Gabapentin

Gabapentin can be taken by adults and children aged 6 years and over.

Gabapentin is not suitable for some people.

To make sure gabapentin is safe for you, tell your doctor if you:

• have ever had an allergic reaction to gabapentin or other medicines in the past
• have ever misused or been addicted to a medicine
• are trying to get pregnant, pregnant or breastfeeding
• are on a controlled sodium or potassium diet, or your kidneys do not work well (gabapentin liquid contains sodium and potassium, so speak to your doctor before taking it)

Pregnancy and breastfeeding

Gabapentin is not generally recommended in pregnancy. There is no firm evidence that it is harmful to an unborn baby, but for safety pregnant women are usually advised to take it only if the benefits of the medicine outweigh the potential harm.

If you take gabapentin for epilepsy and become pregnant, do not stop the medicine without talking to your doctor first.

It is very important that epilepsy is treated during pregnancy as seizures can harm you and your unborn baby.

If you are trying to get pregnant or have become pregnant, you are routinely recommended to take at least 400mcg of a vitamin called folic acid everyday. It helps the unborn baby grow normally.

Pregnant women who take gabapentin are recommended to take a higher dose of folic acid.

Your doctor might prescribe a high dose of 5mg a day for you to take during the first 12 weeks of pregnancy.

If you take gabapentin around the time of giving birth, your baby may need extra monitoring for a few days after they are born because they may have gabapentin withdrawal symptoms.

Gabapentin and breastfeeding

Usually, you can breastfeed while taking gabapentin.

Check with your doctor first though if your baby is premature or has kidney problems.

Non-urgent advice: Tell your doctor if you are:

• trying to get pregnant
• pregnant
• breastfeeding

Gabapentin is a prescription medicine. It’s important to take it as advised by your doctor.

How much to take

The usual dose of Gabapentin to:

• treat epilepsy in adults and older children (aged 12 years and over) is between 900mg and 3,600mg a day split into 3 doses
• treat nerve pain in adults is between 900mg and 3,600mg a day split into 3 doses
• prevent migraine in adults varies, but can be up to 2,400mg a day split into 3 doses

The dose of gabapentin used to treat epilepsy in younger children (aged 6 to 12 years) varies depending on their weight.

If you are taking gabapentin as a liquid, 1ml is usually the same as taking a 50mg tablet or capsule. Always check the label.

How to take it

Swallow gabapentin capsules and tablets whole with a drink of water or juice. Do not chew them.

You can take gabapentin with or without food, but it is best to do the same each day. Try to space your doses evenly through the day. For example, first thing in the morning, early afternoon and at bedtime.

If you or your child are taking a liquid, it will come with a plastic syringe or spoon to measure your dose.

Do not use a kitchen spoon, as it will not give the right amount. If you do not have a spoon, ask your pharmacist for one.

Will my dose go up or down?

To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few days. Once you find a dose that suits you, it will usually stay the same.

How long will I take it for?

If you have epilepsy, it is likely that once your illness is under control you will still need to take gabapentin for many years.

If you have nerve pain, it is likely that once the pain has gone, you will continue to take gabapentin for several months to stop it coming back.

What if I forget to take it?

If you forget a dose, take it as soon as you remember. If it is within 2 hours of the next dose, it is better to leave out the missed dose and take your next dose as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you have epilepsy, it is important to take this medicine regularly. Missing doses may trigger a seizure. If you forget doses often, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Taking too much gabapentin by accident can cause unpleasant side effects.

Urgent advice: Call your doctor or go to the hospital straight away if you take too much gabapentin and you:

• feel dizzy or sleepy
• see double
• start slurring your words
• have diarrhoea
• pass out

If you need to go to hospital, take the gabapentin packet or leaflet inside it, plus any remaining medicine, with you.

Like all medicines, gabapentin can cause side effects, although not everyone gets them.

Common side effects

These common side effects may happen in more than 1 in 100 people. They are usually mild and go away by themselves.

Keep taking the medicine, but talk to your doctor if these side effects bother you or do not go away:

• feeling sleepy, tired or dizzy
• feeling sick (nausea)
• being sick (vomiting) and diarrhoea
• getting more infections than usual
• mood changes
• swollen arms and legs
• blurred vision
• dry mouth
• difficulties for men getting an erection
• weight gain – gabapentin can make you feel hungry
• memory problems
• headaches

Serious side effects

Very few people taking gabapentin have serious problems.

Call a doctor straight away if you have a serious side effect, including:

• thoughts of harming or killing yourself – a small number of people taking gabapentin have had suicidal thoughts, which can happen after only a week of treatment
• yellowing of your skin or whites of your eyes – these may be warning signs of jaundice
• unusual bruises or bleeding – these may be warning signs of a blood disorder
• long-lasting stomach pain, feeling sick or vomiting – these may be warning signs of an inflamed pancreas
• muscle pain or weakness and you are having dialysis treatment because of kidney failure
• hallucinations

Serious allergic reaction

In rare cases, it is possible to have a serious allergic reaction (anaphylaxis) to gabapentin.

Immediate action required: Go to the hospital if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you are wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of gabapentin. For a full list, see the leaflet inside your medicines packet.

How to cope with side effects

What to do about:

• feeling sleepy, tired or dizzy – As your body gets used to gabapentin, these side effects should wear off. If they do not wear off within a week or two, your doctor may reduce your dose or increase it more slowly. If that does not work, you may need to switch to a different medicine.

• feeling sick (nausea) – Take gabapentin with or after a meal or snack. It may also help if you do not eat rich or spicy food.

