GABAPENTIN

Dr C P Ravikumar

What is Gabapentin and how is it prescribed?

Gabapentin is a Medicine recommended for managing seizures and to relieve the pain in post herpetic neuralgia (pain in the nerves after shingles), Diabetic neuropathy,

How is Gabapentin available in the market?

Tablet
Capsule
Oral Solution (not widely available in India)

What is Gabapentin's mode of action?

Gabapentin is structurally similar to the neurotransmitter gamma-amino butyric acids (GABA), It acts through voltage-gated calcium channels thereby reducing the frequency of seizure and reducing the nerve pain.

Gabapentin vs Pregabalin

Pregabalin may be a better option for patients who need a more potent or faster-acting treatment, especially for conditions like generalized anxiety disorder or severe nerve pain.

Gabapentin Gabapentin is often a more affordable and equally effective option for many, especially when the intensity of the symptoms is less severe.

Ultimately, the choice between Gabapentin and Pregabalin depends on the individual patient’s needs, side-effect tolerance, and cost considerations, so it is important to follow doctor’s guidance when choosing between them.

Gabapentin and Methyl-Cobalamin (Mecobalamin)

Gabapentin and Methyl-Cobalamin are both medications that are sometimes used together, especially in conditions involving nerve pain or neurological disorders, though they work in different ways.

Methyl-Cobalamin: This is a form of vitamin B12 that is involved in nerve function and the production of red blood cells. Methyl-Cobalamin is often used as a supplement to address B12 deficiency, which can lead to nerve damage, fatigue, and other neurological issues. It may help in improving nerve regeneration and function, especially in conditions like peripheral neuropathy.

What is the duration of action for Gabapentin?

Gabapentin typically starts to take effect within 1 to 3 hours after taking it. However, the full therapeutic effects might take a few days to a week, especially if you are taking it for nerve pain or other long-term conditions. Everyone responds a bit differently, so the time it takes to feel the effects can vary from person to person.

What is the best time to take Gabapentin?

Morning and evening, twice a day. Ten to twelve hours apart is ideal. Create a routine and this will help to remember to take the medicine. It should ideally be consumed at the same time each day.

What can be done if I forget to take a dose?

If you have time before the next scheduled dose, you can take it as soon as you recall; if not, wait until the next dose.

Never give a Double dose of Gabapentin

You can give your child another dose of medication if he/she throws up within 30 minutes of taking it, but ignore and don’t give another dose if he/she throws up after 30 minutes.

How should I give/take Gabapentin?

Tablets: Swallow the tablet with water.
Capsule: swallow the capsule with glass of water. Can be taken with or without food. Swallow it whole, without crushing or chewing, to ensure it works properly.
Oral solution: Administer with an accurate measuring device (calibrated oral syringe or measuring cup); do not use a household teaspoon or tablespoon to measure dose (over dosage may occur).

When should I take the medicine? (before food or after food)

Gabapentin can be taken either before or after food, as food does not significantly affect its absorption. However, it is important to follow your healthcare provider if there is any specific instructions.

Could this medication have any side effects?

All medicines can cause side effects along with their benefits.
Although these effects are usually mild or uncommon, it’s important to stay informed so you can recognize and manage them early.
Being aware allows you to take prompt action if any issues arise.
In rare cases, some people may experience serious reactions—if you notice any severe or unusual symptoms, contact your doctor or seek medical attention immediately.

Side effects of Gabapentin

Nervous system: Dizziness, drowsiness/fatigue, clumsiness or unsteady movement, blurred vision, headache, tremor, coordination problems.
Gastrointestinal: Nausea, vomiting, diarrhoea, constipation, dry mouth
Oedema & weight: Swelling of hands/feet and weight gain
Mood & cognitive: Confusion, memory issues, depression, agitation, aggression, psychosis, suicidal thoughts
Skin & allergy: Rash, itching, swelling, angioedema, rare anaphylaxis
Respiratory: Breathing suppression with opioids/sedatives or in lung disease
Withdrawal risk: Abrupt stopping may cause anxiety, sweating, insomnia, seizures

Can I take any other medications along with Gabapentin?

Yes, other common medications can often be taken alongside Gabapentin, but it is important to be mindful of potential interactions.
Some drugs, like pain medications (especially opioids), may increase drowsiness or respiratory issues when combined with Gabapentin.
Antacids can interfere with how Gabapentin is absorbed in the body, so it’s recommended to space them out.
Similarly, combining Gabapentin with sedatives or antidepressants can heighten the risk of drowsiness or dizziness.

However, it is crucial to discuss with the doctor.

Pregnancy and Lactation

Gabapentin should only be used during pregnancy and breastfeeding if absolutely necessary and prescribed by a healthcare provider.

Any risk if I conceive while taking Gabapentin?

Conceiving while taking Gabapentin may carry certain risks. your doctor might advise changing your prescription or keeping a closer eye on you during your pregnancy.

Is there any procedure to store this medication?

Store the medicine secured away from heat and direct sunlight and in the same box it was packed in.

How to cope up with side effects of Gabapentin?

Dizziness: Using furniture or a wall for support can help you stay upright. Do not operate machinery or drive.
Fatigue: Getting some exercise, even a quick stroll, can help you feel more energised. Additionally, taking quick naps during the day can help fight off fatigue.
Vision changes: To avoid falls, be especially careful to move slowly and carefully if you notice any changes in your vision.
Heart rhythm changes and severe allergic reactions: As soon as you notice any changes in your heartbeat, chest pain, trouble breathing, or dizziness, you should seek medical help.
Suicidal thoughts: Get in touch with your doctor if you notice any changes in your thinking or mood while taking Gabapentin.

Summary

Gabapentin is a medication which is used to manage nerve pain and seizures. It works by calming overactive nerves in the brain and body, helping to reduce pain, prevent seizures, restless leg syndrome and fibromyalgia. Side effects may include dizziness, fatigue, confusions. It should be taken as directed by your healthcare provider, and it’s important to discuss any other medications you’re using to avoid potential interactions. During pregnancy and breastfeeding, Gabapentin should only be used if necessary and with your doctor’s approval.

Let us know if this was useful!

Author:

Dr. Likitha B S, Pharm. D, Clinical Pharmacologist, Aster Hospitals, Bengaluru
Dr Praveen Kumar, B. Pharm, Pharm D(PB), Lead Clinical Pharmacologist, REGIONAL HEAD KIMS Hospitals, Bengaluru
Dr. C. P. Ravi Kumar Lead & Senior Consultant – Paediatric Neurology KIMS HOSPITALS BENGALURU

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