Jeffrey Panko NP Psychiatry · Patient education
Gabapentin
Neurontin / Gralise / Generic formulations
A guide for adults taking gabapentin.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Immediate-release capsules, tablets, and solution have different schedules from Gralise extended-release tablets. Gabapentin enacarbil (Horizant) is a different formulation with separate indications and dosing.
What it is used for
Gabapentin treats certain seizures and postherpetic nerve pain. Providers also use it off-label for some other pain or anxiety-related conditions. Evidence differs by condition; it is not an established bipolar mood stabilizer.
How it works
It binds to the alpha-2-delta part of calcium channels and changes release of excitatory nerve messengers. Despite its name, it does not act directly like GABA or a benzodiazepine.
What to expect over time
The dose is often increased gradually to balance benefit and side effects. Track the condition being treated and report changes after each adjustment.
Taking your medication
- Follow your formulation’s schedule. Immediate-release doses are often divided across the day.
- Gralise is taken with the evening meal and swallowed whole. Do not copy those instructions to another formulation.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- Consult with your provider before stopping; gradual reduction is usually needed.
When to get help
Emergency symptoms. Call 911 for slow breathing, blue lips, inability to wake, a severe allergic reaction, or a prolonged or repeated seizure.
Prompt medical advice. Contact your provider promptly for a new rash, severe unsteadiness, unusual confusion, or major changes in mood or behavior.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Sleepiness, dizziness, or unsteadiness
- Swelling of the legs or feet
- Fatigue, blurred vision, or weight gain
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Report changes in mood, behavior, concentration, or suicidal thoughts. Antiseizure medicines carry a warning about suicidal thoughts and behavior.
Keep follow-up appointments. Your provider may adjust treatment based on symptoms, kidney or liver function, other medicines, and any recommended laboratory tests.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss kidney or liver disease, previous medication rashes, depression, and the reason for treatment.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Kidney function determines dosing. Discuss lung disease, sleep apnea, opioid use, and any history of medication misuse.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Opioids, benzodiazepines, alcohol, and other sedatives can increase the risk of dangerously slow breathing.
Aluminum- or magnesium-containing antacids reduce absorption; gabapentin is generally taken at least two hours after them.
Everyday tips
Use reminders and arrange refills before you run out.
Avoid driving until you know how treatment affects you; seizure-related driving restrictions may also apply.
Your questions answered
Can I stop if I feel well?
Consult with your provider before stopping. Abrupt withdrawal can cause seizures or a return of the condition being treated.
Does use for seizures mean I have epilepsy?
Not necessarily. Some antiseizure medicines have other approved or off-label uses. Confirm the specific goal of your prescription.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.