Will Gabapentin affect pregnancy or breastfeeding?

This article will help you know if Gabapentin is safe for use during pregnancy or breastfeeding.

Gabapentin and pregnancy

The answer to the question whether taking Gabapentin is safe or not during pregnancy is still not known. Some say yes while other says no. When you decide on this factor, it becomes important to find out how necessary is the use of Gabapentin for you during pregnancy? Also you should calculate the risks to your baby and you and it will depend on how many weeks/months pregnant you are. The main objective during pregnancy is to be healthy while taking care of your unborn baby. Also we cannot ignore the fact that epilepsy should be controlled during pregnancy as seizures can lead to complications in unborn child and mother. In such cases it becomes necessary for some pregnant women to go for Gabapentin therapy.

It is recommended that women who are trying to conceive or are in first trimester of their pregnancy should take high doses of folic acid that is 5mg/day and high doses should be recommended by the doctor.

If you are suffering from epilepsy and taking Gabapentin, then do not stop taking the medication suddenly as it can lead to complications to you and your baby. Do not make any changes in your dose without talking to your doctor. The studies conducted do not show any signs of birth defects in babies born to mothers who used Gabapentin in their pregnancy. There are no evidences available that support any facts that can cause miscarriage or preterm birth too.

Since there are no evidences available that help us know whether Gabapentin is safe or not during pregnancy, pregnant women are asked to get diagnostic ultrasonography done before 20th week of their pregnancy to assess the development of foetus or if the termination of pregnancy is necessary.

So if you are pregnant and taking Gabapentin or planning to use Gabapentin, speak to your doctor as your doctor can examine your current medical condition and depending on your health status he can let you know whether you can use this medication or not. You can take a wise decision with the help of your doctor so that you can be stress free all throughout your pregnancy.

Gabapentin and breastfeeding

Gabapentin passes in the breast milk. There are no evidences available that claim that Gabapentin is not safe while breastfeeding. The manufacturers generally recommend that Gabapentin should be only used during breastfeeding if the benefits of the medications are higher than the risks. Therefore talk to your doctor to know about the benefits and risks. There are very few reports that say that use of Gabapentin by breastfeeding moms didn’t lead to any problems in infants. Normally healthy new born babies easily tolerate amounts of medication (Gabapentin) transferred through breast milk.

If your doctor thinks that Gabapentin is beneficial for you during breastfeeding, make sure you monitor your baby closely for any possible side effects.  Check for signs of feeding problems, drowsiness, slow development and weight gain.

Gabapentin- Drug interactions that can affect your health

Drug interactions should be considered before you start using Gabapentin. You should check with your doctor to know about various drugs that can interact with Gabapentin. If you are using additional medicines other than Gabapentin, let your doctor know as those medicines can interact with Gabapentin to affect your health. Let your doctor know if you are using herbal preparation, dietary supplements or any other medications.

Gabapentin with Opioids

Hydrocodone

Using Gabapentin and hydrocodone together can decrease hydrocodone exposure. The power for changing the hydrocodone exposure and its effect should be determined when Gabapentin is discontinued or started in a patient using hyrdocodone.

Morphine

While using morphine and Gabapentin together, the patients should be monitored for signs of CNS depression like sedation, somnolence and respiratory depression.

Maalox (magnesium hydroxide and aluminium hydroxide)

The efficacy of Gabapentin was decreased by nearly 20% with combined use of Maalox (antacid) consisting of aluminium and magnesium hydroxides. So, Gabapentin should be taken at least 2 hours after using Maalox.

Naproxen

Using Gabapentin with naproxen can elevate the Gabapentin amount absorbed in your body. Although the increased amount is quite low to cause any severe side effects, still extra caution should be taken while using the two medications together. Such patients tend to experience some side effects as well.

Cimetidine

Using Gabapentin and cimetidine together can reduce the renal secretion of the medication resulting in increased level of Gabapentin in the blood. However small decrease in Gabapentin cannot result in adverse effects.

