Gabapentin is Used to Treat Seizures and Postherpetic Neuralgia ?

What is gabapentin?

Gabapentin is a prescription drug. It comes as an oral capsule, an immediate-release oral tablet, an extended-release oral tablet, and an oral solution.

Gabapentin oral capsule is available as the brand-name drug Neurontin. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.

Why it’s used

Currently, gabapentin has FDA approval for:

    • Postherpetic neuralgia
    • Adjunctive therapy in the treatment of partial seizures with or without secondary generalization in patients over the age of 12 years old with epilepsy, and the pediatric population, 3 to 12 year-olds with a partial seizure
    • Moderate to severe restless leg syndrome (RLS) moderate to severe

It also has off-label use for neuropathic pain, fibromyalgia, bipolar disorder, postmenopausal hot flashes, essential tremors, anxiety, resistant depressant and mood disorders, irritable bowel syndrome (IBS), alcohol withdrawal, postoperative analgesia, nausea and vomiting, migraine prophylaxis, headache, interstitial cystitis, painful diabetic neuropathy, social phobia, generalized tonic-clonic seizures, pruritus (itching), insomnia, post-traumatic stress disorder (PTSD), and refractory chronic cough.

Gabapentin oral capsule is used to treat the following conditions:

    • Seizures: Gabapentin is used to treat partial (focal) seizures. It’s taken together with other seizure medications in adults and in children 3 years of age and older who have epilepsy.
    • Postherpetic neuralgia: This is pain from nerve damage caused by shingles, a painful rash that affects adults. Shingles appears after infection with the varicella zoster virus. This virus occurs in people who have had chicken pox.

Nerve pain can be a symptom of many different conditions, including cancer, HIV, diabetes, and shingles. For some, nerve pain is frustrating; for others, nerve pain is devastating and life-changing.

Whether it feels like burning, pinpricks, or sudden shocks of electricity, nerve pain can disrupt your life at home and at work. It can limit your ability to get around. Over time, it can grind you down. Studies show that people with nerve pain have higher rates of sleep problems,anxiety, and depression.Your nervous system is involved in everything your body does, from regulating your breathing to controlling your muscles and sensing heat and cold.

There are three types of nerves in the body:

    1. Autonomic nerves. These nerves control the involuntary or partially voluntary activities of your body, including heart rate, blood pressure, digestion, and temperature regulation.
    2. Motor nerves. These nerves control your movements and actions by passing information from your brain and spinal cord to your muscles.
    3. Sensory nerves. These nerves relay information from your skin and muscles back to your spinal cord and brain. The information is then processed to let you feel pain and other sensations.

Because nerves are essential to all you do, nerve pain and damage can seriously affect your quality of life.

When you have a serious medical condition such as cancer or HIV, dealing with the additional misery of nerve pain can be especially hard. But there is good news. While nerve pain can’t always be cured, it can be treated — and there are a lot of good options available.

Experts believe that 40 million Americans are living with nerve pain. The impact of nerve pain is tremendous. Both the costs to the healthcare system as well as loss of wages and productivity are staggering.

What is Postherpetic Neuralgia ?

Postherpetic neuralgia (post-hur-PET-ik noo-RAL-juh) is the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear.

The chickenpox (herpes zoster) virus causes shingles. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time.

How Are Nerve Pain and Nerve Damage Treated?

In many instances, nerve damage cannot be cured entirely. But there are various treatments that can reduce your symptoms. Because nerve damage is often progressive, it is important to consult with a doctor when you first notice symptoms. That way you can reduce the likelihood of permanent damage.

