NEURONTIN (GABAPENTIN)

Generic Name: gabapentin (GA ba PEN tin)
Brand Names: Gralise, Horizant, Neurontin, Gabarone

What is Neurontin?

Neurontin (gabapentin) is an anti-epileptic drug, 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 in adults to treat neuropathic pain (nerve pain) caused by herpes virus or shingles (herpes zoster).

The Neurontin is also used to treat seizures in adults and children who are at least 3 years old.

Before taking this medicine

You should not use Neurontin if you are allergic to gabapentin.

To make sure Neurontin is safe for you, tell your doctor if you have ever had:

• lung disease, such as chronic obstructive pulmonary disease (COPD);
• kidney disease (or if you are on dialysis);
• diabetes;
• depression, a mood disorder, or suicidal thoughts or actions;
• a seizure (unless you take gabapentin to treat seizures);
• liver disease;
• heart disease; or
• (for patients with RLS) if you are a day sleeper or work a night shift.

How should I take Neurontin?

Take Neurontin exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Neurontin can be taken with or without food.

If you break a Neurontin tablet and take only 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.

Swallow the capsule or tablet whole and do not crush, chew, break, or open it.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

If your doctor changes your brand, strength, or type of gabapentin, your dosage needs may change. Ask your pharmacist if you have any questions about the new kind of gabapentin you receive at the pharmacy.

Do not stop using Neurontin suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.

Wear a medical alert tag or carry an ID card stating that you have seizures. Any medical care provider who treats you should know that you take seizure medication.

This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using Neurontin.

Store Neurontin tablets and capsules at room temperature away from light and moisture.

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.

What should I avoid while taking Neurontin?

Avoid driving or hazardous activity until you know how gabapentin will affect you. Your reactions could be impaired.

Avoid taking an antacid within 2 hours before or after you take Neurontin. Antacids can make it harder for your body to absorb gabapentin.

Drinking alcohol with this medicine can cause side effects.

Neurontin side effects

Get emergency medical help if you have signs of an allergic reaction to Neurontin: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, upper stomach pain, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using Neurontin.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• weak or shallow breathing;
• blue-colored skin, lips, fingers, and toes;
• confusion, extreme drowsiness or weakness;
• problems with balance or muscle movement;
• unusual or involuntary eye movements.

Gabapentin can cause life-threatening breathing problems. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Breathing problems may be more likely in older adults or in people with COPD.

Some side effects are more likely in children taking Neurontin. Contact your doctor if the child taking this medicine has any of the following side effects:

• changes in behavior;
• memory problems;
• trouble concentrating; or
• acting restless, hostile, or aggressive.

Common Neurontin side effects may include:

• headache;
• dizziness, drowsiness, tiredness;
• problems with balance or eye movements; or
• (in children) fever, nausea, vomiting.

Neurontin dosing information

Usual Adult Dose for Epilepsy:

Initial dose: 300 mg orally on day one, 300 mg orally 2 times day on day two, then 300 mg orally 3 times a day on day three
Maintenance dose: 300 to 600 mg orally 3 times a day
Maximum dose: 3600 mg orally daily (in 3 divided doses)
-Maximum time between doses in the 3 times a day schedule should not exceed 12 hours

Comment:
-May be taken with or without food.
-Half-tablets not used within 28 days of breaking the scored tablet should be discarded.

Use: Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization

Usual Adult Dose for Postherpetic Neuralgia:

-Initial dose: 300 mg orally on day one, 300 mg orally 2 times day on day two, then 300 mg orally 3 times a day on day three
-Titrate up as needed for pain relief
-Maximum dose: 1800 mg per day (600 mg orally 3 times a day)
COMMENT:
-May be taken with or without food.
-Half-tablets not used within 28 days of breaking the scored tablet should be discarded.

Usual Pediatric Dose for Epilepsy:

Less than 3 years: Not recommended

Greater than or equal to 3 and less than 12 years:
Starting Dose: Ranges from 10 to 15 mg/kg/day in 3 divided doses
Effective Dose: Reached by upward titration over a period of approximately 3 days; the effective dose in patients 5 years of age and older is 25 to 35 mg/kg/day in divided doses (3 times a day). The effective dose in pediatric patients ages 3 and 4 years is 40 mg/kg/day and given in divided doses (3 times a day). Gabapentin may be administered as capsule, or tablet, or using combinations of these formulations. Dosages up to 50 mg/kg/day have been well tolerated in a long term clinical study. The maximum time interval between doses should not exceed 12 hours.

Greater than 12 years:
-Initial dose: 300 mg orally on day one, 300 mg orally 2 times a day on day two, then 300 mg orally 3 times a day on day three
-Maintenance dose: 900 to 1800 mg orally in 3 divided doses; the dose may be increased up to 1800 mg/day. Dosages up to 2400 mg/day have been well tolerated in long term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated. The maximum time between doses in the three times a day schedule should not exceed 12 hours.