Some other drugs that can interact with Gabapentin are as given below

  • Magnesium Trisilicate
  • Magnesium Carbonate
  • Ginkgo
  • Dihydroxyaluminum Aminoacetate
  • Aluminium Carbonate, Basic
  • Morphine Sulfate Liposome
  • Magnesium Oxide
  • Magaldrate
  • Aluminium Phosphate
  • Dihydroxyaluminum Sodium Carb

Although the above medications should not be taken with Gabapentin, there are some cases where the combination of the medications is required in spite of the different interactions that take place. In such cases, your doctor may change your dose or ask you to take necessary precautions. Also your doctor should be aware of other medicines you are taking so that you can use the combination safely.  The combination of the drugs might be the better option for the treatment so your doctor will help you know how to use the drugs safely.

The drugs also have some other interactions with certain foods, tobacco or alcohol. So discuss with your doctor if you are drinking alcohol, using tobacco etc.

Drug interactions lead to many complications depending upon the severity of the interaction. If you are using any other medications, it is necessary for your health care provider to know about the drugs so that he can check for possible drug interactions and suggest you whether you can take the drug or not. He can also make dosage adjustment so that you get maximum benefits from combination of drugs.

Always consult your doctor before making any changes to your dose and do not stop any medication without consulting your doctor.

Gabapentin – Dosage information for RLS, Epilepsy and Postherpetic Neuralgia

The Gabapentin dosage differs in each individual depending upon the age of the person, current medical condition and patient’s tolerance to the medicine. This article will help you know about the general Gabapentin dosage information for RLS, Epilepsy and Postherpetic Neuralgia. Again the dosage can differ thus you should take Gabapentin as recommended by your doctor.

Normal Dose for Epilepsy- In Adults

Initial dose: 300mg to be taken orally on first day


300 mg to be taken orally two times a day on the second day

300mg to be taken orally thrice a day on third day

Maintenance dose: 300-600mg to be taken orally thrice a day

Maximum dose: 3600mg to be taken orally daily in 3 split doses

Maximum time gap between doses in a schedule wherein the patient is taking the medicine thrice a day should not be more than 12 hours

Note:  Gabapentin can be taken with/without food

If you have not used the half tablets (broken) within 28 days after breaking, the tablet should be disposed.

Normal Dose for Postherpetic Neuralgia – In Adults

Initial dose: 300mg to be taken orally on first day

300 mg to be taken orally two times a day on the second day

300mg to be taken orally thrice a day on third day

The dosage can be adjusted as required

Maintenance dose: 1800mg/day (600mg to be taken orally three times a day)

Note: Gabapentin can be taken with/without food

If you have not used the half tablets (broken) within 28 days after breaking, the tablet should be disposed

Gabapentin available under the brand name GRALISE(R)

Maintenance dose: GRALISE(R) should be adjusted to 1800mg to be taken orally once in a day during meal.

Recommended dosage schedule

Day 1: 300 mg to be taken orally with meal in the evening

Day 2: 600 mg to be taken orally with meal in the evening

From Day 3 to day 6: 900 mg to be taken orally with meal in the evening

From Day 7 to day 10: 1200 mg to be taken orally with meal in the evening

From Day 11 to day 14: 1500 mg to be taken orally with meal in the evening

Day 15: 1800 mg to be taken orally with meal in the evening

Gabapentin (enacarbil extended release tablets) are sold under brand name HORIZANT (R)

The recommended dosage – 600 mg to be taken orally twice a day

Therapy should be started at a dose of 600mg to be taken orally in the morning till 3 days of therapy and can be increased up to 600mg to be taken twice a day and 1200 mg/day on fourth day.

Normal Dose for Restless Leg Syndrome- In Adults

600mg to be taken orally once daily during 5 PM with food

The medication is used to treat mild to severe RLS in adults

The above dosage information is general dosage information that can vary from person to person depending upon his/her medical condition and age. Your doctors can advice the right dose for you.

Gabapentin- An anticonvulsant used to treat seizures

Gabapentin is an anticonvulsant or an anti-epileptic medicine used to treat seizures. The generic name is Gabapentin and the brand names are Gabarone, Neurontin and Gralise. It influences the nerves and chemicals present inside our body that cause pain or seizures.

Gabapentin is used to treat nerve pain that occurs due to shingles or herpes virus in adults. The horizant brand of this medication is used to treat RLS(restless leg syndrome)

The Neurontin brand of this medication is used to treat seizures in children aged 3 years and adults as well.

Some important information

Take the right form and brand of Gabapentin as recommended by your doctor and check the medicine every time you buy a refill to make sure you got the correct form of this drug.