Often, the first goal of treatment is to address the underlying condition that’s causing your nerve pain or nerve damage. This may mean:

    • Regulating blood sugar levels for people with diabetes
    • Correcting nutritional deficiencies
    • Changing medications when drugs are causing nerve damage
    • Physical therapy or surgery to address compression or trauma to nerves
    • Medications to treat autoimmune conditions

Additionally, your doctor may prescribe medications aimed at minimizing the nerve pain you are feeling. These may include:

    • Pain relievers
    • Tricyclic antidepressants
    • Certain anti-seizure drugs – Gabapentin

Complementary and alternative approaches may also help alleviate your nerve pain and discomfort. These include:

    • Acupuncture
    • Biofeedback
    • Hypnosis
    • Meditation

Dosage for postherpetic neuralgia

Adult dosage (ages 18–64 years)

    • Typical starting dosage: Day 1, 300 mg; day 2, 600 mg (300 mg two times per day, spaced evenly throughout the day); day 3, 900 mg (300 mg, three times per day, spaced evenly throughout the day). Your doctor may further increase your dosage after day 3.
    • Maximum dosage: 1,800 mg per day (600 mg, three times per day, spaced evenly throughout the day)

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years has not been established.

Senior dosage (ages 65 years and older)

Your kidney function may decrease with age. Your body may get rid of this drug more slowly. Your doctor may start you on a lower dose so that too much of this drug does not build up in your body. Too much of the drug in your body can be dangerous. Your doctor may change your dose based on how well your kidneys are working.

Gabapentin in Non-Epilepsy Neuropathic Pain like Postherpetic Neuralgia

The FDA approved gabapentin for the management of postherpetic neuralgia in adults. Recently, gabapentin underwent systemic evaluation in the management of diabetic neuropathy. In 1998, Rowbotham and his research team concluded that in 229 postherpetic neuralgia patients, gabapentin had more significant pain reduction as early as two weeks after initiating the treatment.

Furthermore, other measurements of mood, depression, anger-hostility, fatigue, and physical functioning, were more effectively managed with gabapentin compared to placebo.

During the same time, Backonja reviewed the effect of gabapentin in 165 diabetic neuropathy patients and showed the result that pain reduction in the gabapentin group is greater (as measured with an 11-point Likert scale) in comparison to the placebo group. And the results were significant from 2 weeks of initiation of therapy and stayed significant during the eight weeks of study.

Patients in the treatment group also reported improvement in their quality of life. This medication was well tolerated in 67% of patients who received a maximum daily dosage of 3600 mg.

Treatment for Postherpetic neuralgia

Postherpetic neuralgia is a nerve disease occurs after an attack of herpes zoster infection. Herpes zoster or ‘shingles’ is a viral infection which affects the skin, especially sides of the chest, caused by varicella zoster virus. This is the same virus which causes chicken pox in children.

After an episode of herpes, the virus remains dormant in the nerve tissues of the body. This virus may become active when the immunity of the individual reduces or during convalescence after a major illness, resulting in blisters on the skin, known as shingles. It is accompanied with a rash which disappears without major consequences in about two to four weeks. Around 50% of individuals with shingles go on to develop post herpetic neuralgia (PHN) or after-shingles pain.

The neuralgia begins when the herpetic eruptions begin to heal. The pain appears usually in the affected dermatone or the affected nerve course and results in severe pain in the region which has the same nerve supply. The pain is a drawing, pricking type of intense pain, sometimes accompanied with burning sensation of the skin. The pain lasts from a few weeks to few months, rarely years.

Uploaded Image

 Causes

      • Severe rash within three days of shingles infection
      • A study shows that, 65% of patients were women
      • The chances of developing PHN, increases when the shingles occurs in persons over 50 years.
      • The incidence of herpes zoster is up to 15 times higher in HIV-infected patients than in uninfected persons, and as many as 25 percent of patients with Hodgkin’s lymphoma develop herpes zoster.
      • Blacks are one fourth as likely as whites to develop this condition.
      • Site of HZ involvement
        • Lower risk – Jaw, neck, sacral, and lumbar
        • Moderate risk – Thoracic
        • Highest risk – Trigeminal (especially ophthalmic division), brachial plexus.

