide or death
- Suicide attempt
- New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior
Changes in Behavior and Thinking. Children between 3 and 12 years of age taking certain forms of gabapentin may have emotional changes; school performance changes; or develop aggressive behavior, restlessness, hyperactivity, or concentration problems. Tell your child’s healthcare provider if you notice changes in your child’s behavior or thinking.
Warnings & Precautions
Who should not use gabapentin?
Allergies to Ingredients. People who are allergic to any of the following should not take gabapentin.
- Gralise
- Neurontin
- Gabapentin
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all the ingredients in the specific gabapentin products they stock.
What should I know about gabapentin before using it?
Do not take gabapentin unless it has been prescribed to you by a healthcare provider. Take it as prescribed. Different forms of gabapentin are not interchangeable even if the strength is the same. Always follow the instructions given by your healthcare provider, and take the specific medicine prescribed to you.
Do not stop taking gabapentin without talking to your healthcare provider. Stopping gabapentin suddenly can cause side effects, including seizures. If you need to stop taking gabapentin, your healthcare provider will give you instructions on how to stop the medicine.\

Do not share gabapentin with other people, even if they have the same condition as you. It may harm them.
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Keep gabapentin out of the reach of children. As the oral liquid must be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.
Some forms of gabapentin need to be taken with food. If you are unsure whether or not to take your medicine with food, ask your healthcare provider.
Do not chew, cut, or crush gabapentin capsules. Swallow them whole with water.
Some gabapentin tablets should not be chewed, cut, or crushed. Ask your pharmacist or healthcare provider about the best way to take your medicine. If you are told that it is okay to split a gabapentin tablet in half, take the other half at the time you are supposed to take your next dose. Throw away any unused half tablets within 28 days.
People who are 65 years of age or older can be at a greater risk for some side effects of gabapentin. Talk to your healthcare provider about your risks if you are in this age group.
For gabapentin oral liquid, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.
What should I tell my healthcare provider before using gabapentin?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if gabapentin is right for you.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Kidney problems or on dialysis
- Breathing problems
- Diabetes
- Seizures (if you are taking gabapentin for another reason)
Mental Health Problems. Tell your healthcare provider about any recent and current mental health problems, especially if you have had thoughts of suicide, have ever attempted suicide, or have depression or mood problems.
Other Medicines and Supplements. Gabapentin may interact with other medicines and supplements. Before taking gabapentin, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. It is not known if or how gabapentin could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take gabapentin while you are pregnant or trying to get pregnant. You can register for the North American Antiepileptic Drug Pregnancy Registry by calling 888-233-2334 if you become pregnant. This registry collects safety information about the use of anticonvulsant medicines during pregnancy.
Breastfeeding. Gabapentin passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take gabapentin while breastfeeding.
Overdose/Missed Dose
What should I do if I accidentally use too much gabapentin?
If you or someone else has taken too much gabapentin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of gabapentin?
If you miss a dose, take it as soon as you remember with food. If it is almost time for your next dose, skip the missed dose and only take the next dose at your scheduled time. Do not take double or extra doses.
Gabapentin Interaction
Gabapentin can interact with other medications, supplements, and substances, potentially leading to reduced effectiveness or increased risk of side effects.
Understanding these interactions is crucial for safe use. Here’s a breakdown of gabapentin interactions:
1. CNS Depressants
- Examples: Alcohol, benzodiazepines (e.g., diazepam, lorazepam), opioids (e.g., morphine, oxycodone), sleep aids, antihistamines (e.g., diphenhydramine), muscle relaxants.
- Interaction: Gabapentin can increase the sedative effects of these substances, leading to excessive drowsiness, dizziness, impaired coordination, and respiratory depression.
- Advice: Avoid alcohol and use other central nervous system (CNS) depressants cautiously. Discuss with your doctor if you are taking any sedative medications.
2. Antacids Containing Aluminum or Magnesium
- Examples: Maalox, Mylanta, Gaviscon, Tums.
- Interaction: Antacids can decrease the absorption of gabapentin, reducing its effectiveness if taken too closely together.