Check the label and read the instructions mentioned on the label carefully and inform your doctor about any other medicines you use, you medical conditions and allergies.

Avoid using this  medicine if you are suffering from

  • diabetes
  • kidney disease or if you are on dialysis
  • seizure disorder or epilepsy
  • liver disease
  • heart disease
  • history of mood disorder, depression, drug abuse, suicidal actions or thoughts
  • Suffering from RLS (if you sleep during the day as you at work in a night shift)

Some people get suicidal thoughts while using this medication. Your doctor will check your progress at regular intervals while you are using Gabapentin. Your caregivers or family members also need to be alert to monitor any changes in your mood.

Take Gabapentin as prescribed by the doctor. Do not use Gabapentin in smaller or larger amounts than recommended and also do not use the medication for a prolonged period than advised by your doctor.

Taking the Horizant brand during the day should be avoided. To get positive effects, use Horizant with food at 5.00 in the evening. Both Horizant and Gralise should be taken with food. Neurontin can be taken with/without food.

If you had broken a Neurontin tablet and used only half tablet, then take the other half at the next dose. Any broken tablet should not be kept for too long, so use the tablet as soon as you can or    within a couple of days. If you are using liquid form of this medicine, then measure the medicine using the dosing syringe enclosed with the medicine or use dose measuring cup or spoon.

Do not halt the use of Gabapentin all of a sudden, even if you feel you are well. Halting suddenly can lead to increased seizures. Ask your doctor for dose adjustment or change in dose.

Store the medicine away from moisture and light in a room temperature. Store the liquid form of medication in refrigerator but do not freeze.

If you have to undergo a urine protein lab test while you are using Gabapentin, let your laboratory staff know that you are using Gabapentin as Gabapentin can cause false positive result of urine protein test.

Common, Major and Minor side effects of Gabapentin

Well, talking about the side effects of Gabapentin, in this article we are going to discuss about the common, major and minor side effects.

Let us start with the common side effects first

Common side effects

  • drowsiness
  • sedation
  • dizziness
  • fatigue
  • fever
  • nystagmus
  • ataxia
  • viral infection
  • tremor
  • blurred vision
  • xersotomia
  • irritability
  • peripheral edema
  • diplopia
  • amblyopia

Some Major side effects that need immediate medical attention are

More Common

  • unsteadiness or clumsiness
  • uncontrolled, rolling, continous eye movements

More common effects in children

  • crying
  • anxiety
  • depression
  • behavioural problems like aggressiveness etc
  • constant change in moods
  • increase or hyperactivity in body movements
  • restlessness
  • distrust or suspiciousness
  • overacting, reacting too emotional or too quickly
  • concentration problems or in change in performance at school

Less Common

  • chills
  • cough
  • chest pain
  • memory loss
  • fever
  • irritability, depression or other changes in moods
  • swelling or pain in legs or arms
  • unusual weakness or tiredness
  • difficult or painful urination
  • swollen glands
  • breathlessness
  • unusual bruising or bleeding
  • sore throat
  • tarry, black stools
  • ulcers, sores or white spots in the mouth or lips

Occurrence not known

  • coma
  • dark urine
  • confusion
  • diarrhoea
  • headache
  • increased thirst
  • convulsions
  • joint pain
  • dizziness
  • appetite loss
  • muscle pain or ache
  • nausea
  • irritated or red eyes
  • yellow skin or eyes
  • irregular or fast heartbeat
  • decreased volume of urine
  • hive like or large swelling on eyelids, throat, tongue, feet, sex organs, hands, lips or face

Minor Side effects

Some minor side effects of Gabapentin do not need medical attention. As the body adjusts to the medication the side effects vanish with time.  Your doctor can advise you on how to reduce or prevent such side effects. If the minor side effects turn bothersome or continue to last for a longer period, consult your doctor immediately

More common

  • dementia
  • delusions
  • blurred vision
  • flu or cold like symptoms
  • shaking or trembling
  • hoarseness
  • side or lower back pain
  • swelling of feet, lower legs and hands
  • loss or lack or strength

Less Common side effects

  • body pain or aches
  • full or bloated feeling
  • vision problems
  • congestion
  • constipation
  • earache
  • excessive tearing
  • eye discharge
  • impaired vision
  • increased hunger
  • in coordination
  • frequent urination
  • indigestion
  • ringing ears
  • increased sensitivity to touch and pain
  • sneezing
  • runny nose
  • chest tightness
  • trouble sleeping
  • passing gas
  • trouble thinking
  • twitching
  • weight gain
  • vomiting
  • loss of strength or weakness
  • unexpected weight loss
  • tingling in feet and hands
  • dry or flushed skin
  • excess gas or air in intestines or stomach
  • decreased sexual ability of desire
  • Itching, burning or dry eyes.

