Gabapentin

Brand names of gabapentin

  • Neurontin

FDA approved gabapentin in December 1993 as an anticonvulsant. It is taken to prevent seizures and is also used for treating postherpetic neuralgia. Structurally gabapentin is similar to gamma aminobutyric acid (GABA) which is actually a neurotransmitter. The similarity possibly comes from gabapentin's mode of action, though how it works is not defined. When tested on animals for anticonvulsant and analgesic reaction it was found that gabapentin reduced seizures and pain related responses.

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Things you need to tell your physician before taking gabapentin

Before you begin taking gabapentin your doctor must be informed if you are allergic to it or to any other medication. It could be a possibility that you are allergic to any of the inactive ingredients in the various types of gabapentin that you might be planning on taking. The pharmacist could probably supply you with a list of the inactive ingredients.

The doctor must also know what prescription and non-prescription medicaments, vitamins, nutritional supplements and herbal products you might be taking or planning to take so that he can change the dosage of your medication and also monitor you for side effects, if required. If you are on antacids like Maalox or Mylanta, it is advisable to take them at least 2 hours before you take gabapentin.

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Other conditions like kidney disease, pregnancy or if you are breast feeding need to be reported to your doctor and if by chance you do become pregnant while on gabapentin your doctor must know immediately. Your surgeon and dentist need to know you are on gabapentin in case they recommend surgical proceedings for you.

Gabapentin could make you dizzy or drowsy and so caution is required till you know how the medication affects you so driving a car or operating any kind of machinery should be avoided. Alcohol is another substance that should be shunned while on gabapentin as it can add to the drowsiness.

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There might be some changes in the behaviour and mental abilities of your child while on gabapentin. The child may have mood swings, become hostile or hyperactive. Other reactions the child might show are that the child might find it hard to concentrate or pay attention or may become drowsy and hence clumsy. Should the child be on gabapentin then activities like riding a bicycle which could cause harm should be avoided until the affects of the drug become clearly known.

While taking gabapentin for epilepsy, mental illness or other symptoms your mental health could change unexpectedly too and suicidal thoughts could enter your mind and you could plan or actually harm or kill yourself. It was found in clinical studies that adults and children above 5 years who took anti-epileptics like gabapentin became suicidal while on treatment.

Suicidal thoughts could appear as early as one week after commencement of medication. After taking gabapentin your mental health might change but there is a risk of your mental health changing also if your condition goes untreated. So before you begin gabapentin discuss the pros and cons of taking or not taking the medication with the doctor.

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If you are on gabapentin, your family, caregiver and you should be aware of these symptoms and must seek help if you experience panic attack, anxiety, depression worsening or new irritability, agitation or restlessness, impulsive dangerous behaviour. If you find it hard to sleep or are experiencing aggressive, angry or manic behaviour or entertaining suicidal thoughts that could result in harming yourself or are withdrawing from friends and giving away your prized possessions then you are perhaps reacting to the medication and hence family and caregivers should take you to a doctor for consultation in case you cannot reach the doctor by yourself.

Usage

Gabapentin along with other medications is mainly prescribed to control seizures in children above 3 years and in adults. Besides this, it is also used in adults for relieving pain in the nerves caused by shingles or herpes zoster infection.

How to use gabapentin

The medication is taken orally, with or without food. Take it whichever way the doctor directs. Your medical condition including your response to therapy will be the deciding factor in prescribing the dosage. It is possible that the doctor will increase the dose gradually over the first few days as your body adjusts to the medication.

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Aluminium and magnesium in antacids interferes with absorption of gabapentin and so these antacids are best taken two hours prior to gabapentin.

The very first dose of gabapentin should be taken at bedtime so that any side effects could be minimized. Henceforth it should be taken regularly and at equally paced intervals, during the 24 hour period, for the medication to show the best results as the level of medication in the body will then remain constant. The medicine should neither be increased nor taken more nor less often than what the doctor directed. Your condition is not likely to improve faster if you take more; in fact the side effects could harm you seriously. Seizures could become worse if the medication is suddenly stopped and so gabapentin should be decreased gradually in consultation with the doctor. The doctor also needs to be informed if your condition becomes worse or shows no improvement.

How gabapentin works

How gabapentin actually works is not known but it curtails the activity in that part of the brain where seizures originate and so the suppressed neurons cannot trigger the mechanism that causes seizures.

Side effects

Serious
  • fever
  • swollen glands
  • blistering or peeling skin lesions
  • easy bruising
  • weakness
  • lethargy
  • sore throat
  • mouth sores
  • paleness
  • confusion
  • seizures can be an indication of a potentially deadly blood disorder (aplastic anemia) or other problem
Common
Less common

Possible interactions

Minerals and herbal remedies like ma huang (ephedra) can cause the blood pressure to accelerate and can also cause increased sympathetic stimulation. Other herbal remedies like ginseng, saw palmetto, hawthorn, eleuthero root (Siberian ginseng), licorice and goldenseal could also affect blood pressure increase. Alcohol needs to be taken with caution as imbibing excessive quantities over a long period could cause gabapentin to lose its effectiveness in preventing seizures.

Discontinuation

Consult your doctor before you discontinue gabapentin as a sudden withdrawal could lead to serious and repetitive seizures. The doctor would probably advise a slow withdrawal to prevent a reaction. Sometimes sudden withdrawal could land the patient in serious trouble as it could cause a condition known as status epilepticus where seizures are continuous.

It is also beneficial for a patient to speak with the healthcare provider to determine whether the suicidal tendencies are due to the medication or because of some other reasons.

Children between 3 to 12 years, who are treated with gabapentin for seizures sometimes experience emotional changes, aggressive and restless behaviour. There could be concentration problems leading to hyperactivity and could affect the performance of the child in school.

Storage instructions

Normally gabapentin is stored away from light and moisture at 25°Celsius. It can be stored below room temperature for short periods. Medicines should be kept away from pets and children and should not be stored in the bathroom. The medication should not be flushed down or discarded on expiry in the drain unless advised by the pharmacist or the area waste disposal company who could also guide you as to its proper disposal.

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