- Advice: Take gabapentin at least 2 hours before or after antacids to prevent reduced absorption.
3. Opioids
- Examples: Hydrocodone, morphine, oxycodone, tramadol.
- Interaction: Combining gabapentin with opioids can lead to enhanced CNS depression, increasing the risk of drowsiness, confusion, respiratory depression, and overdose.
- Advice: Use gabapentin and opioids together only under strict medical supervision. Your doctor may adjust the dosage or monitor you closely for signs of respiratory distress.
4. Muscle Relaxants
- Examples: Cyclobenzaprine, baclofen, tizanidine.
- Interaction: The combination can amplify drowsiness and dizziness, increasing the risk of falls and accidents.
- Advice: If taking muscle relaxants with gabapentin, avoid activities that require full alertness until you know how they affect you together.
5. Other Anti-Seizure Medications
- Examples: Carbamazepine, valproate, lamotrigine, topiramate.
- Interaction: Gabapentin can interact with other anti-seizure medications, potentially leading to changes in blood levels, increased side effects, or reduced effectiveness of either drug.
- Advice: Your doctor may need to monitor blood levels of certain anti-seizure medications and adjust dosages accordingly.
6. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- Examples: Ibuprofen, naproxen.
- Interaction: NSAIDs can increase the risk of side effects like swelling (edema) when used with gabapentin.
- Advice: Use NSAIDs with caution, especially if you have a history of kidney problems or fluid retention. Monitor for any unusual swelling.
7. Medications that Affect the Kidneys
- Examples: Diuretics (e.g., furosemide), certain antibiotics (e.g., aminoglycosides), ACE inhibitors (e.g., lisinopril).
- Interaction: Since gabapentin is excreted through the kidneys, combining it with other kidney-impacting drugs can lead to altered drug levels, either increasing side effects or reducing effectiveness.
- Advice: If you have kidney disease or are on medications that affect the kidneys, your doctor may need to adjust the gabapentin dosage.
8. Certain Herbal Supplements
- Examples: St. John’s Wort, valerian root, kava.
- Interaction: These supplements may increase drowsiness and dizziness when taken with gabapentin.
- Advice: Discuss any herbal supplements you are using with your doctor before starting gabapentin.
9. Oral Contraceptives
- Examples: Birth control pills.
- Interaction: While there is no direct interaction, some reports suggest gabapentin may reduce the effectiveness of oral contraceptives, though this is not well-established.
- Advice: If you’re on birth control, discuss with your healthcare provider to ensure adequate contraceptive measures are in place.
10. Certain Antidepressants
- Examples: Tricyclic antidepressants (e.g., amitriptyline), SSRIs (e.g., sertraline, fluoxetine), SNRIs (e.g., duloxetine, venlafaxine).
- Interaction: Using gabapentin with antidepressants can increase the risk of drowsiness and dizziness. There may also be additive effects in managing pain or anxiety.
- Advice: Monitor for any unusual side effects, especially when starting or changing dosages of either medication.
11. Blood Pressure Medications
- Examples: ACE inhibitors, beta-blockers (e.g., atenolol, metoprolol).
- Interaction: Gabapentin can potentially increase the sedative effect of these medications, leading to increased dizziness or fainting.
- Advice: Monitor blood pressure regularly and report any unusual symptoms to your doctor.
12. Diabetes Medications
- Examples: Insulin, metformin, glipizide.
- Interaction: Gabapentin may cause fluctuations in blood sugar levels, which could interfere with diabetes management.
- Advice: Monitor blood glucose levels regularly if you have diabetes and adjust medications with your doctor’s guidance if needed.
How to Manage Gabapentin Interactions
- Inform Your Doctor: Always inform your healthcare provider about all the medications, supplements, and herbal remedies you are currently taking.
- Monitor Side Effects: Keep track of any unusual symptoms, especially when starting a new medication or supplement alongside gabapentin.
- Take at the Right Time: Follow guidelines about when to take gabapentin relative to other medications, particularly antacids.
- Do Not Stop Suddenly: Never stop gabapentin or any interacting medication suddenly without consulting your doctor, as this can cause withdrawal symptoms or other health issues.