The active ingredient gabapentin is used to treat epileptic seizures as well as to relieve neuropathic pain. Unlike many other antiepileptic drugs, it is considered well tolerated but still has a number of side effects. The most common include headache, fatigue, dizziness and nausea. If the drug is stopped suddenly, other side effects may occur. Read here how gabapentin works, how to dose the active ingredient correctly, and all the things you need to be aware of when taking it.
Effect of gabapentin
The active substance gabapentin belongs to the group of anticonvulsants (antiepileptics). These are used to treat or prevent epileptic seizures. Gabapentin is suitable for patients in whom only a certain part of the brain is affected by the epileptic seizure (focal seizure). In addition, the active ingredient can be used for so-called secondary generalized seizures, in which the seizure starts from a point in the brain and only later spreads to the entire brain. Gabapentin is also used to relieve neuropathic pain. These can occur, for example, in the context of shingles or in diabetic polyneuropathy. The active ingredient is also suitable for the treatment of phantom limb pain. However, the exact mechanism of action has not yet been clarified.
Side effects of gabapentin
A number of side effects may occur while taking gabapentin. Despite this, the drug is considered to be better tolerated than many other antiepileptic drugs. The most common complaints during use include headache, fatigue, dizziness, nervousness, insomnia, and nausea and vomiting. In addition, increased appetite and weight gain may occur, as well as loss of appetite and anorexia. Other side effects that may occur during treatment with gabapentin include respiratory infections, middle ear infection, memory impairment, speech disorders, and leukopenia or thrombocytopenia. In addition, treatment may also have effects on the mind, manifested by symptoms such as anxiety, confusion, hallucinations, or depression. For a complete listing of all side effects, please take a look at your medication’s package insert.
When in doubt, see a doctor
If you experience more severe side effects, it is always advisable to see a doctor. This is especially true if you experience any of the following symptoms:
- Severe skin reactions
- Constant abdominal pain, coupled with nausea and vomiting
Similarly, if symptoms include fever, itching, glandular swelling, swelling of the lips and tongue, yellowing of the skin or eyes, constant fatigue, muscle pain, and frequent bruising or bleeding, be sure to seek medical attention. In some patients, the tendency to commit suicide or the desire to harm themselves increased during treatment. Therefore, patients should be monitored closely, especially at the beginning of use.
Dosage of Gabapentin
Gabapentin comes in the form of tablets, capsules, and hard capsules. These are dosed differently – there are medications with 100, 300, 400, 600, or 800 milligrams. Which dosage is suitable for you must be determined individually by your doctor. It is important that the medication is taken with sufficient liquid. Adolescents and adults often start with a gabapentin dose of 300 milligrams once daily. This is increased to 300 milligrams three times daily over the next two days. If necessary, the dose may be increased further by 300 milligrams each time thereafter until a maximum daily dose of 3600 milligrams is reached. The dose is usually taken three times daily, with no more than twelve hours between each dose. Children under six years of age should not be treated with gabapentin. In older children, the dose depends on body weight. A usual dose is 25 to 35 milligrams per kilogram of body weight. This amount is usually divided into three individual doses, taken in the morning, at noon, and in the evening. It is not yet clear whether long-term treatment with this active ingredient for more than nine months can have negative effects on development. For this reason, a careful risk-benefit assessment must be carried out in children and adolescents.
Discontinuing gabapentin
If you have taken too high a dose of gabapentin, you should immediately contact your doctor or alternatively the nearest hospital. An overdose may be manifested by symptoms such as dizziness, lightheadedness, double vision, as well as slurred speech. If you forgot to take a dose, make up for it as soon as possible. However, do not take a double dose: If it is already time for the next dose, refrain from making up the dose. Do not stop treatment with gabapentin without first consulting your doctor. Under no circumstances should you simply stop the drug abruptly overnight. To end the therapy, gabapentin must be slowly discontinued step by step – this process should take at least one week. If the drug is stopped suddenly, side effects such as anxiety, insomnia, sweating, nausea, and pain may occur.
Contraindications
You may not take medications containing gabapentin under certain circumstances. This is the case, for example, if there is hypersensitivity to the active ingredient. Likewise, the active ingredient must not be used if you have acute pancreatitis. In the case of certain pre-existing conditions, the antiepileptic drug may only be taken with special caution. These include:
- Kidney problems
- Chronic pancreatitis
- Primary generalized epileptic seizures
- Psychoses
Pregnancy and lactation
During pregnancy, medications containing gabapentin should not be taken or should only be taken if specifically ordered by the treating physician. While no studies have been conducted with the drug itself, an increased risk of malformations has been observed with other antiepileptic drugs. This was particularly the case when more than one antiepileptic drug was taken simultaneously. Gabapentin passes into breast milk. It is not yet known whether it can have effects on the infant as a result. Therefore, you should not take the active substance during breastfeeding. If treatment is absolutely necessary, you should wean beforehand.
Interactions with antacids
When taking gabapentin, it may interact with several other medications. Antacids containing aluminum or magnesium are among those affected. When taken at the same time, the absorption of gabapentin may be slowed. Therefore, you should take the antiepileptic drug no earlier than two hours after the antacid. Unlike antacids, taking cimetidine, which is used when there is too much stomach acid, can prolong the duration of action of gabapentin. Alcohol as well as painkillers containing morphine should not be taken at the same time as the antiepileptic drug, otherwise the effect and side effects may increase. Please also note that gabapentin may falsify protein levels in urine tests. Therefore, if you are given a urine test, be sure to tell the doctor that you are currently being treated with the antiepileptic drug.
