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Why it's used

Gabapentin is a prescription medicine that is used for the management of nerve pain due to untreated herpes viral infection. This medicine works by entering the brain and decreasing the abnormal excitement of the brain by binding to a specific brain cell site. This medicine helps by preventing the seizures and relieving nerve pain. Gabapentin is also used to treat nerve pain due to diabetes, and to treat partial seizures, with and without secondarily generalized seizures used together with the primary treatment or as a monotherapy.
Anti-epileptic Agent
Gabapentin belongs to the Anti-epileptic Agent class of medicines. Antiepileptic drugs are a class of medicines which are used to treat epilepsy by controlling seizures.

How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Gabapentin. If you have any questions related to this medicine, ask your doctor or pharmacist. Eat this medicine as recommended by your doctor.
Gabapentin is eaten with or without food. Gabapentin should be swallowed whole with a glass of water.
The typical dose of Gabapentin is 300 mg single dose on day 1, two 300 mg doses on day 2 and three 300 mg doses on day 3. The usual dose for children is 25-40 mg/kg/day (11.4-18.2 mg/lb/day) in three divided doses. The maximum adult dose of Gabapentin is 3600 mg in a day. Although this medicine helps people, it may sometimes cause addiction. You may be at higher risk if you have a substance use disorder, such as an addiction to drugs, or to alcohol. To reduce your risk of addiction, take this medicine exactly as prescribed by your doctor.
This medicine is to be used for longer periods of time. Gabapentin typically used for a long time to treat epilepsy.
Talk to your doctor if you develop new symptoms. Tell your doctor if persistent stomach pain, feeling sick, suicidal thoughts, suicidal behavior, worsening of depression, and unusual changes in behavior or mood. If you have any kidney disease, dose adjustment is required in patients with compromised functioning of the kidney. You should consult with your doctor before stopping the use of Gabapentin.
Your doctor may recommend a lower initial dose of this medicine to see the impact of this medicine on the body. Please follow your doctor's directions. Older patients may see an increase in the incidence of side-effects with this medicine. As a result, a lower dose may be recommended for older patients.
When stopping this medicine, you may experience withdrawal symptoms such as nervousness (agitation), a state of mental confusion (disorientation), confusion, anxiety, insomnia, nausea, pain, sweating, and seizures that will not stop (called as status epilepticus). You may need to gradually decrease the dose of this medicine before stopping.
If you are giving Gabapentin to a child, be sure to use a product that is meant for children. Before giving this medicine to a child, use the child's weight or age to find the right dose from the product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.
To decrease the possibility of side-effects, you might be recommended to use the extended-release form of this medicine by your doctor. The extended-release medicine helps in maintaining a steady level of the medicine in your body for a longer period of time. Do not crush or chew the medicine, unless indicated on the package or by your doctor.
If using the liquid form of this medicine, measure the dose using the provided measuring cup, spoon, or dropper. Before pouring the medicine into the measuring device, you should check the measurement markings carefully. Then, pour the dose amount into the device. After use, clean and store the measuring device in a safe place for your next use. You should not use a tablespoon or teaspoon as the dose measuring devices since it can result in an incorrect dose. If indicated on the product package, shake the medicine before use.
Avoid the consumption of alcohol with Gabapentin.
You should store Gabapentin at 15-30°C (59°F to 86°F) for tablet and capsule, 2-8°C (36°F to 46°F) in refrigerator for oral solution. Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Gabapentin for conditions for which it was not prescribed. Do not give Gabapentin to other people who might have the same conditions or symptoms that you have. Self-medication may harm them.

