Gabapentin comes as a capsule, a tablet, an extended-release (long-acting) tablet, and an oral solution (liquid) to take by mouth.
Gabapentin is usually started at a low dose and then gradually increased. Be sure to follow your doctor’s instructions. A typical dose ranges between 900 mg and 1,800 mg daily, divided into three doses. You shouldn’t stop taking gabapentin suddenly. Be sure to talk to your doctor about the proper weaning procedure for the dose you’re taking.
Gabapentin capsules, tablets, and oral solution are usually taken with a full glass of water (8 ounces [240 milliliters]), with or without food, three times a day.
These medications should be taken at evenly spaced times throughout the day and night; no more than 12 hours should pass between doses. The extended-release tablet (Horizant) is taken with food once daily at about 5 PM. 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.
Gabapentin extended-release tablets cannot be substituted for another type of gabapentin product. Be sure that you receive only the type of gabapentin that was prescribed by your doctor. Ask your pharmacist if you have any questions about the type of gabapentin you were given.
How Gabapentin Works
Gabapentin is believed to work by altering the release of glutamate and other neurotransmitters in your brain.1 Neurotransmitters send messages from one brain cell to another. Glutamate is really helpful for certain things, like learning new information. That’s because it gets your brain cells stirred up and active.
Kind of like a toddler with chocolate, though, if you have too much glutamate running around, your brain cells can become overstimulated. That can make all kinds of things go wrong.
Glutamate has more than one job, though. It also helps transmit pain signals in your brain and nerves. Too much glutamate may play a role in hyperalgesia, which essentially turns up the volume of pain.
Some diseases and conditions—including fibromyalgia—may interrupt this balance and let glutamate run amok. Gabapentin is believed to reduce your brain’s release of glutamate so the cells can calm down and your brain can function better.
Swallow the extended-release tablets whole; do not cut, chew, or crush them.
If your doctor tells you to take one-half of a regular 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 dispose of any half-tablets that you have not used within several days of breaking them.
How Gabapentin is Used ?
If you are taking gabapentin to control seizures or PHN, 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, even if you experience side effects such as unusual changes in behavior or mood.
If you suddenly stop taking gabapentin tablets, capsules, or oral solution, 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 may decrease your dose gradually over at least a week.
Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with gabapentin and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs) or the manufacturer’s website to obtain the Medication Guide.
Gabapentin is somewhat commonly prescribed as a fibromyalgia treatment. It’s available as a generic and is also sold under the brand names Neurontin, Horizant, and Gralise.
Gabapentin is not FDA approved for treating this condition, so it’s prescribed off-label. However, the drug is chemically related to Lyrica (pregabalin), which is approved for fibromyalgia. In fact, Lyrica is sometimes referred to as the “son of Neurontin.”