Fibromyalgia-Gabapentin- New study about Brain Fog occurrence

Many people who suffer from chronic fatigue or Fibromyalgia use prescription drug like Gabapentin (Neurontin) to aid and manage symptoms of pain and epileptic seizure. the disturbed epileptic seizure results in sleep apnea, sleep dysfunction or restless leg syndrome.

The new study shows that due to thrombospondin and unnatural function of brain the possible results seen are brain dysfunction. If you are suffering from brain fog related to Fibromyalgia or deficiency of immune system related to chronic fatigue syndrome, then Gabapentin may not be the best choice or first line choice of drug.  It proves to be logical that it adds to the existing symptoms if you continue using this drug(prescription).

Let us know how and why?

By using Gabapentin, you might disturb the important brain connection that is important for you for cognition and proper memory. Most of us are aware of how delicate our brain is. If anything goes wrong with this delicate part of our body, it can be life-threatening. Too much of drug interactions or anesthesia and you might lose your senses. In simple words anything that leaves a negative impact on the normal functioning of our brain should be researched, suspected, avoided and reported, if possible.

New study shows that an individual who is suffering from chronic fatigue syndrome or fibromyalgia can show the following symptoms if using this drug

  • Not able to think properly or not able to think only
  • Couldn’t recollect memories of say a week before even if the brain is recessed.
  • Mentally incapable of thinking even below normal level, unable to think and feel numb.
  • Not being able to do logical reasoning even simple ones like solving a financial problem or not able to judge what needs to be spoken in a discussion.
  • Not able to think or care what will happen in a stressful situation or vice versa like not bothered about what will be the result. This even leads to emotional detachment. These results in like a person who is least bothered about living his life and in turn it creates suicidal thoughts or chronic depression.

Brain fog is a situation that pulls you down and is incredibly tough and scary symptom to handle as compared to other symptoms.

This is something to explain how powerful the drug is and can affect your loved one. If the brain has stopped functioning normally, then how would you know what the reason is or cause behind it?  What might be happening? So if you notice such symptoms it is better to consult your health care person to take actions immediately. There are many people who lose connection to life while taking the drug and if they get well, they see a new life as the brain becomes functional and live again and body follows the brain.

Make sure you consult your doctor before taking this drug as the symptoms can be scary and you might lose your connection with life. Better start with right medication and speak to your doctor.

Treatment effects of gabapentin for primary insomnia

OBJECTIVES:

The prevalence of insomnia is very high in our society. Although pharmacological treatment of insomnia is available, most hypnotics have been shown to alter sleep architecture and have many adverse effects. Gabapentin was originally designed for antiepileptic therapy; however, some studies reported that its use increases slow-wave sleep in healthy volunteers or patients. Our goal was to evaluate the benefits of gabapentin in the treatment of primary insomnia in patients.

METHODS:

Eighteen patients with primary insomnia participated in the study. They received gabapentin treatment for at least 4 weeks. All patients received polysomnography, a biochemical blood test, and neuropsychological tests before and after the treatment period. All measures were analyzed with Student t test to examine the treatment effects of gabapentin, except that the measures of heart rate variability were analyzed with analysis of variance.

RESULTS:

Polysomnographic study revealed increased sleep efficiency and slow-wave sleep, decreased wake after sleep onset, and spontaneous arousal index after gabapentin treatment. The biochemical blood test revealed decreased prolactin levels in the morning after treatment. Electroencephalographic power spectral analysis showed increased delta-2 and theta power in sleep stage 1 and decreased sigma activity power in sleep stages N2 and N3 after gabapentin treatment. Heart rate variability analyses also showed a significant increase in normalized high frequency percentage in sleep stages N2 and N3 and low frequency-high frequency ratio in sleep stage N2 after treatment. In addition, neuropsychological tests revealed the elevation of visual motor processing speed after gabapentin treatment.

insomnia

CONCLUSIONS:

Gabapentin enhances slow-wave sleep in patients with primary insomnia. It also improves sleep quality by elevating sleep efficiency and decreasing spontaneous arousal. The results suggest that gabapentin may be beneficial in the treatment of primary insomnia.

