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Neurontin

Neurontin, the brand name for gabapentin, is a medication primarily used to treat seizures, nerve pain (neuropathy), and restless legs syndrome (RLS). It belongs to the class of anticonvulsants and is often prescribed for conditions like postherpetic neuralgia (pain following shingles) and as an adjunctive therapy for seizures in people with epilepsy. Gabapentin helps by stabilizing electrical activity in the brain and reducing the intensity of nerve pain.

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Frequently Asked Questions

How long does it take for Neurontin to work?
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For nerve pain, it can take a few days to a few weeks to notice the full effects of Neurontin. For seizures, it is typically effective soon after reaching the target dose.

Can I take Neurontin long-term?
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Yes, Neurontin can be taken long-term, but it should be done under the guidance of your healthcare provider. Regular follow-ups are recommended to monitor for any side effects or the need for dosage adjustments.

What should I do if I miss a dose?
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If you miss a dose of Neurontin, take it as soon as you remember. If it’s close to your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at once.

Can Neurontin cause weight gain?
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Yes, weight gain is a potential side effect of Neurontin. It is more commonly seen with long-term use. Speak with your healthcare provider if you have concerns about weight changes.

Is Neurontin addictive?
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While Neurontin itself is not considered addictive, it has been associated with abuse, particularly in individuals taking it in combination with opioids or other substances. Always take Neurontin as prescribed and inform your doctor of any concerns.

Comprehensive Drug Guide

How Does Neurontin Work?

While the exact mechanism of action for Neurontin is not fully understood, it is believed to work by affecting GABA receptors (a neurotransmitter involved in calming nerve activity) and modulating calcium channels in the brain and nervous system. This helps reduce the abnormal brain activity that causes seizures and decreases the nerve signals responsible for chronic pain.

Common Dosages

  • Capsules: 100 mg, 300 mg, 400 mg
  • Tablets: 600 mg, 800 mg
  • Oral solution: 250 mg per 5 mL

Typical Dosing

  • For partial seizures: The starting dose is typically 300 mg taken three times a day, with adjustments based on the patient’s response and tolerance. Doses can be increased up to 1800 mg per day.
  • For postherpetic neuralgia: The starting dose is often 300 mg on the first day, increasing to 300 mg three times daily. The maximum recommended dose is 1800 mg per day.
  • For restless legs syndrome (RLS): Doses typically start at 300 mg, taken in the evening.

Typical Dosing

FDA Approved Indications

  • Partial seizures (as adjunct therapy) in adults and children over 3 years old
  • Postherpetic neuralgia (nerve pain following shingles)

Off-label uses include:

  • Restless legs syndrome (RLS)
  • Peripheral neuropathy due to diabetes or other conditions
  • Fibromyalgia
  • Anxiety disorders

Who Shouldn't Take Neurontin?

  • A known allergy or hypersensitivity to gabapentin or any of the components in its formulation.

Advice From The Pharmacist

  • Neurontin should be taken at the same time(s) each day to maintain consistent levels in your body.
  • It is important to taper off Neurontin gradually under medical supervision if discontinuing the medication, as stopping abruptly can cause withdrawal symptoms or worsen seizures.
  • Avoid drinking alcohol while taking Neurontin, as it can enhance the sedative effects of the drug.
  • Store Neurontin at room temperature and away from moisture and light.
  • Inform your healthcare provider of any changes in mood or unusual behavior, as gabapentin may increase the risk of suicidal thoughts in some individuals.

Side Effects of Neurontin

Common Side Effects

  • Drowsiness
  • Dizziness
  • Fatigue
  • Swelling of the legs or ankles
  • Weight gain

Uncommon/Severe Side Effects

  • Changes in mood or behavior (such as depression or suicidal thoughts)
  • Difficulty breathing or shortness of breath
  • Severe allergic reactions (rash, itching, swelling)
  • Muscle weakness or loss of coordination

Risks and Warnings of Neurontin

  • Suicidal Thoughts: Neurontin may increase the risk of suicidal thoughts or behaviors in a small number of individuals. Patients should be closely monitored for changes in mood or behavior.
  • CNS Depression: Neurontin can cause central nervous system (CNS) depression, leading to drowsiness, dizziness, and impaired coordination. Caution is advised when driving or operating heavy machinery.
  • Respiratory Depression: Taking Neurontin in combination with opioids or other sedatives can increase the risk of severe respiratory depression. Always inform your doctor of all medications you are taking.

Interactions with Neurontin

Common Drug Interactions

  • Opioids: Taking Neurontin with opioids like morphine or hydrocodone can increase the risk of respiratory depression and sedation.
  • Antacids: Antacids containing aluminum or magnesium may reduce the absorption of Neurontin. It is recommended to take Neurontin at least two hours after taking an antacid.
  • CNS Depressants: Combining Neurontin with other CNS depressants (such as alcohol, benzodiazepines, or muscle relaxants) can enhance drowsiness and impair cognitive function.

Alternatives to Neurontin

  • Lyrica (pregabalin): A similar anticonvulsant and neuropathic pain agent, often used when Neurontin is not effective.
  • Carbamazepine: Another anticonvulsant used to treat seizures and nerve pain.
  • Duloxetine (Cymbalta): An antidepressant that is also used for chronic pain conditions, including fibromyalgia and diabetic neuropathy.
  • Topiramate: An anticonvulsant used for epilepsy and migraine prevention.