Signs and symptoms:

    • A pain that continues for 3 months or more, after the healing of shingles, is defined as PHN.
    • PHN pain may be burning, aching, itching and sharp and the pain can be constant or it can come and go
    • The skin which was affected with blisters, may show scarring
    • The involved dermatome may show altered sensations, either hypersensitivity or reduced sensitivity.
    • In rare cases, where if the nerves involved also control muscle movement, the patient might also experience muscle weakness, tremor or paralysis

Postherpetic Neuralgia Treatment:

The conventional treatment is directed at pain control while waiting for the condition to resolve.  Pain therapy may include multiple interventions, such as topical medications, over-the-counter analgesics, tricyclic antidepressants,  anticonvulsants and a number of non medical modalities. Occasionally, narcotics may be required.

When it comes to treating postherpetic neuralgia, you may need to take a combination of medications to effectively manage your pain and other PHN symptoms. No single treatment plan is right for everyone—what medications you take will depend on your PHN symptoms.

While symptoms differ from person to person, for most people, PHN does improve over time. Researchers found that more than half of all patients with PHN stop experiencing pain within one year.1

Fortunately, during that period of intense pain and other symptoms, there are certain medications that you can take to significantly help control postherpetic neuralgia symptoms.

Before trying a prescription medication, your doctor will most likely want you to try an over-the counter (OTC) analgesic (painkiller) medication, such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). These medications can help relieve pain and other PHN symptoms.

Tylenol is an example of acetaminophen, and Advil is an example of an NSAID you can take to help treat PHN.

Another OTC medication you may want to try for PHN is capsaicin cream. This cream—made from hot chili pepper seeds—is applied to the affected skin, and it can be helpful for reducing PHN-related pain. But this cream can be painful, so talk to your doctor about how much you should apply.

If these medications aren’t strong enough to treat your PHN symptoms, your doctor may suggest some of the prescription medications below to treat your postherpetic neuralgia.

    • Tricyclic antidepressants, such as amitriptyline (Elavil), nortriptyline (Pamelor), and desipramine (Norpramin) are effective at treating postherpetic neuralgia pain. Other classes of antidepressant are also helpful. All classes of antidepressant take a few weeks to start working.
    • Anticonvulsants, developed to control seizures, can help reduce the pain of PHN. These include gabapentin (Neurontin), carbamazepine (Tegretol) and pregabalin (Lyrica). Gabapentin enacarbil (Horizant) and gabapentin (Gralise) are approved by the FDA for the treatment of PHN in adults.
    • Anti-viral drugs valacyclovir and acyclovir are also becoming medications of choice for treating postherpetic neuralgia.
    • Lidocaine Patches for Postherpetic Neuralgia. Lidocaine patches are FDA-approved to treat PHN. The medication in the patch—lidocaine—can penetrate your skin and go to the nerves that are sending the pain signals. A benefit of lidocaine patches is that they don’t numb the skin.
    • Prescription capsaicin patches. These patches contain a very high concentration of the chili pepper extract capsaicin. The capsaicin patch Qutenza is applied in a doctor’s office for one hour every three months.

If you have severe pain and other medications don’t work for you, your doctor may want you to try an opioid.  Tramadol (eg, Ultram) is an example of a relatively weak opioid that can be used to help you manage PHN. Your doctor may have you try a weaker opioid first.  Opioids, such as morphine (MS Contin), oxycodone (OxyContin), and hydrocodone (Vidocin), are also used to treat moderate to severe pain of postherpetic neuralgia.

Homoeopathic Medicine:

Mezereum – For Postherpetic Neuralgia with Intense Burning

Mezereum is rated among the best medicines for postherpetic neuralgia. It is the best-suited prescription when postherpetic neuralgic pains are violent and attended with marked burning.  Mezereum is the most helpful among medicines for postherpetic neuralgia in postherpetic pains located in the face. The pain in the face may get worse while eating.

Warmth brings relief. Mezereum is also helpful during active herpes zoster where eruptions are present. The key symptoms to look out for before prescribing Mezereum during herpes zoster infection are violently itching vesicles with shining red areola and intense burning.

2. Ranunculus Bulbosus – For Pains coming in Paroxysms

Another of the prominently indicated medicines for postherpetic neuralgia is Ranunculus Bulbosus. It is indicated for sharp, shooting, postherpetic neuralgic pains that come in paroxysms.

