Is Gabapentin (Neurontin) Really The Best Option For Your Nerve Pain?

Today's post from medicalnewstoday.com (see link below) highlights the potential dangers of another drug commonly prescribed for neuropathic pain - Gabapentin! Pregabalin (Lyrica) is not the only high risk drug that was originally designed for something else:- gabapentin was also originally also an anti-convulsant but because modelling showed that it had potential for dampening nerve pain, it quickly became a popular addition to doctors' prescription pads (bolstered by efficient lobbying by the pharmaceutical company) to treat neuropathy. The problem is, just like with Lyrica, the side effects were hugely underestimated (or if you're a cynic...ignored!) and now many neuropathy patients are suffering problems with gabapentin side effects. The fact that it has also entered the list of traded 'street' drugs should flap a red flag in front of your eyes if you're taking it, or are about to be prescribed it for your nerve pain. This article comes from medicalnewstoday which is a pretty reliable source of information for medications. It's not an opinion article, it just lays out the uses, dosages and potential side effects and that may be worrying enough for you to have a serious discussion with your doctor as to whether it's the best drug for you.

 

Gabapentin: What to know
Last reviewed Tue 13 November 2018 By Jayne Leonard Reviewed by Lindsay Slowiczek, PharmD

Uses
Dosage
Side effects
Safety and risks
Takeaway

Gabapentin is an anticonvulsant medication that helps control seizures in people with epilepsy. Some forms of gabapentin can also treat restless legs syndrome or certain types of nerve pain.Gabapentin appears to work by altering electrical activity in the brain and influencing the activity of chemicals called neurotransmitters, which send messages between nerve cells.


Brand names for gabapentin include Horizant, Gralise, and Neurontin. The medication is available in capsule, tablet, or liquid form.

In this article, we describe the uses, dosages, and side effects of gabapentin. We also look into the associated risks and other safety considerations.

Uses


Gabapentin can prevent or control seizures.

Gabapentin's primary use is to prevent or control seizures. It works by calming down nerve activity to reduce seizure intensity or occurrence.

Children and adults can take the drug. The Neurontin brand can treat one form of epilepsy in children as young as 3 years old.

Some people take other medications with gabapentin to control epilepsy symptoms.

Gabapentin can also help reduce post-herpetic neuralgia, a burning or stabbing nerve pain that is a common complication of shingles.

According to a 2017 review, oral gabapentin, at a minimum daily dosage of 1,200 milligrams, can reduce moderate or severe nerve pain that results from shingles or diabetes.

Extended-release gabapentin (Horizant) tablets can treat restless legs syndrome (RLS), a condition characterized by uncomfortable sensations in the legs and a strong or irresistible urge to move the lower limbs.

A study from 2016 suggests that gabapentin combined with oxycontin, an opioid painkiller, can control pain and increase the quality of life for people with severe cancer pain. However, doctors do not typically prescribe gabapentin for this purpose.

Dosage

The right dosage of gabapentin depends on several factors, including:

the type and brand of gabapentin
the strength of the product
the condition
the person's kidney function
their weight, age, and general health

The number of daily doses, the hours that should pass between the doses, and the length of time that a person takes gabapentin will vary among individuals.

A person should take some forms of gabapentin with food, but for other forms it is unnecessary.

Anyone prescribed the Horizant brand of gabapentin for RLS should take it only in the evening or at night.

Some brands or dosages require a person to break the tablets in half. Always use the other half with the next dose, or as soon as possible.

Never break or chew extended-release gabapentin tablets — always swallow them whole.

It is vital to take only the recommended dose of gabapentin and not to continue using it for longer than prescribed. If a person misses a dose, they should follow the instructions on labeling or call a pharmacist for advice.

Side effects


Side effects of gabapentin can include dizziness and feeling sleepy.
Image credit: Rachel Demsick, 2013

Gabapentin can cause side effects. According to a 2017 review, these effects were slightly more common in people taking gabapentin than a placebo.

The most common side effects, occurring in 10 percent of participants on gabapentin, were:

dizziness
sleepiness
water retention (swelling of the arms, hands, legs, and feet)
problems walking

Serious side effects were not common and were the same in those taking the placebo.