Author information

  • Department of Neurology and Sleep Center, Chung Shan Medical University and University Hospital, Tai-Chung, Taiwan.

Gabapentin Side Effects Weight Gain

Gabapentin 800 mg Tab-IVAGabapentin is frequently used off-label due to the fact that it is considered to have a low potential for abuse and is regarded as non-addictive.  Due to the fact that the drug elicits both analgesic and anticonvulsant effects, it is sometimes preferred by those undergoing various types of surgery.  It reduces preoperative anxiety via its mechanism acting on GABA ergic neurotransmission, and provides postoperative pain relief.

Gabapentin is an effective treatment for neuropathic pain, seizures, and various off-label conditions – many people experience unwanted side effects.  One unwanted side effect that has been reported in a small percentage of users is weight gain.

It is estimated that approximately 3% of all users will experience some form of weight gain.  Most people won’t notice any significant fluctuations in body weight throughout their treatment.  For this reason, Gabapentin is often referred to as a “weight neutral” drug.

there are some studies highlighting the fact that weight gain can occur on Gabapentin, especially when taken at high doses.  In one study of 28 patients taking 3000 mg per day of Gabapentin, 10 patients gained approximately 10% of their bodyweight.  Despite this finding, the majority of patients remained weight neutral, and some even lost weight (3 patients).

The most common side-effects of Gabapentin  listed are these:

Back pain; changes in vision (double or blurred vision); clumsiness; constipation; diarrhea; dizziness; drowsiness; dry mouth; nausea; stomach upset; tiredness; vomiting; weight gain.


Incidentally, these side-effect listings must, by law, include all effects noted by anyone during any of the trials on the way to becoming a drug. That’s why we see strange listings like the one above, where constipation and diarrhea are listed, side by side!

I don’t know the mechanism of the gain, but suspect it’s mostly water retention, since the weight usually fluctuates a lot. An interesting fact about Neurontin is that it is not metabolized by the body at all – nearly all of the unchanged drug is excreted in urine. This is good news for folks taking a lot of it, since if a drug isn’t metabolized, it won’t cause liver or kidney damage.

Drug action and drug metabolism are unrelated, unless metabolism converts a molecule to an active drug in the body (making that molecule a “prodrug”

The body’s job is to get rid of anything that’s not normally there – especially small molecules like drugs. Metabolism is designed to make things easier to excrete, but Neurontin is already easily excreted due to its structure, so the body need do nothing to assure its excretion.

Digestive Side Effects

It is unclear why a small percentage of people lose weight when taking Neurontin, but it may be related to the small percentage who experience unpleasant digestive effects. In the studies highlighted at DailyMed, up to 5.7 percent of adult and adolescent participants experienced diarrhea, up to 3.9 percent nausea, up to 3.3 percent vomiting and up to 2.2 percent heartburn. In children ages 3 to 12, 8.4 percent experienced nausea, some with vomiting.

Gabapentin for Migraine and Gabapentin for Migraine Dosage

Gabapentin 800 mg Tab-IVAGabapentin is is an antiepileptic drug, prescribed as adjunctive therapy in the treatment of partial seizures with and without secondary generalization in patients over 12 years of age with epilepsy. Neurontin is also indicated as adjunctive therapy in the treatment of partial seizures in pediatric patients age 3-12 years.. It is typically added to the treatment regimen when other drugs fail to fully control a patient’s attacks. Gabapentin is also quite effective in the treatment of cluster and chronic daily headaches.  Most people achieve the reduction of headache frequency within 1-2 weeks.

In one study, eight patients with intractable cluster headache were headache-free at a maximum of 8 days after starting gabapentin at the daily dose of 900 mg. Patients with the episodic type remained headache-free at 3 months after discontinuation of therapy. Patients with chronic cluster were headache-free during the 4 months after initiation of treatment while taking this medication.

