Neurontin: 7 things you should know
Medically reviewed by C. Fookes, BPharm. Last updated on Oct 3, 2019.
1. How it works
- Neurontin is a brand (trade) name for gabapentin. Neurontin may be used for the treatment of some seizure disorders or to relieve nerve pain.
- Experts aren't sure exactly how gabapentin works, but research has shown that gabapentin binds strongly to a specific site (called the alpha2-delta site) on voltage-gated calcium channels. This action is thought to be the mechanism for its nerve-pain relieving and anti-seizure properties.
- Neurontin belongs to the group of medicines known as anticonvulsants.
- May be used in addition to other medication to reduce seizure frequency in adults and children aged three and older with partial onset seizures.
- May be used in the management of postherpetic neuralgia (persistent nerve pain following Shingles infection).
- Neurontin is available as a generic under the name gabapentin. However, not all generics are interchangeable with some branded versions of gabapentin.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Dizziness, drowsiness, tiredness, fever, and nystagmus (a rapid and uncontrollable movement of the eyes) are some of the more common side effects.
- May cause behavioral problems, hostility or aggression, or thought disturbances when used to treat epilepsy in children aged three to twelve years.
- Other side effects may include blurred vision, amblyopia (lazy eye), dry mouth, peripheral edema (fluid retention in the feet and hands), tremor, sexual dysfunction and gastrointestinal disturbances.
- Best titrated up slowly to reduce the risk of side effects; however, this may delay the onset of an effect.
- Similar to other anticonvulsant medicines, Neurontin may increase the risk of depression and suicidal thoughts, particularly in young adults under the age of 24.
- Neurontin has been associated with a discontinuation syndrome when abruptly stopped. Symptoms include anxiety, insomnia, nausea, pain, and sweating. It should be tapered off slowly under a doctor's advice.
- The dosage of Neurontin needs to be reduced in kidney disease.
- Rarely, hypersensitivity reactions may occur. Symptoms may include fever, rash, swollen lymph nodes, swollen facial features or throat.
- May interact with some other medications including antacids, hydrocodone, morphine, and other drugs that cause sedation or dizziness. May also cause false positive results on some urinary protein tests.
- There have been some reports of Neurontin misuse and abuse, particularly in people with a history of drug abuse. Be alert for this possibility.
- Neurontin requires three times daily administration because of its short duration of effect.
- Only effective for partial onset seizures, not other types of seizure disorders.
Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.
- May be taken with or without food. Swallow capsules whole with water. Do not take Neurontin at the same time as antacids such as Maalox or Gaviscon. Separate administration by at least two hours. Take exactly as directed by your doctor, do not increase or decrease the dose without his or her advice.
- Avoid operating machinery, driving, or performing tasks that require mental alertness if Neurontin makes your drowsy or impairs your judgment.
- Neurontin tablets are scored and can be halved. The unused half tablet should be taken as the next dose or used within 28 days of breaking.
- For dosage schedules of three times daily, do not allow more than 12 hours between doses.
- Do not substitute Neurontin for the Gralise brand of gabapentin due to differing administration requirements.
- The side effects from Neurontin, such as dizziness or drowsiness, may increase your risk of falling. Remove any fall hazards from your home if possible (such as loose rugs), and be careful when ascending or descending stairs.
- Talk to your doctor if you experience any worsening of your mood or if you develop any suicidal thoughts.
- Do not stop taking Neurontin without your doctor's advice as it may precipitate a withdrawal reaction (symptoms include agitation, disorientation, confusion). When the time comes to discontinue Neurontin your doctor will tell you how to taper it off.
- Seek urgent medical advice if you develop a rash, fever, difficulty breathing or facial swelling while taking Neurontin.
6. Response and Effectiveness
- Peak concentrations of Neurontin occur 2 to 3 hours after oral administration and its effects last for 5 to 7 hours. It may take several weeks before a reduction in nerve pain or seizure frequency is observed.
- Requires three times daily dosing (except in kidney disease).
Medicines that interact with Neurontin may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Neurontin. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with Neurontin include:
- antacids, such as those containing aluminum and magnesium
- anti-anxiety medications, such as diazepam, lorazepam, and flunitrazepam
- antidepressants, such as amitriptyline, citalopram, fluoxetine, paroxetine
- antihistamines, such as chlorpheniramine, promethazine
- antipsychotics, such as aripiprazole, chlorpromazine, haloperidol
- narcotic pain relievers, such as oxycodone and morphine
- sedatives or sleeping pills
Alcohol may worsen the side effects of Neurontin such as drowsiness and dizziness.
Note that this list is not all-inclusive and includes only common medications that may interact with Neurontin. You should refer to the prescribing information for Neurontin for a complete list of interactions.
Neurontin (gabapentin) [Package Insert]. Revised 04/2019. Parke-Davis Div of Pfizer Inc. https://www.drugs.com/pro/neurontin.html
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Neurontin only for the indication prescribed.
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