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How to take Gabapentin

The dose and frequency of using Gabapentin will depend on the following factors:
  • age of the patient
  • the weight of the patient
  • patient's health
  • the health of the patient's liver
  • response to the medicine

Gabapentin Dosage

Dosage for nerve pain due to untreated herpes viral infection

Adult
  • Initial: 300 mg on day 1, 300 mg two times on day 2 and 300 mg three times on day 3
  • Maximum: 1800-3600 mg/day based on patient's response

Dosage for epilepsy with partial onset seizures

Adult (aged 12 years and above)
  • Recommended: 300-600 mg three times a day
  • Initial: 300 mg three times a day
  • Maximum: 2400-3600 mg/day
Children (aged 3 to 4 years)
  • Recommended: 40 mg/kg/day (18.2 mg/lb/day) in three divided doses
  • Initial: 10-15 mg/kg/day (4.5-6.8 mg/lb/day) in three divided doses
  • Maximum: 50 mg/kg/day (22.7 mg/lb/day) within 12 hours
Children (aged 5 to 11 years)
  • Recommended: 25-35 mg/kg/day (11.4-15.9 mg/lb/day) in three divided doses
  • Initial: 10-15 mg/kg/day (4.5-6.8 mg/lb/day) in three divided doses
  • Maximum: 50 mg/kg/day (22.7 mg/lb/day) within 12 hours

Minimum Age

3 years

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Capsule
Strength: 100 mg, 300 mg, 400 mg and 600 mg
Oral Solution
Strength: 250 mg/5 ml
Tablet
Strength: 100 mg, 300 mg, 400 mg, 600 mg, and 800 mg
Film-Coated Tablet
Strength: 100 mg, 300 mg, 400 mg, 600 mg, and 800 mg
Suspension
Strength: 250 mg/5 ml

Special Instructions

Patients with creatinine clearance (more than or equal to 80 ml/min)
900-3600 mg/day of Gabapentin should be given in three divided doses in such patients.
Patients with creatinine clearance (50-79 ml/min)
600-1800 mg/day of Gabapentin should be given in three divided doses in such patients.
Patients with creatinine clearance (30-49 ml/min)
300-900 mg/day of Gabapentin should be given in three divided doses in such patients.
Patients with creatinine clearance (15-29 ml/min)
150-600 mg/day of Gabapentin should be given in three divided doses in such patients.
Patients with creatinine clearance (less than 15 ml/min)
150-300 mg/day of Gabapentin should be given in three divided doses in such patients. If creatinine clearance is less than 15 ml/min then the dose should be adjusted accordingly.
Patient undergoing hemodialysis with no production of urine by the kidney
The starting dose of Gabapentin should be 300-400 mg, then 200-300 mg every 4 hours of hemodialysis is recommended in such patients. Gabapentin should not be given when dialysis is not performed.
Patient undergoing hemodialysis with kidney dysfunction
The maintenance dose of Gabapentin should be based on the creatinine clearance, then 200-300 mg every 4 hours of hemodialysis is recommended in such patients.

Missed Dose

Take the missed dose as soon as you remember. Skip the missed dose if it's time for next dose. Avoid taking a double dose to make up for the missed dose.

Overdose

What to do if you overdose on Gabapentin?
In case of overdose, close supervision and supportive care should be provided. Gabapentin should be removed from the body by blood purifying technique (called hemodialysis). Coma can be treated with blood purifying technique (dialysis) in patients with severe kidney dysfunction.
Symptoms of an overdose of Gabapentin
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Gabapentin, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Gabapentin

Before you use Gabapentin, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
Before you use Gabapentin, tell your doctor of your medical history including drug abuse, kidney problems, patients on hemodialysis, depression, mood problems, suicidal thoughts or behavior, or diabetes. When using Gabapentin in patients with the history of drug abuse, the patient should be carefully observed for the symptoms of misuse or abuse of Gabapentin. These symptoms include the development of tolerance, drug-seeking behavior, and increased self-dosing (self-dose escalation).
The use of Gabapentin may change white blood cell count. A decrease in white blood cell count is seen in patients while using Gabapentin.
The use of this medicine may change creatine kinase. The use of Gabapentin may increase creatine kinase enzyme levels.
The use of Gabapentin may change liver function tests. An increase in the alanine transaminase, bilirubin, and aspartate transaminase level is seen in patients using this medicine.
The safety of the use of this medicine during pregnancy is not known. Consult with your doctor before using Gabapentin during pregnancy or if you plan to become pregnant. There is no sufficient data available on the use of Gabapentin in pregnant women. It is not known if this medicine is safe for use in women who nurse/breastfeed. Consult with your doctor before you use Gabapentin while breastfeeding. Gabapentin may pass into human milk. The effect of Gabapentin on milk production and breastfed baby is unknown. The benefits and clinical need of Gabapentin in the mother should be considered along with its side effects on the baby. Consult with your doctor on the use of Gabapentin, if you are trying to conceive.
Avoid drinking alcohol with Gabapentin. Consumption of alcohol may cause sleepiness, and dizziness.
Gabapentin can make you feel sleepy. Be careful, especially while driving, while using heavy machinery, or when doing any activity that needs you to be completely alert. The consumption of alcohol with Gabapentin can worsen the sleepiness. Gabapentin may cause seizures in some people. Hence, you should discuss with your doctor before performing any activities where a loss of consciousness may cause harm to you or others.
Older patients may have a higher incidence of side-effects when using Gabapentin. Elderly patients may see an increased risk of sleepiness, lack of energy, lack of voluntary coordination of muscle movements, and fluid accumulation causing swelling of limbs.

