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Brand Name: Neurontin
Generic Name: Gabin, Gabapin
Manufacturer: PfiZer
Diseases: Seizures, Epilepsy, Shingles, Postherpetic Neuralgia
Dosage: 300mg / 400mg / 600mg / 800mg
Neurontin Gabapentin is an anticonvulsant previously approved as an adjunct treatment for partial epileptic seizures in adults and children. It is also indicated in over 50 countries for the adjunctive treatment of epilepsy and a range of neuropathic pain conditions. It is now approved in the United States for the management of post-herpetic neuralgia (PHN). Neurontin is the first oral medication approved by the FDA for this indication.
PHN is a syndrome of often intractable pain that persists after the resolution of herpes zoster, a condition commonly known as shingles. This intense pain is described as burning, deep aching, tearing and electric shock-like. Approximately 10 to 15 percent of all patients with herpes zoster develop PHN, which may persist for a number of years.
What is Neurontin?
Neurontin (gabapentin) is an anti-epileptic medication, also called an anticonvulsant. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain.
Neurontin is used alone or in combination with other medications to treat seizures caused by epilepsy in adults and children who are at least 12 years old. Neurontin is also used with other medications to treat partial seizures in children who are 3 to 12 years old.
Neurontin is also used in adults to treat nerve pain caused by herpes virus or shingles (herpes zoster).
Neurontin may also be used for purposes not listed in this medication guide.
How does Neurontin work?
Neurontin capsules and tablets contain the active ingredient gabapentin, which is a medicine that is mainly used to treat epilepsy. (NB Gabapentin is also available without a brand name, ie as the generic medicine.) Gabapentin works by stabilising electrical activity in the brain.
The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly. When abnormally rapid and repetitive electrical signals are released in the brain, the brain becomes over-stimulated and normal function is disturbed. This can result in seizures or fits.
Gabapentin prevents epileptic fits by preventing the excessive electrical activity in the brain. It is thought to do this by mimicking the activity of a neurotransmitter called GABA.
Neurotransmitters are natural body chemicals that are stored in nerve cells. They are involved in transmitting messages between the nerve cells. GABA is a neurotransmitter that acts as a natural 'nerve calming' agent. It helps keep the nerve activity in the brain in balance. Gabapentin is structurally similar to GABA and so is thought to mimick its action. This helps calm the nerve activity in the brain.
Gabapentin is used to prevent partial seizures, and partial seizures that spread to secondary generalised seizures.
As gabapentin stabilises electrical nerve activity, it can also be used to treat pain that occurs a result of damage to or a disturbance in the function of nerves (neuropathic pain).
Important information about Neurontin
You should not use Neurontin if you are allergic to gabapentin.
Before taking Neurontin, tell your doctor if you have kidney, liver, or heart disease.
You may have thoughts about suicide while taking Neurontin. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Do not stop taking Neurontin for seizures without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using Neurontin suddenly. You may need to use less and less before you stop the medication completely.
Contact your doctor if your seizures get worse or you have them more often while taking Neurontin.
Wear a medical alert tag or carry an ID card stating that you take Neurontin. Any doctor, dentist, or emergency medical care provider who treats you should know that you take seizure medication.
Before taking Neurontin
You should not use Neurontin if you are allergic to gabapentin.
To make sure you can safely take Neurontin, tell your doctor if you have any of these other conditions:
- kidney disease;
- liver disease;
- heart disease; or
- (for patients with RLS) if you are a day sleeper or work a night shift.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.
FDA pregnancy category C. It is not known whether Neurontin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Gabapentin can pass into breast milk and may harm a nursing baby. Do not use Neurontin without telling your doctor if you are breast-feeding a baby.
How should I take Neurontin?
Take Neurontin exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Neurontin can be taken with or without food.
If you break a tablet and take one half of it, take the other half at your next dose. Any tablet that has been broken should be used as soon as possible or within a few days.
Measure Neurontin liquid with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
Do not stop taking Neurontin for seizures without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using Neurontin suddenly. You may need to use less and less before you stop the medication completely.
Contact your doctor if your seizures get worse or you have them more often while taking Neurontin.
Wear a medical alert tag or carry an ID card stating that you take Neurontin. Any doctor, dentist, or emergency medical care provider who treats you should know that you take seizure medication.
Use this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Neurontin can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using this medicine.
Store Neurontin tablets at room temperature away from light and moisture. Store the liquid medicine in the refrigerator. Do not freeze.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include blurred vision, drowsiness, weakness, slurred speech, or diarrhea.
What should I avoid while taking Neurontin?
Neurontin may cause blurred vision or impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.
Avoid taking an antacid within 2 hours before or after you take Neurontin. Antacids can make it harder for your body to absorb Neurontin.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
Very common (affect more than 1 in 10 people)
- Sleepiness or fatigue.
- Fever.
- Dizziness.
- Shaky movements and unsteady walk (ataxia).
- Infections.
- Decrease in the number of white blood cells in the blood (leucopenia).
- Changes in appetite.
- Unstable moods (emotional lability).
- Confusion, loss of memory (amnesia).
- Depression.
- Anxiety or nervousness.
- Difficulty sleeping (insomnia).
- Headache.
- Tremor or twitching.
- Changes in sensation, for example pins and needles or numb sensations.
- Visual disturbances.
- Raised blood pressure (hypertension).
- Shortness of breath, cough.
- Gut disturbances such as dry mouth, indigestion, nausea, vomiting, constipation, diarrhoea or abdominal pain.
- Small haemorrhage (bleeding) in the skin (purpura), often seen as bruises.
- Skin reactions such as rash, itching or acne.
- Swelling of the legs, ankles or face due to excess fluid retention (oedema).
- Impotence.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
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Clinical Results
The approval of Neurontin was supported by a multi-center trial involving 229 subjects with PHN. Results showed that subjects suffering from PHN experienced a statistically significant reduction in average daily pain after treatment with Neurontin. Almost twice as many subjects treated with Neurontin (16 percent) were pain-free versus those treated with placebo (8.8 percent) at the end of the trial. The study also showed that those receiving Neurontin experienced improvement in sleep and overall quality of life.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Indigestion remedies (antacids) containing aluminium or magnesium may reduce the absorption of gabapentin from the gut. Indigestion remedies should therefore not be taken at the same time as a dose of gabapentin, or in the two hours before a dose.
It is recommended that people who are taking any antiepileptic medicines should avoid taking the herbal remedy St John's wort (Hypericum perforatum). This is because St John's wort may affect the level of antiepileptic medicines in the blood and could increase the risk of seizures.
This medicine is not known to interact significantly with other medicines. However, if it makes you feel sleepy or dizzy, this effect is likely to be increased if you take it in combination with other medicines that can cause drowsiness, in particular morphine, or with alcohol. If you are prescribed morphine in combination with gabapentin you should let your doctor know if it makes you feel sleepy, or if any drowsiness gets worse.
This medicine does not affect hormonal contraceptives such as the pill.
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