It is also one of the top listed medicines for intercostal neuralgia following herpetic infection. Ranunculus Bulbosus is also indicated for herpes zoster when the vesicles eruptions are bluish in colour. The eruptions are attended with itching and burning symptoms which worsen on contact.

3. Rhus Tox – One of the best Medicines for Postherpetic Neuralgia

Rhus Tox also figures on the list of highly effective medicines for postherpetic neuralgia. It is one of the best medicines for postherpetic neuralgia where the pains are attended with marked restlessness. The skin is sensitive to cold air in such cases. In herpes zoster, Rhus Tox is the most preferred among medicines when the vesicles are yellowish with itching and stinging.

 

Adverse Reactions in Pooled Placebo-Controlled Trials in Postherpetic Neuralgia

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Postherpetic Neuralgia

The most common adverse reactions associated with the use of NEURONTIN in adults, not seen at an equivalent frequency among placebo-treated patients, were dizziness, somnolence, and peripheral edema.

In the 2 controlled trials in postherpetic neuralgia, 16% of the 336 patients who received NEURONTIN and 9% of the 227 patients who received placebo discontinued treatment because of an adverse reaction. The adverse reactions that most frequently led to withdrawal in NEURONTIN-treated patients were dizziness, somnolence, and nausea.

Following table lists adverse reactions that occurred in at least 1% of NEURONTIN-treated patients with postherpetic neuralgia participating in placebo-controlled trials and that were numerically more frequent in the NEURONTIN group than in the placebo group.

TABLE 3. Adverse Reactions in Pooled Placebo-Controlled Trials in Postherpetic Neuralgia
NEURONTIN
N=336
%
Placebo
N=227
%
Reported as blurred vision
Body as a Whole
  Asthenia 6 5
  Infection 5 4
  Accidental injury 3 1
Digestive System
  Diarrhea 6 3
  Dry mouth 5 1
  Constipation 4 2
  Nausea 4 3
  Vomiting 3 2
Metabolic and Nutritional Disorders
  Peripheral edema 8 2
  Weight gain 2 0
  Hyperglycemia 1 0
Nervous System
  Dizziness 28 8
  Somnolence 21 5
  Ataxia 3 0
  Abnormal thinking 3 0
  Abnormal gait 2 0
  Incoordination 2 0
Respiratory System
  Pharyngitis 1 0
Special Senses
  Amblyopia 3 1
  Conjunctivitis 1 0
  Diplopia 1 0
  Otitis media 1 0

Other reactions in more than 1% of patients but equally or more frequent in the placebo group included pain, tremor, neuralgia, back pain, dyspepsia, dyspnea, and flu syndrome.

There were no clinically important differences between men and women in the types and incidence of adverse reactions. Because there were few patients whose race was reported as other than white, there are insufficient data to support a statement regarding the distribution of adverse reactions by race.

 

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What is gabapentin?

Gabapentin is a prescription drug. It comes as an oral capsule, an immediate-release oral tablet, an extended-release oral tablet, and an oral solution.

Gabapentin oral capsule is available as the brand-name drug Neurontin. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.

Gabapentin (Generic Neurontin ) was developed to treat epilepsy, but it is now used to treat various forms of chronic pain. It works by reducing the number of signals sent through the nerves. If the signals are reduced then the pain will be reduced. Research has shown that Gabapentin can help in treating various types of nerve pain.

Why Gabapentin is used

Gabapentin oral capsule is used to treat the following conditions:

    • Seizures: Gabapentin is used to treat partial (focal) seizures. It’s taken together with other seizure medications in adults and in children 3 years of age and older who have epilepsy.
    • Postherpetic neuralgia: This is pain from nerve damage caused by shingles, a painful rash that affects adults. Shingles appears after infection with the varicella zoster virus. This virus occurs in people who have had chicken pox.

Gabapentin may be used as part of a combination therapy. This means you may need to take it with other drugs.

How Gabapentin works

gabapentin mechanism of actions
gabapentin mechanism of actions

Gabapentin belongs to a class of drugs called anticonvulsants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

It’s not fully understood how gabapentin works. For postherpetic neuralgia, it seems to prevent the increase in sensitivity to pain that occurs. For seizures, it may alter the effect of calcium (low levels of calcium may cause seizures).