The longest period of being continuously headache free on gabapentin was 18 months

gabapentin-300Since this is a relatively new way to use some of the newer neuronal stabilizers (anticonvulsants) such as Neurontin® (gabapentin) (As well as others such as Topamax® (topiramate), Lamictal® (lamotrigine) and Gabatril® (tiagabine)) prophylactically for Migraine disease, the dosage will be directed by your physican. Having noted that we will post recommend clinical practice guidelines for use as soon as we get that information from the manufacturer, FDA or AHS. his anticonvulsant is a prophylactic drug for treatment of migraine (Silberstein, 2000).  Gabapentin (strangely enough) does not affect Gaba-b receptors or other commonly studied receptors. It may nevertheless increase glutamate-dependent GABA synthesis and it also binds to the calcium channel. Adverse effects include sleepiness, dizziness, fatigue and weight gain associated with increased appetite. A newer version of Neurontin is “Lyrica”. This is basically a far more expensive version of gabapentin with a few advantages. Imbalance is common as a side effect of Lyrica. Pregnancy category C.

It reduces the frequency of headaches, pain intensity, and the use of symptomatic medications. Gabapentin is a good preventive therapy for migraines refractory to other medications.

Current Canadian Headache Society guideline for migraine prophylaxis rate gabapentin as strongly recommended prophylactic treatment with moderate quality evidence.

Mechanism of migraine prophylaxis

Experimental research suggests that gabapentin reduces neuronal excitability in spinal trigeminal nuclei and prevents central sensitization during migraine attack.

Gabapentin dosage: 1,200 mg to 2,400 mg per day divided in three doses.

Following is the Reviews of Gabapentin for Migraine from some patients in drugs.com

“I’ve had headaches since I was 6 years old. Cluster headaches almost every single day. Migraines once or twice a week. I went to so many doctors, went through so many scans, and tests that I actually learned to read MRI sheets before I was a teenager. Apparently there’s nothing physically wrong. So I went to PT, and chiropractors and they only helped a bit. At 14 I was old enough to start taking the harsher pills. Most turned me into a zombie. And I’ve only stuck with two in the end. I have just started having hand joint pains, and possible carpal tunnel, so I was put on a very high dose of Gabapentin. Two days later, headaches were gone. No rhyme or reason. Poof. It makes zero sense, but it’s a miracle drug. 100/10 would refer to anyone”

gabapentin-memory-loss“I started having migraine headaches when I was 14. The first time I had one, I was sitting in Biology class and could not see the faces of other students around me. I was terrified and had a panic attack. The school nurse thought I was on drugs and called my mother who immediately took me to a doctor. The migraines continued through out my life and caused me difficulty in my employment. I am a solo practitioner lawyer. When I would get one in court, I could not see, speak or think. Obviously, I had migraines with an aura. My family doctor only treated the pain, but finally I went to a psychiatrist and he prescribed Gabapentin and Lexapro. My migraines stopped completely. It has been seven months now and I am migraine free.”

If topiramate or propranolol are unsuitable or ineffective, you may be prescribed a medication called gabapentin. Like topiramate, this is a medication that is normally used to treat people with epilepsy that may also help prevent migraines. It is usually taken every day in tablet form.

Most people can take gabapentin, but it should be used with caution in people with kidney problems and those over 65 years of age.

Side effects of gabapentin can include dizziness, drowsiness, increased appetite, weight gain and suicidal thoughts.

Gabapentin has been recommended as a possible treatment for migraines by the National Institute for Health and Care Excellence (NICE), but recent research has suggested it may not be effective in preventing attacks and concerns have been raised about the quality of earlier research into the medication.

“I have been having chronic migraines for 5 years now and probably 50 other prescriptions wrote for me and finally gabapentin is like a miracle for me.My migraines were 24/7 with tension in shoulders and neck. Felt little tired and strange first day but great relief now. My doctor and neurologist all but gave up on me and was filling pretty depressed. Thank you gabapentin!!!!!”

“I had been taking topomax and Botox injections. They helped initially, the Botox helps within one week, sometimes two. I got injections ev’y 3 mths. Quit working after awhile. Now on gabapentin. Seems to be helping somewhat on higher dose but weight gain is horrible! I do not have increased appetite nor eat more either. Not sure what to do about it. Can’t keep increasing weight.”