What precautions should be taken during Pregnancy and Nursing, and administering Gabapentin to Children or the Older Adults?

Pregnant Women

Only When Necessary
Warning: There is no sufficient data available on the use of Gabapentin in pregnant women.

Breastfeeding

Only When Necessary
Warning: Gabapentin may pass into human milk. The effect of Gabapentin on milk production and breastfed baby is unknown. The benefits and clinical need of Gabapentin in the mother should be considered along with its side effects on the baby.

Younger Adults Population

Possibly safe
Warning: The safety and effectiveness of Gabapentin to treat partial seizures together with primary treatment in children aged below 3 years have not been established. Also, the use of Gabapentin in the management of nerve pain due to untreated herpes viral infection (postherpetic neuralgia) has not been established in children. The benefits and risks should be considered while using Gabapentin for a long term.

Older Adults Population

Precaution
Warning: Gabapentin is mainly excreted by the kidney. The dose for an elderly patient should be carefully selected usually starting at the low dose due to a higher incidence of reduced liver, kidney, heart function in the elderly and having other concurrent disease or drug therapy.

Gabapentin Side-effects

The following side-effects may commonly occur when using Gabapentin. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in older patients on the use of Gabapentin. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • fluid accumulation causing swelling of the limbs
  • lack of energy
  • lack of voluntary coordination of muscle movements
  • sleepiness
The following side-effects may commonly occur in children when using Gabapentin. Discuss with your doctor if any of these side-effects last for a long time or are severe:
Rarely, the use of Gabapentin may cause the following side-effects:
  • abnormal voluntary movement (dyskinesia)
  • chest pain
  • decreased bodily movement (hypokinesia)
  • enlargement of male breast
  • enlargement of the breast (breast hypertrophy)
  • fall
  • hair loss
  • involuntary movements (choreoathetosis)
  • involuntary muscle contractions (dystonia)
  • leaking of urine (incontinence)
  • mental disorder
  • muscle spasm
  • palpitation
  • ringing in the ears (tinnitus)
  • sexual dysfunction
  • sweating
  • swelling of the lips
  • swelling of the trunk and limbs
  • swelling of tongue
  • swollen glands
The following severe side-effects may also occur when using Gabapentin:
Your doctor has prescribed Gabapentin because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Gabapentin.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Gabapentin by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Older Adults

Following are the side-effects of this medicine in elderly patients:

Side-effects in Children

Following are the side-effects of this medicine in young patients:

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
If such symptoms appear, contact the doctor immediately.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Patients who drive or operate heavy machinery

The patients who use Gabapentin may suffer from sleepiness and dizziness, this may affect the patient's ability to drive. The patients are advised not to drive vehicle and operate machinery while using this medicine.

Sleepiness and dizziness

The patients with nerve pain due to untreated herpes viral infection are at an increased risk while using this medicine. Such patients are at risk of sleepiness, dizziness, confusion, loss of consciousness, and mental disorders. Such patients should take caution while using Gabapentin. The patients using Gabapentin with other sedative drugs must be carefully observed for CNS depression such as sleepiness and sedation due to the possibility of an additive effect. The use of Gabapentin with morphine may require dosage adjustment.