 Gabapentin off-label usages

Some Research Team performed searches to look for clinical trials where gabapentin was used to treat neuropathic pain or fibromyalgia. They found that 5633 participants had been involved in 37 studies of reasonable quality.  They tested gabapentin against placebo for four weeks or more.  Studies lasting only one or two weeks are unhelpful when pain can last for years.

Neuropathic pain is pain coming from damaged nerves. It differs from pain messages carried along healthy nerves from damaged tissue (a fall, cut, or arthritic knee).

Neuropathic pain is treated by different medicines than pain from damagedtissue. Medicines like paracetamol or ibuprofen are not effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain.

Our understanding of fibromyalgia (a condition of persistent, widespread pain and tenderness, sleep problems, and fatigue) is poor, but fibromyalgia can respond to the same medicines as neuropathic pain.

Gabapentin is helpful for some people with chronic neuropathic pain or fibromyalgia. Gabapentin comes as a capsule, tablet, or solution. You take it by mouth. Gabapentin is available as the brand-name drugs Neurontin, Gralise, and Horizant.  It’s also available as a generic drug.

By Drugs.com, Gabapentin Can be used for a lot of Nerve Pain related health conditions. Gabapentin is also used for a lot of off-label usage such as  Cough, Hot Flashes, Alcohol Withdrawal, Anxiety 161 reviews, Bipolar Disorder, Trigeminal Neuralgia, Postherpetic Neuralgia, Migraine, Insomnia, Occipital Neuralgia, Peripheral Neuropathy,Vulvodynia, Benign Essential Tremor, Epilepsy, Fibromyalgia, Pain Relief, Diabetic Peripheral Neuropathy , Neuropathic Pain,Reflex Sympathetic Dystrophy Syndrome,Periodic Limb Movement Disorder, Spondylolisthesis, Burning Mouth Syndrome,Pudendal Neuralgia, Small Fiber Neuropathy.

A lot of Patients use Gabapentin (Neurontin) to treat Hot Flashes, Anxiety, Bipolar Disorder, Migraine, Insomnia, Restless Legs Syndrome, Peripheral Neuropathy, Fibromyalgia, Neuropathic Pain. Fe patients use gabapentin to treat Pruritus, Cough, Occipital Neuralgia, Benign Essential Tremor, ement Disorder, Spondylolisthesis, Burning Mouth Syndrome, Pudendal Neuralgia, Small Fiber Neuropathy.

There are totally 1359 reviews on Gabapentin, only eleven reviews are on Epilepsy whereas 1348 reviews are on Gabapentin Off-label usage. The most widely usage of Gabapentin is for Anxiety ( 243 Reviews ), Pain Relief ( 241 Reviews ), Fibromyalgia ( 137 Reviews ), Peripheral Neuropathy (119 reviews ), Bipolar Disorder ( 83 reviews ), Migraine ( 79 reviews), Neuropathic Pain ( 75 reviews ), Hot Flashes (70 reviews ), Restless Legs Syndrome (61 Reviews ) and Insomnia ( 59 reviews). The most effective usage of Gabapentin is for Pruritus and Cough.

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DIN (Drug Identification Number)
02084260     Neurontin 100 mg capsule
02084279     Neurontin 300 mg capsule
02084287     Neurontin 400 mg capsule
02239717     Neurontin 600 mg tablet
02239718     Neurontin 800 mg tablet
How long will I have to take Gabapentin for?

This is different for different people. In general, Gabapentin will have to be taken for as long as you are requiring pain relief for nerve pain. Do not stop taking your Gabapentin suddenly if you have been taking it for a while. Your body will be used to the Gabapentin and stopping it suddenly may cause withdrawal symptoms. Reducing the dose slowly as advised by your pain specialist or GP will help stop withdrawal symptoms happening. You may wish to reduce the dose every so often, to check nerve pain is still a problem.

How to take Gabapentin ?

