Gabapentin for Neuropathy
Brand names: Gabarone®
Neurontin®
Why is this medication prescribed?
Pending revision, the
material in this section should be considered in light
of more recently available information in the MedWatch
notification at the beginning of this monograph.
Gabapentin is
used to help control certain types of seizures in
patients who have epilepsy. Gabapentin is also used to
relieve the pain of postherpetic neuralgia (PHN; the
burning, stabbing pain or aches that may last for months
or years after an attack of shingles). Gabapentin is in
a class of medications called anticonvulsants.
Gabapentin treats seizures by decreasing abnormal
excitement in the brain. Gabapentin relieves the pain of
PHN by changing the way the body senses pain.
How should this medicine be used?
Gabapentin comes as a
capsule, a tablet, and an oral solution (liquid) to take
by mouth. It is usually taken with a full glass of water
(8 oz) three times a day. Gabapentin may be taken with
or without food. Take this medication at evenly spaced
times throughout the day and night; do not let more than
12 hours pass between doses. Follow the directions on
your prescription label carefully, and ask your doctor
or pharmacist to explain any part you do not understand.
Take gabapentin exactly as directed. Do not take more or
less of it or take it more often than prescribed by your
doctor.
If your doctor tells
you to take one-half of a tablet as part of your dose,
carefully split the tablet along the score mark. Use the
other half-tablet as part of your next dose. Properly
throw away any half-tablets that you have not used
within several days of breaking them.
Your doctor will
probably start you on a low dose of gabapentin and
gradually increase your dose as needed to treat your
condition. If you are taking gabapentin to treat PHN,
tell your doctor if your symptoms do not improve during
your treatment.
Gabapentin may help
to control your condition but will not cure it. Continue
to take gabapentin even if you feel well. Do not stop
taking gabapentin without talking to your doctor. If you
suddenly stop taking gabapentin, you may experience
withdrawal symptoms such as anxiety, difficulty falling
asleep or staying asleep, nausea, pain, and sweating. If
you are taking gabapentin to treat seizures and you
suddenly stop taking the medication, you may experience
seizures more often. Your doctor probably will decrease
your dose gradually over at least a week.
Other uses for this medicine
Gabapentin is also
sometimes used to relieve the pain of diabetic
neuropathy (numbness or tingling due to nerve damage in
people who have diabetes), and to treat and prevent hot
flashes (sudden strong feelings of heat and sweating) in
women who are being treated for breast cancer or who
have experienced menopause ('change of life', the end of
monthly menstrual periods). Talk to your doctor about
the risks of using this medication for your condition.
This medication may
be prescribed for other uses; ask your doctor or
pharmacist for more information.
What special precautions should I
follow?
Pending revision, the
material in this section should be considered in light
of more recently available information in the MedWatch
notification at the beginning of this monograph.
Before taking
gabapentin,
tell your doctor and pharmacist if you
are allergic to gabapentin, any other medications, or
any of the inactive ingredients in the type of
gabapentin you plan to take. Ask your pharmacist for a
list of the inactive ingredients.
tell your doctor and pharmacist what
prescription and nonprescription medications, vitamins,
nutritional supplements, and herbal products you are
taking or plan to take. Be sure to mention any of the
following: hydrocodone (in Hydrocet, in Vicodin,
others), morphine (Avinza, Kadian, MSIR, others), and
naproxen (Aleve, Anaprox, Naprosyn, others). Your doctor
may need to change the doses of your medications or
monitor you carefully for side effects.
if you are taking antacids such as
Maalox or Mylanta, take them at least 2 hours before you
take gabapentin.
tell your doctor if you have or have
ever had kidney disease.
tell your doctor if you are pregnant,
plan to become pregnant, or are breast-feeding. If you
become pregnant while taking gabapentin, call your
doctor.
if you are having surgery, including
dental surgery, tell the doctor or dentist that you are
taking gabapentin.
you should know that this medication
may make you drowsy or dizzy. Do not drive a car or
operate machinery until you know how this medication
affects you.
if you are giving gabapentin to your
child, you should know that your child's behavior and
mental abilities may change while he or she is taking
gabapentin. Your child may have sudden changes in mood,
become hostile or hyperactive, have difficulty
concentrating or paying attention, or be drowsy or
clumsy. Have your child avoid activities that could be
dangerous, such as riding a bicycle, until you know how
gabapentin affects him or her.
remember that alcohol can add to the
drowsiness caused by this medication.
