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Gabapentin
Gabapentin is an anticonvulsant/antiepileptic medication used to treat various conditions such as epilepsy, nerve pain, and certain types of seizures. It may also be prescribed off-label for other conditions like anxiety or sleep disturbances.
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Frequently Asked Questions
Can gabapentin be used for anxiety or sleep problems?
It can sometimes be prescribed off-label for these conditions, but it's primarily used for epilepsy and nerve-related pain.
Is gabapentin addictive?
Gabapentin has a lower risk of addiction compared to some other medications, but it's important to take it as prescribed and not misuse or abuse it.
Can I drive or operate machinery while taking gabapentin?
It can cause drowsiness and dizziness in some people, so it's best to assess how it affects you before engaging in activities that require alertness.
How long does it take for gabapentin to start working?
The effects may vary, but some people may start to notice improvements in their symptoms within a few days or weeks of starting treatment.
Can I stop taking gabapentin abruptly?
It's generally recommended to gradually reduce the dose under the guidance of a healthcare professional to avoid potential withdrawal symptoms.
Comprehensive Drug Guide
How Does Gabapentin Work?
Gabapentin acts on the central nervous system. It is structurally similar to the neurotransmitter GABA, yet it does not interact with GABA receptors. Instead, its mechanism of action involves the inhibition of 2 subunit-containing voltage-dependent calcium channels, which ultimately reduces the release of excitatory neurotransmitters and modulates neural excitement.
What is Gabapentin Used For?
Gabapentin is approved by the FDA for the management of postherpetic neuralgia in adults and as an adjunctive therapy in the treatment of partial-onset seizures in pediatric patients (aged 3 years and older) and adults.
Gabapentin is also used off-label for a variety of conditions including fibromyalgia, neuropathic pain, restless legs syndrome, alcohol withdrawal, and anxiety disorders.
Common Dosages
Gabapentin is commonly manufactured in the following formulations:
Capsules: 100 mg, 300 mg, and 400 mg.
Tablets: 600 mg and 800 mg.
Oral solution: 250 mg per 5 mL.
Extended-release tablets (brand name Gralise): 300 mg and 600 mg.
Typical Dosing
FDA Approved Indications
Postherpetic Neuralgia: Begin at a dose of 300 mg on day one, 600 mg on day two, and 900 mg on day three, then adjust as needed up to a maximum dose of 1800 mg per day.
Partial-Onset Seizures (Adults and Pediatric Patients over 12 years): Begin with 300 mg three times daily and may increase to as much as 2400 mg per day.
Off-Label Uses
Neuropathic pain: The typical starting dose is 300 mg on day one, 600 mg on day two, and 900 mg on day three, and can be further up-titrated according to symptom severity. It's always important to consult with a healthcare provider for dosing information related to off-label uses of gabapentin.
Who Shouldn't Take Gabapentin?
- Allergy or hypersensitivity to gabapentin or any of its components
- Kidney problems or impaired kidney function
- History of specific mental health conditions, such as depression or suicidal thoughts
- History of substance abuse or addiction
Advice From The Pharmacist
- Be aware of possible side effects like drowsiness or dizziness and avoid activities that require alertness until you know how gabapentin affects you.
- If you have kidney problems, discuss this with your doctor, as the dose may need to be adjusted.
Side Effects of Gabapentin
Common Side Effects
- Drowsiness or sleepiness
- Dizziness or lightheadedness
- Fatigue or tiredness
- Difficulty concentrating or thinking
- Nausea or upset stomach
Uncommon/Severe Side Effects
- Allergic reactions such as rash, hives, or swelling of the face, lips, or tongue
- Difficulty breathing or chest pain
- Suicidal thoughts or behavior
- Yellowing of the skin or eyes (jaundice)
- Persistent fever or signs of infection
Risks and Warnings of Gabapentin
- Gabapentin may cause drowsiness or dizziness, so be careful when driving or doing activities that require alertness.
- It's important to take gabapentin exactly as prescribed by your doctor and not stop it abruptly without consulting them.
- Some people may experience changes in mood or behavior while taking gabapentin, so let your doctor know if you notice any unusual feelings or thoughts.
Interactions with Gabapentin
Common Drug Interactions
- Antacids (e.g., aluminum hydroxide, magnesium hydroxide)
- Opioids (e.g., morphine, oxycodone)
- Antidepressants (e.g., fluoxetine, sertraline)
- Antiepileptic drugs (e.g., carbamazepine, phenytoin)
- Sedatives or tranquilizers (e.g., lorazepam, diazepam)
- Diuretics (e.g., furosemide, hydrochlorothiazide)
Alternatives to Gabapentin
- Pregabalin (Lyrica)
- Carbamazepine (Tegretol)
- Lamotrigine (Lamictal)
- Topiramate (Topamax)
- Valproic acid (Depakote)
- Levetiracetam (Keppra)