The dose of gabapentin required varies from person to person. To avoid side effects we build up to the dose gradually. The tables in this leaflet show you how this can be done. Some patients can put their dose up faster than others. We call this faster way the FAST TRACK (see table 1).

If you find you are getting side effects with the fast track way of putting your dose up, you can switch to the SLOWER METHOD. ( see table 2).ther people will need to put their dose up less quickly over a number of weeks. This is THE SLOWER METHOD .

As with any medication it is important to check how well it works.  With gabapentin this can be in a few days but for most patients may take 4-8 weeks to assess the full benefit. If you feel you are getting no benefit from this medication please discuss this with your GP or pain specialist.

Gabapentin other Off-label usages

Gabapentin is one drug that researchers have studied for preventing migraines. It has a high safety profile and few side effects. This makes it a good option for Migraine prevention.  Results from some clinical trials have shown a modest benefit from the use of gabapentin for migraine prevention.

However, the American Academy of Neurology (AAN), the organization that provides guidance for the use of drugs to prevent migraines, has stated that there is not enough evidence at this time to support the use of gabapentin for migraine prevention. Healthcare professionals can choose to prescribe gabapentin when other prevention therapies have not worked, however.

Gabapentin has been proven to be effective for people who have hard-to-treat depression or other mood disorders.  Neurontin is not your traditional anxiety drug. It’s a drug primarily described to those with bipolar disorder, not anxiety. Bipolar disorder is a complicated mental health problem.

Gabapentin was successful in helping with rapid cycling and mixed bipolar states in people who have not received relief from valproate or carbamazepine. It appeared that Gabapentin helped more with anxiety and agitation than the other two drugs.

It has also been shown that Gabapentin could aid people with certain types of tardive dyskinesia. That’s why anyone that has been prescribed Neurontin should strongly consider taking it, despite the side effects above and questions about its effectiveness. Bipolar disorder is not something that should be left to chance.

The total number of patients treated with NEURONTIN in controlled clinical trials in patients with postherpetic neuralgia was 336, of which 102 (30%) were 65 to 74 years of age, and 168 (50%) were 75 years of age and older. There was a larger treatment effect in patients 75 years of age and older compared with younger patients who received the same dosage. Since gabapentin is almost exclusively eliminated by renal excretion, the larger treatment effect observed in patients ≥ 75 years may be a consequence of increased gabapentin exposure for a given dose that results from an age-related decrease in renal function.

However, other factors cannot be excluded. The types and incidence of adverse reactions were similar across age groups except for peripheral edema and ataxia, which tended to increase in incidence with age.

Clinical studies of NEURONTIN in epilepsy did not include sufficient numbers of subjects aged 65 and over to determine whether they responded differently from younger subjects.

Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and dose should be adjusted based on creatinine clearance values in these patients.

What form(s) does this medication come in?

Capsules

100 mg – Each hard gelatin Coni-Snap capsule, with white opaque body and cap printed with “PD” on one side and “Neurontin/100 mg” on the other, contains gabapentin 100 mg.

300 mg – Each hard gelatin Coni-Snap capsule, with yellow opaque body and cap printed with “PD” on one side and “Neurontin/300 mg” on the other, contains gabapentin 300 mg.

400 mg – Each hard gelatin Coni-Snap capsule, with orange opaque body and cap printed with “PD” on one side and “Neurontin/400 mg” on the other, contains gabapentin 400 mg.

Tablets

600 mg – Each white, elliptical, film-coated tablet with “Neurontin 600” printed on one side contains gabapentin 600 mg.

800 mg –  Each white, elliptical, film-coated tablet with “Neurontin 800” printed on one side contains gabapentin 800 mg.

How to take gabapentin

The gabapentin dosage your doctor prescribes will depend on several factors. These include:

      • the type and severity of the condition you’re using gabapentin to treat
      • your age
      • the form of gabapentin you take
      • other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

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Normally Gabapentin is suitable for all adult and children bigger than six years old. But you are not allowed to order Gabapentin online especially in our online pharmacies if you have any of following health conditions (But you are OK to order in your local street pharmacies):

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      5. kidney disease,liver disease and heart diseases;
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We hope you can refill your Gabapentin online using our online pharmacy. You have already checked by your local doctors and they have prescribed you Gabapentin.  After your first prescription, you can order in our websites. Our doctors and pharmacists will review your health conditions too and it is much easier for you to understand the gabapentin prescription you are taking.