• being sick (vomiting) and diarrhoea – Drink plenty of water or other fluids to avoid dehydration. Take small sips if you feel sick. Signs of dehydration include peeing less than usual or having dark strong-smelling pee. Do not take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor.

• mood changes – If you feel this medicine is causing mood changes, talk to your doctor. You may be able to change to an alternative medicine.

• swollen arms and legs – Try sitting with your feet raised and try not to stand for a long time. Gently exercising your arms might help. Talk to your doctor if this does not get better.

• blurred vision – Avoid driving or using tools or machines while this is happening. If it lasts for more than a day or two, speak to your doctor as they may need to change your treatment.

• a dry mouth – Chew sugar-free gum or suck sugar-free sweets.

• difficulties for men getting an erection – Speak to your doctor, as they may be able to change your medicine or offer other treatments that might help with this problem.

• weight gain – Gabapentin can make you hungrier, so it can be quite a challenge to stop yourself putting on weight. Try to eat a healthy, balanced diet without increasing your portion sizes. Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets. If you feel hungry between meals, eat fruit and vegetables and low-calorie foods. Regular exercise will also help to keep your weight stable.

• memory problems – If you are having problems with your memory, speak to your doctor. They may want to try a different medicine.

• headaches – Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking gabapentin. Talk to your doctor if they last longer than a week or are severe.

Cautions with other medicines

There are not usually any problems mixing gabapentin with other medicines.

Some indigestion remedies, called antacids, reduce the amount of gabapentin that the body takes in so it does not work as well. To stop this happening, take an antacid at least 2 hours before or after your dose of gabapentin.

For safety, tell your doctor if you are taking these medicines before you start Gabapentin treatment:

• strong painkillers, such as morphine – these can increase the tiredness and dizziness you can feel when you start gabapentin
• antidepressants, such as amitriptyline or fluoxetine
• antipsychotic medicines for mental health problems like schizophrenia or bipolar disorder
• a medicine to prevent malaria called mefloquine
• a weight loss medicine called Orlistat – it may stop gabapentin working as well

Mixing Gabapentin with herbal remedies or supplements

There are no known problems with taking herbal remedies and supplements with gabapentin.

Important

For safety, tell your doctor or pharmacist if you are taking any other medicines, including herbal remedies, vitamins or supplements.

How does Gabapentin work?

In epilepsy, it is thought that gabapentin stops seizures by reducing the abnormal electrical activity in the brain.

With nerve pain and migraine, it is thought to interfere with pain messages travelling through the brain and down the spine to block pain.

When will I feel better?

It takes a few weeks for gabapentin to work properly. You may still have seizures or pain during this time.

Can I get addicted to Gabapentin?

Some people have become addicted to gabapentin after taking it for a long time. If this happens, you will have withdrawal symptoms after you stop taking the medicine.

Talk to your doctor if you are concerned about becoming physically dependent on gabapentin.

Are there similar medicines to Gabapentin?

Pregabalin (also called Lyrica) is a medicine that works in a similar way to gabapentin. Like gabapentin, it is taken for epilepsy and nerve pain. It can also be taken for anxiety. But there are differences between pregabalin and gabapentin.

Pregabalin can be taken less often and in different doses to gabapentin.

If you need to change to pregabalin treatment, your doctor will explain how to safely swap from gabapentin.

Is Gabapentin a controlled medicine?

This means there are strict rules on how it is prescribed and dispensed to make sure it is not given to the wrong person or misused.

Should I stick to the same brand of Gabapentin?

Most people do not have to stay on the same brand of gabapentin as there is very little difference between brands. Talk to your doctor if you have been asked to switch to a different brand and are worried about that.

If your epilepsy has been hard to control in the past and the brand you are now taking is working well for you, your doctor may recommend you stay on the same one.

Is it safe to take it for a long time?

There is no evidence that gabapentin has lasting harmful effects, even if you take it for many months or years.

What will happen when I come off it?

Do not stop taking gabapentin suddenly, even if you feel fine. Stopping gabapentin suddenly can cause serious problems.

If you have epilepsy, stopping gabapentin suddenly can cause seizures that will not stop. If you are taking it for any reason and stop suddenly, you may have a severe withdrawal syndrome.

This can have unpleasant symptoms, including:

• anxiety
• difficulty sleeping
• feeling sick
• pain
• sweating

It is possible to prevent withdrawal seizures and other symptoms by gradually reducing the dose of gabapentin. Do not stop taking gabapentin without talking to your doctor – you will need to reduce your dose gradually.

Will recreational drugs affect it?

Gabapentin can intensify the highs of recreational drugs like cannabis and heroin. So, if you use recreational drugs alongside gabapentin, there may be more chance of unpleasant side effects like panic attacks, anxiety and memory loss.

Can I drink alcohol with it?

Yes, you can drink alcohol with gabapentin. But it may make you feel sleepy or tired.

During the first few days of taking gabapentin, it might be best to stop drinking alcohol until you see how the medicine affects you.

Will it affect my fertility?

There is no firm evidence to suggest that taking gabapentin will reduce fertility in either men or women. But speak to a pharmacist or your doctor before taking it if you are trying to get pregnant.

Will it affect my contraception?

Gabapentin does not affect any type of contraception, including the combined contraceptive pill and emergency contraception.

Can I drive or ride a bike?

You may feel sleepy, tired or dizzy when you first start taking gabapentin. This may also happen if your dose has increased. If this happens to you, do not drive or ride a bike until you feel better.

If you have epilepsy, you are not allowed to drive until you have had no seizures for 1 year, or if you only have seizures while you are asleep. If you change your epilepsy medicine, your doctor will tell you whether you need to stop driving and for how long.