Children and older adults may be most susceptible to adverse reactions to gabapentin. Possible side effects include:

back or chest pain
constipation
diarrhea
vomiting
upset stomach
increased appetite and weight gain
blurry vision
bruising
changes in mood
chills
a cough
fatigue
a fever
flu-or cold-like symptoms
hoarseness and dry mouth
memory loss
mouth ulcers
shortness of breath
a sore throat and swollen glands
trembling
urinary problems
weakness
uncontrollable eye-rolling

In children, some of the more common adverse reactions are: 

anxiety, depression, or other mood changes
behavioral problems
changes in performance at school
hyperactivity
lack of concentration

Individuals taking gabapentin should talk to their doctors about any side effects that occur, especially if they are severe, ongoing, or get worse.

Seek emergency medical treatment if symptoms of a severe or allergic reaction occur. These include: 

breathing difficulties
extreme dizziness
fever
hives
rash
severe weakness
swelling of the face, lips, tongue, or throat
yellowing of the skin or eyes (jaundice)

People can report adverse drug reactions to the United States Food and Drug Administration (FDA) at 1-800-FDA-1088 or at https://www.fda.gov/safety/medwatch.


Safety and risks

People taking gabapentin should be aware of the following:
Risk of suicidal thoughts or behaviors

Some people experience thoughts of suicide or exhibit suicidal behavior when taking gabapentin or other anticonvulsants.

If a person or their loved one notices changes in mood or behavior, they should contact a doctor immediately.
Interactions with other medications and substances

Gabapentin can interact with other prescription or over-the-counter medications, vitamins, and herbal supplements.

Be sure to give the doctor a full list of current medications and supplements before taking gabapentin.

Results of a 2017 review suggest that the following are the main substances that interact with the drug:

caffeine, which is present in tea, coffee, and cola
ethacrynic acid, a diuretic
losartan, a medication for high blood pressure
magnesium oxide, a mineral supplement and antacid
mefloquine, an antimalarial drug
morphine, an opioid pain medication
phenytoin, an anti-seizure medication

If gabapentin causes sleepiness, speak to the doctor before taking other medications that can also cause drowsiness, including: 

antianxiety medications
antidepressants
antihistamines
cold and flu medications
muscle relaxers
narcotics (pain medications)
sleeping pills




Symptoms, causes, and treatment of epilepsy
Learn more about epilepsy, including the causes and risk factors.
Read now

Presence of other health conditions

To ensure that gabapentin is safe to take, a person should tell their doctor if they currently have or have ever experienced:
breathing problems
depression or other mental health disorders
diabetes
dialysis treatment
drug and alcohol misuse issues
heart disease
kidney disease
liver disease
seizures (if taking gabapentin for conditions unrelated to seizures) 

Risks during pregnancy and when breastfeeding


Pregnant women should only take gabapentin if it is unavoidable.


People who are pregnant, or intend to become pregnant, should tell their doctor before taking gabapentin.

Pregnant women should only take the drug if it is absolutely necessary. However, it is also essential to control seizures while pregnant.

Do not start or stop taking gabapentin for seizure control before talking to the doctor, who will assess the potential risks and benefits.

Gabapentin passes into breast milk, but its effects on babies are unknown. It is best to discuss this issue with a doctor before breastfeeding.
Potential for a drug allergy

Individuals with gabapentin allergies should not take the drug.

Also, the medication may contain other ingredients that can trigger allergy symptoms in some people. Discuss all drug and food allergies with a doctor before taking gabapentin.
Other safety considerations

Because gabapentin can cause drowsiness, anyone taking the drug should exercise caution while driving or using machinery.

Do not take antacids within 2 hours of taking gabapentin, as antacids reduce the body's ability to absorb the drug.

People should also avoid alcohol or limit their intake while on gabapentin because there is a risk of adverse reactions.


Takeaway

Doctors prescribe gabapentin to control seizures, treat RLS, and reduce nerve pain.

Several types of gabapentin are available, and different forms can treat different medical issues.

The right dosage will vary, depending on the condition and other factors. A doctor can best advise about drug interactions and other safety considerations.

Although gabapentin has the potential to cause several adverse reactions, many people experience no serious side effects.


https://www.medicalnewstoday.com/articles/323681.php