Gabapentin may interact with other medications

Gabapentin oral capsule can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with gabapentin. This list does not contain all drugs that may interact with gabapentin.

Before taking gabapentin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Pain drugs

When used with gabapentin, certain pain drugs can increase its side effects, such as tiredness. Examples of these drugs include:

  • morphine

Stomach acid drugs

When used with gabapentin, certain drugs used to treat stomach acid problems can reduce the amount of gabapentin in your body. This can make it less effective. Taking gabapentin 2 hours after taking these drugs can help prevent this problem. Examples of these drugs include:

  • aluminum hydroxide
  • magnesium hydroxide

What Diseases Gabapentin can treat ?

Gabapentin was developed to treat epilepsy, but it is now used to treat various forms of chronic pain. It works by reducing the number of signals sent through the nerves. If the signals are reduced then the pain will be reduced. Research has shown that Gabapentin can help in treating various types of nerve pain.

Some Research Team performed searches to look for clinical trials where gabapentin was used to treat neuropathic pain or fibromyalgia. They found that 5633 participants had been involved in 37 studies of reasonable quality.  They tested gabapentin against placebo for four weeks or more.  Studies lasting only one or two weeks are unhelpful when pain can last for years.

Neuropathic pain is pain coming from damaged nerves. It differs from pain messages carried along healthy nerves from damaged tissue (a fall, cut, or arthritic knee). Neuropathic pain is treated by different medicines than pain from damagedtissue.

Medicines like paracetamol or ibuprofen are not effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain.  Our understanding of fibromyalgia (a condition of persistent, widespread pain and tenderness, sleep problems, and fatigue) is poor, but fibromyalgia can respond to the same medicines as neuropathic pain.

Gabapentin and Fioricet are not recommended for a long term use. If you want to reduce your pain for a long time purpose, we suggest you to take some anti-aging products and natural Pain relief products.

By drus.com, Gabapentin Can be used for a lot of Nerve Pain related health conditions. including Cough, Hot Flashes, Alcohol Withdrawal, Anxiety 161 reviews, Bipolar Disorder, Trigeminal Neuralgia, Postherpetic Neuralgia, Migraine, Insomnia, Occipital Neuralgia, Peripheral Neuropathy,Vulvodynia, Benign Essential Tremor, Epilepsy, Fibromyalgia, Pain Relief, Diabetic Peripheral Neuropathy , Neuropathic Pain,Reflex Sympathetic Dystrophy Syndrome,Periodic Limb Movement Disorder, Spondylolisthesis, Burning Mouth Syndrome,Pudendal Neuralgia, Small Fiber Neuropathy.

A lot of Patients use Gabapentin (Neurontin) to treat Hot Flashes, Anxiety, Bipolar Disorder, Migraine, Insomnia, Restless Legs Syndrome, Peripheral Neuropathy, Fibromyalgia, Neuropathic Pain. Fe patients use gabapentin to treat Pruritus, Cough, Occipital Neuralgia, Benign Essential Tremor, ement Disorder, Spondylolisthesis, Burning Mouth Syndrome, Pudendal Neuralgia, Small Fiber Neuropathy.

What are the Precautions When Taking Gabapentin (Neurontin®)?

Gabapentin (brand name: Neurontin) is a generic prescription drug that is FDA-approved as an add-on treatment with other medications for partial seizures in those with epilepsy. It can also be used to treat nerve pain from postherpetic neuralgia (a complication of shingles).  Gabapentin is frequently prescribed off-label for many other conditions, such as diabetic peripheral neuropathy, fibromyalgia, and alcohol dependence. 

