What To Know About Neurontin (Gabapentin)

Neurontin is a type of medication used to treat seizures in adults and children who are living with certain types of seizure disorders. It belongs to a class of drugs known as anticonvulsants.

It works by decreasing the brain’s vulnerability to having seizures and can also help to reduce pain. Neurontin is also available as a generic medication sold under the name gabapentin. It comes as a tablet or an oral solution.

What is the most important information I should know about Neurontin?

  • You should not take Neurontin if you have a known hypersensitivity to gabapentin or other ingredients in this medication.
  • This medication should be used with caution if you are an older adult or have COPD. Report any difficulty breathing to your doctor immediately.

Uses for Neurontin 

Neurontin is approved by the FDA for the treatment of the following conditions:1

  • Seizures: This medication is used to reduce the occurrence of seizures in children and adults with epilepsy. It can be taken alongside other seizure medication. However, this medication isn’t a cure for epilepsy and will only help to treat seizures for as long as you take the medication.
  • Postherpetic neuralgia: Postherptic neuralgia is a condition that causes persistent nerve pain in people who have had shingles. It especially affects people who are older. Neurontin is also used to treat this nerve pain.

Off-Label Uses

Neurontin is sometimes prescribed off-label for the treatment of the following conditions:

  • Bipolar disorder: Bipolar disorder is a mental condition that causes sudden and extreme changes, in mood, energy levels, and daily functioning. These moods can range from irritable and sad to happy and energetic with no warning.2
  • Fibromyalgia: Fibromyalgia is a condition that causes you to experience widespread and continuous pain throughout your body. The pain could feel like a burning sensation, a sharp pain, or an ache.3
  • Migraines: A migraine is a type of headache that causes severe pain, which is often accompanied by nausea and a sensitivity to light, loud sounds, and physical activity. A migraine can last for hours and, in severe cases, days. Some research suggests Neurontin may also be helpful for chronic daily headaches.4
  • Anxiety: Neurotonin is used off-label for certain types of anxiety5 as it a less potential for abuse than medications like benzodiazepines. There is some potential for abuse with this medication, however.

A 2015 systematic review concluded that further research is needed to better understand gabapentin’s role in the treatment of mental health disorders.5

Before Taking Neurontin 

Before taking this medicine you should go over the list of active and inactive ingredients with your doctor to make sure you are not allergic to any ingredient in it.

Gabapentin is the active ingredient in Neurontin, signs of an allergic reaction to gabapentin include swelling of the tongue, throat, or face, hives, and difficulty breathing.

If you are pregnant or plan to become pregnant while taking this medication, please inform your doctor. There is not a lot of data on the effects of Neurotonin in pregnancy, and is generally avoided if possible. One study found some evidence of an increased risk for cardiac malformations linked to gabapentin exposure in early pregnancy.6

It’s a great practice to keep your doctor updated on all medication you might be using when pregnant.

You should also tell your doctor if you have any history of the following conditions:

  • Liver disease
  • Diabetes
  • Depression
  • Heart disease
  • Lung disease
  • Seizures
  • Drug addiction

Precautions and Contraindications 

Neurontin has been found to potentially contribute to respiratory suppression in people with chronic obstructive pulmonary disease and elderly people.7 If you notice you have trouble breathing while using this medication, contact your doctor immediately.

Some people have reported an increase in suicidal thoughts and behaviors when using these types of medications. If you notice a sudden change in your moods and behaviors or begging to experience suicidal thoughts, alert your doctor about this.

Other Types of Gabapentin

Gralise and Horizant are two other brand-name drugs that contain gabapentin as an active ingredient.

  • Gralise: Gralise, which is not available in the U.S., is indicated for the treatment of nerve pain after shingles.8
  • Horizant: Horizant has been approved by the FDA for the treatment of nerve pain and restless leg syndrome. It’s best for this medication to be taken in the latter part of the day with food, for effective results.9

Neurontin Dosage

Your doctor is most likely to consider a couple of things when deciding your dosage for Neurontin. They’ll consider the severity of your condition, other medications you might be taking, and your tolerability (the degree to which a patient can handle adverse effects of a particular treatment)10 of the drug.

However, the manufacturer also recommends the following dosages for these conditions:

  • Epileptic seizures: An initial dose of 300 milligrams is given on day one, 300 milligrams twice a day on day two, and 300 milligrams three times a day on day three. This is followed up by a maintenance dose of 300 to 600 milligrams given three times daily, depending on a person’s tolerability of the medication. A maximum dose of 3,600 milligrams in one day where this dosage is spread out over the course of the day (i.e., a 1,200 mg dose would be taken at three points during the day).1
  • Nerve pain: As with epilepsy, an initial dose of 300 milligrams is given on day one, 300 milligrams twice a day on day two, and 300 milligrams three times a day on day three. However, the maximum dose for this condition is 1,800 milligrams (i.e., the patient might take three 600 milligrams doses during the course of a day).1

Modifications 

Neurontin is not indicated for children younger than three years old. For children, the initial dose ranges between 10 to 15 milligrams for each kilogram of their weight. A patient might be directed to take one 10 or 15 mg dose at three separate times of the day (morning, afternoon and night).1

How to Take and Store 

You can take Neurontin with or without food. Swallow any pill you take whole, without chewing or crushing it.

If you miss a dose, take it as soon as you remember, but if it’s time for your next dose, skip the missed dose—don’t double your dose.

In many cases, Neurontin is prescribed to be taken three times a day. You shouldn’t take all three doses at once or close together. Try to take your first dose in the morning, the second in the afternoon, and the last at bedtime.11

Side Effects of Neurontin

Some people might experience adverse effects while using Neurontin, most are mild and will go away with time. In rare cases, these side effects might be more severe or worsen. If you notice any lingering or unbearable side effects while using this medication, you should speak with your doctor.

Common 

Some common but mild side effects you might experience while using this medication include:1

  • Insomnia
  • Anxiety
  • Mood swings
  • Headache
  • Dizziness
  • Tiredness
  • Nausea and vomiting in children

Severe 

In rare cases, you might experience more severe side effects such as:1

  • More frequent seizures
  • Difficulty breathing
  • Extreme fatigue
  • Confusion
  • Extreme drowsiness

If you experience any of the above side effects, contact emergency health services and your doctor immediately.

Neurontin Warnings and Interactions 

This medication can cause drowsiness, and taking alcohol alongside this medication can worsen this side effect. If you are about to go in for any kind of surgery, including dental surgery, inform your doctor that you are currently taking Neurontin.

This medication might also make you lose coordination and slow down your reflexes. You shouldn’t drive or operate heavy machinery until you’ve monitored how this medication affects you.

Watch out for changes in moods and behaviors if you have a child who’s taking Neurontin. They might experience sudden mood swings, become more hyperactive, or have difficulty paying attention.

Neurontin could interact adversely with other medications. It’s important to give your doctor a full list of any other medication, vitamins, and supplements you might be taking alongside this medication to prevent adverse effects.12

In rare cases, stopping Neurontin abruptly could cause withdrawal symptoms like tremors, high blood pressure, and gastrointestinal problems.

Do not stop taking your medication without talking to your doctor first. They may recommend gradually tapering your dose over time to minimize potential withdrawal effects.

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