What special dietary instructions
should I follow?
Unless your doctor
tells you otherwise, continue your normal diet.
What should I do if I forget a dose?
Take the missed dose
as soon as you remember it. However, if it is almost
time for the next dose, skip the missed dose and
continue your regular dosing schedule. Do not take a
double dose to make up for a missed one.
What side effects can this medication
cause?
Pending revision, the
material in this section should be considered in light
of more recently available information in the MedWatch
notification at the beginning of this monograph.
Gabapentin may cause
side effects. Tell your doctor if any of these symptoms
are severe or do not go away:
Gabapentin may cause
other side effects. Call your doctor if you have any
unusual problems while taking this medication.
If you experience a
serious side effect, you or your doctor may send a
report to the Food and Drug Administration's (FDA)
Medwatch Advers Event reporting Program or by
phone [1-800-332-1088].
What storage conditions are needed
for this medicine?
Keep this medication
in the container it came in, tightly closed, and out of
reach of children. Store the tablets and capsules at
room temperature, away from excess heat and moisture
(not in the bathroom). Store the oral solution in the
refrigerator. Throw away any medication that is outdated
or no longer needed. Talk to your pharmacist about the
proper disposal of your medication.
In case of emergency/overdose
In case of overdose,
call your local poison control center at 1-800-222-1222.
If the victim has collapsed or is not breathing, call
local emergency services at 911.
What other information should I know?
Pending revision, the
material in this section should be considered in light
of more recently available information in the MedWatch
notification at the beginning of this monograph.
Keep all appointments
with your doctor.
Before having any
laboratory test, tell your doctor and the laboratory
personnel that you are taking gabapentin.
If you use a dipstick
to test your urine for protein, ask your doctor which
product you should use while taking this medication.
Do not let anyone
else take your medication. Ask your pharmacist any
questions you have about refilling your prescription.
It is important for
you to keep a written list of all of the prescription
and nonprescription (over-the-counter) medicines you are
taking, as well as any products such as vitamins,
minerals, or other dietary supplements. You should bring
this list with you each time you visit a doctor or if
you are admitted to a hospital. It is also important
information to carry with you in case of emergencies.
|
IMPORTANT WARNING:
[Posted
01/31/2008] FDA informed healthcare
professionals that the Agency has analyzed
reports of suicidality (suicidal behavior or
ideation) from placebo-controlled clinical
studies of eleven drugs used to treat epilepsy
as well as psychiatric disorders, and other
conditions. In the FDA's analysis, patients
receiving antiepileptic drugs had approximately
twice the risk of suicidal behavior or ideation
(0.43%) compared to patients receiving placebo
(0.22%). The increased risk of suicidal behavior
and suicidal ideation was observed as early as
one week after starting the antiepileptic drug
and continued through 24 weeks. The results were
generally consistent among the eleven drugs. The
relative risk for suicidality was higher in
patients with epilepsy compared to patients who
were given one of the drugs in the class for
psychiatric or other conditions.
Healthcare
professionals should closely monitor all
patients currently taking or starting any
antiepileptic drug for notable changes in
behavior that could indicate the emergence or
worsening of suicidal thoughts or behavior or
depression.
The drugs
included in the analyses include (some of these
drugs are also available in generic form):
- Carbamazepine (marketed
as Carbatrol, Equetro, Tegretol, Tegretol
XR)
- Felbamate (marketed as
Felbatol)
- Gabapentin (marketed as
Neurontin)
- Lamotrigine (marketed as
Lamictal)
- Levetiracetam (marketed
as Keppra)
- Oxcarbazepine (marketed
as Trileptal)
- Pregabalin (marketed as
Lyrica)
- Tiagabine (marketed as
Gabitril)
- Topiramate (marketed as
Topamax)
- Valproate (marketed as
Depakote, Depakote ER, Depakene, Depacon)
- Zonisamide (marketed as
Zonegran)
Although the
11 drugs listed above were the ones included in
the analysis, FDA expects that the increased
risk of suicidality is shared by all
antiepileptic drugs and anticipates that the
class labeling changes will be applied broadly.
For more information visit the FDA website at:
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Antiepileptic
and
http://www.fda.gov/cder/drug/InfoSheets/HCP/antiepilepticsHCP.htm |
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