Gabapentin is typically prescribed as a generic, but the drug is also available under the brand names Neurontin and Gralise. Some patients may be prescribed drugs very similar to gabapentin—such as Horizant (gabapentin enacarbil) or Lyrica (pregabalin)—instead of gabapentin. 

Gabapentin is taken as a tablet, capsule, or oral liquid. Dosing will depend on the condition being treated, age of the person being treated, and kidney function. The usual dose for epilepsy starts at 300 mg on the first day. The dose can then be increased until an effective dose is reached, which is usually 300 to 600mg taken three times per day.

Forms and Strengths

Gabapentin Forms and Strength
Gabapentin Forms and Strength

Generic: Gabapentin

    • Form: oral capsule
    • Strengths: 100 mg, 300 mg, 400 mg

Brand: Neurontin

    • Form: oral capsule
    • Strengths: 100 mg, 300 mg, 400 mg

Dosage for postherpetic neuralgia

Adult dosage (ages 18–64 years)

  • Typical starting dosage: Day 1, 300 mg; day 2, 600 mg (300 mg two times per day, spaced evenly throughout the day); day 3, 900 mg (300 mg, three times per day, spaced evenly throughout the day). Your doctor may further increase your dosage after day 3.
  • Maximum dosage: 1,800 mg per day (600 mg, three times per day, spaced evenly throughout the day)

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years has not been established.

Senior dosage (ages 65 years and older)

Your kidney function may decrease with age. Your body may get rid of this drug more slowly. Your doctor may start you on a lower dose so that too much of this drug does not build up in your body. Too much of the drug in your body can be dangerous. Your doctor may change your dose based on how well your kidneys are working.

This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using Gabapentin (buy neurontin® online), tell your doctor or pharmacist your medical history, especially of: kidney disease, mental/mood problems (such as depression, thoughts of suicide), use/abuse of drugs/alcohol.

This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially swelling of the hands/ankles/feet, dizziness, or loss of coordination. Dizziness and loss of coordination can increase the risk of falling.

Children may be more sensitive to the side effects of this drug, especially mental/mood/behavior changes (such as hostility, problems concentrating, restlessness).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

Gabapentin passes into breast milk. Consult your doctor before breast-feeding.

Gabapentin OVERDOSE

A lethal dose of gabapentin was not identified in mice and rats receiving single oral doses as high as 8000 mg/kg. Signs of acute toxicity in animals included ataxia, labored breathing, ptosis, sedation, hypoactivity, or excitation.

Acute oral overdoses of NEURONTIN up to 49 grams have been reported. In these cases, double vision, slurred speech, drowsiness, lethargy, and diarrhea were observed. All patients recovered with supportive care. Coma, resolving with dialysis, has been reported in patients with chronic renal failure who were treated with NEURONTIN.

Gabapentin can be removed by hemodialysis. Although hemodialysis has not been performed in the few overdose cases reported, it may be indicated by the patient’s clinical state or in patients with significant renal impairment.

If overexposure occurs, call your poison control center at 1-800-222-1222.

 

Gabapentin may interact with other medications

 

Gabapentin oral capsule can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with gabapentin. This list does not contain all drugs that may interact with gabapentin.

Before taking gabapentin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Pain drugs

When used with gabapentin, certain pain drugs can increase its side effects, such as tiredness. Examples of these drugs include:

  • morphine

Stomach acid drugs

When used with gabapentin, certain drugs used to treat stomach acid problems can reduce the amount of gabapentin in your body. This can make it less effective. Taking gabapentin 2 hours after taking these drugs can help prevent this problem. Examples of these drugs include:

  • aluminum hydroxide
  • magnesium hydroxide

Important considerations for taking gabapentin

 

Keep these considerations in mind if your doctor prescribes gabapentin oral capsule for you.

General

Gabapentin oral capsules can be taken with or without food. Taking them with food can help to reduce upset stomach.

Storage

  • Store gabapentin at room temperature between 68°F and 77°F (20°C and 25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Be sure to carry with you the prescription-labeled box that your medication came in.
  • Do not put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will monitor your kidney function.

Insurance

Many insurance companies require a prior authorization for gabapentin. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.