Slow and ineffective breathing

The patients with nervous system disorder, respiratory disorder, kidney dysfunction, using other CNS depressants and the elderly are at an increased risk while using this medicine. Such patients are at risk of slow and ineffective breathing. The dosage adjustment may be required in such patients.

Abuse and dependence

The patients with a history of drug abuse are at an increased risk while using this medicine. Such patients may experience symptoms of drug abuse, for example, drug-seeking behavior, developing tolerance or increasing the dose consumption. The patients with a history of drug abuse should be carefully evaluated and observed for the presence of such symptoms.

Patients with birth defects

The patients with rare birth defects such as Lapp lactase deficiency, galactose intolerance, or decreased absorption of glucose-galactose are at an increased risk. The medicinal product of Gabapentin which contains lactose is not recommended in such patients.

Multi-organ allergic reaction

Drug reaction with eosinophilia and systemic symptoms (DRESS)/multi-organ allergic reaction can be life-threatening or possibly fatal. This drug reaction may be accompanied by rash, fever, increase in the number of a type of white blood cells or disease of lymph nodes. It may involve other organ systems, such as inflammation of the kidneys or liver, blood disorders, inflammation of the muscles, inflammation of heart membrane (myocarditis), sometimes look like a viral infection. If such symptoms appear, examine the patient for the presence of multi-organ allergic reaction (known as DRESS) and if such drug reaction is confirmed Gabapentin should be discontinued immediately.

Suicidal thoughts and behavior

The patients treated with Gabapentin are at an increased risk while using this medicine. Such patients may experience an increase in suicidal thoughts or behavior, developing depression, worsening of the depression, any abnormal fluctuations in behavior or mood. The doctor must consider the risk of suicidal thoughts or behavior to untreated illness before prescribing this medicine in such patients. The patients should be advised to remain alert and carefully monitored for the emergence of such symptoms. If such symptoms appear, contact the doctor immediately and take appropriate treatment.

Neuropsychiatric disorders

The children with epilepsy of age 3-12 years are at an increased risk while using this medicine. The patients are at risk of developing central nervous system disorders such as aggressive behavior, hatred, emotional lability mainly behavioral problems, thought disorder, difficulty while focusing, restlessness, hyperactivity, and changes in school performance.

Inflammation of the pancreas

The patients are at an increased risk of inflammation of the pancreas (acute pancreatitis) while using this medicine. If the patient develops such condition, the discontinuation of Gabapentin should be considered.

Seizures

The patients with epilepsy are at an increased risk while using this medicine. The sudden withdrawal of Gabapentin in such patients may precipitate a life-threatening seizure disorder (called as status epilepticus). Some patients may also experience increased seizure frequency or occurrence of new types of seizures while using Gabapentin. Gabapentin should be used with caution in patients with absence seizures or mixed seizures.

Interactions with Gabapentin

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Gabapentin may interact with hydrocodone, which is used to relieve pain. The use of Gabapentin in patients taking hydrocodone can decrease the effect of hydrocodone. Such patients should take caution while starting or discontinuing Gabapentin.
There may be an interaction of Gabapentin with morphine, which is used to relieve pain. The use of Gabapentin with morphine may cause slow and ineffective breathing, sedation, and sleepiness. Such patients should be monitored for the signs of CNS depression and slow and ineffective breathing.
Gabapentin interacts with Maalox, which is used to treat acidity. The use of Gabapentin with an antacid containing magnesium and aluminum hydroxide may cause a decrease in the amount of Gabapentin in the blood. Gabapentin should be taken only after 2 hours following an antacid containing magnesium and aluminum hydroxide.
Special instructions need to be followed while taking this medicine along with a dipstick test, which is used to diagnose urinary proteins. The use of Gabapentin with other antiepileptic medicines may cause false positive results of a dipstick test. The use of sulfosalicylic acid precipitation procedure is considered to determine the presence of urinary protein in such patients.
This page does not contain all the possible interactions of Gabapentin. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Interactions of Gabapentin by Severity

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Gabapentin be not used?

Severe allergy

This medicine is not recommended in patients who are allergic to Gabapentin. These patients may have the following symptoms if they use this medicine:

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Gabapentin is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Gabapentin .
Viral Infections
Diabetic Neuropathy
Seizures
Brain Diseases

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