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Need To Know: Top 9 Facts About Gabapentin

Medically reviewed on Dec 31, 2016 by L. Anderson, PharmD

Gabapentin: A Versatile Treatment

Gabapentin, in the drug class of anticonvulsants, is known by brands names such as Gralise, Horizant, and Neurontin. It is one of the most highly prescribed drugs as it has so many uses. Gabapentin affects chemicals and nerves in the body that are involved in the cause of seizures and some types of nerve pain. Gabapentin was FDA-approved in 1993 and it treats many different types of medical conditions, like:

Gabapentin Use for Seizures

If you are familiar with Neurontin (gabapentin), you remember it's first FDA approved use was for seizures. Gabapentin is used to treat seizures in adults and children who are at least 3 years old. Gabapentin does come in a liquid dose form for small children who have trouble swallowing capsules. Gabapentin may be taken with or without food. If you take gabapentin three times a day for seizures, do not allow more than 12 hours to pass between any two gabapentin doses. Also, wait at least two hours after taking an antacid that contains magnesium, calcium or aluminum and taking your gabapentin dose. The antacid may prevent proper absorption of the anti-seizure medication and lower its effectiveness.

Postherpetic Neuralgia: What Is It?

Most people are familiar with the seizures that occur with epilepsy, but what is postherpetic neuralgia (PHN)? Postherpetic neuralgia can occur due to an outbreak of shingles. Most cases of shingles clear up within a few weeks. However, postherpetic neuralgia is a burning pain that lasts for more than a month after the rash and blisters have cleared up. In fact, the burning pain that affects the nerves may last for months or even years. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60 years of age. You may be more at risk for the lingering pain of PHN if the shingles breaks out on your face, too.

Restless Legs Syndrome: What Is It?

Restless legs syndrome (RLS) results in an uncontrollable urge to move your legs around, usually due to leg discomfort. The symptoms usually occur in the evenings or at night while you're sitting or lying down. Moving around eases the leg discomfort, but only temporarily.

Restless legs syndrome generally worsens as you age, but it can happen at any age. It can disrupt sleep - leading to daytime drowsiness - and make traveling, like air travel or long car rides - difficult.

Gabapentin at the Pharmacy: How Does it Come?

Gabapentin immediate-release (IR) comes in capsules (100, 300, 400 mg), tablets (100, 300, 400, 600, and 800 mg) and as a liquid oral solution (250 mg per 5 mL). Doses of the IR form are usually given three times per day. The IR form of gabapentin (Neurontin) is also available generically. If you are able to use the generic immediate-release form of gabapentin for your condition (ask your doctor as this may not always be possible), it could save you hundreds of dollars each month or might be cheaper than your copay. But remember, prices can fluctuate wildly, so check with other pharmacies if the price seems out of reach. Be sure to check for online coupons, too, that can save you money on both generics and brands.

The ER Forms: What's the Difference?

Gralise (gabapentin) comes as a 300 and 600 milligram (mg) extended-release (ER) tablet and Horizant (gabapentin enacarbil) is available in a 600 mg ER tablet only. For both brands, the total dose is given only once or twice daily, which can be very convenient for those on-the-go. Gralise is FDA-approved only to treat post-herpetic neuralgia, while Horizant is used for restless leg syndrome and post-herpetic neuralgia. No generics exist yet for these brands. It is important you use only the brand or the generic form of gabapentin that your doctor has prescribed. Check your medicine each time you get a refill at the pharmacy; be sure you have received the correct type.

Off-Label Uses of Gabapentin

Unapproved, or "off-label" uses of gabapentin are uses that have not been approved by the FDA and are not in the professional package labeling. However, some doctors may have had good experience using gabapentin in an off-label fashion, and it may be an accepted use even if not specifically FDA-approved. For example, gabapentin has been used off-label in the treatment of alcohol withdrawal, neuropathic (nerve) pain, fibromyalgia, and trigeminal neuralgia. However, the FDA turned down the approval for menopausal hot flashes due to lack of effectiveness and side effects like dizziness, fatigue and balance problems. Only use a drug for an off-label use if your doctor has specifically written you a prescription with appropriate dosing.

Gabapentin Side Effects and Abuse Potential

Gabapentin is usually well-tolerated but there may be side effects that occur more commonly, especially at the outset. Drowsiness and dizziness can be common side effects and it's important to know how the drug will affect you before driving. You should avoid or limit the use of alcohol with gabapentin. Depression and suicide tendencies have been associated with seizure medications, too. Call your doctor right away if you notice signs of an allergic reaction, like: a rash, hives, itching; red, swollen, blistered, or peeling skin, difficulty breathing, unusual hoarseness; or swelling of the face or throat. Increased appetite and weight gain have been reported, too, so keep an eye on the scale if you are concerned about adding a few pounds.

In an alarming 2016 report, it was noted that 1 in 5 opioid medication users may also be abusing and misusing gabapentin. Gabapentin can be abused to boost the high a person gets from opioid painkillers like oxycodone, muscle relaxants like Soma, and anxiety medications, such as Valium and Xanax.

Don't Abruptly Stop Gabapentin

Thinking of stopping your gabapentin? Think again, and contact your doctor first. Abruptly stopping any form of gabapentin can lead to worsened seizures and unpleasant withdrawal side effects, so it's best to slowly stop the drug over a period of time. Your doctor will know how to do this. Doses may need to be reduced if you have kidney disease, too. Bottom line? It's important to review the Medication Guide that comes with your gabapentin prescription, whether it be the generic, or the brand Horizant or Gralise. There are many side effects, and most you will not experience; however, it's still important to be aware of them and discuss with your doctor.

Finished: Need To Know: Top 9 Facts About Gabapentin

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Sources

  • 1 in 5 Opioid Users Also Might Be Abusing Seizure Drug: Study. Drugs.com. August 3, 2016. Accessed December 31, 2016 at https://www.drugs.com/news/1-5-opioid-users-also-might-abusing-seizure-study-62193.html
  • Gabapentin [package insert]. Revised: 10/2015. Greenstone. https://www.drugs.com/pro/gabapentin.html. Accessed December 31, 2016.
  • Gabapentin: Patient drug information. Up To Date (Lexicomp). Accessed December 31, 2016 at https://www.uptodate.com/contents/gabapentin-patient-drug-information.
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