Neuropathic pain is a chronic nerve pain that can significantly impair a patient’s functioning and quality of life. Neuropathic pain results from damaged nerves that have been affected by tissue injury due to trauma or disease. Diabetes mellitus and herpes zoster are commonly associated with the development of neuropathies. Other disease states that may result in neuropathic pain include complex regional pain syndrome, radiculopathy, and phantom limb pain.
Neuropathic pain can also be medicationrelated, as in the case of nerve damage due to cancer treatment.
Neuropathic pain originates from the reduced inability of a neuron to relay messages to and from the brain because of damage to the nerve. This can cause a person to feel a variety of sensations or hypersensitivities.1,2 A patient may feel different types of pain, depending on the origin and cause of the pain.
Neuropathic pain can be distinguished from nociceptive pain by determining the quality of the pain. Typically, patients experience variations in sensation or hypersensitivity. Neuropathic pain symptoms can be classified as negative or positive. Negative symptoms of neuropathic pain are described as a loss of sensation or numbness. Positive symptoms are characterized by the increased perception of pain or abnormal sensations. Positive symptoms can be either induced by a stimulus or spontaneous (nonstimulus induced).
Gabapentin at doses of 1800 mg to 3600 mg daily (1200 mg to 3600 mg gabapentin encarbil) can provide good levels of pain relief to some people with postherpetic neuralgia and peripheral diabetic neuropathy. Evidence for other types of neuropathic pain is very limited.
The outcome of at least 50% pain intensity reduction is regarded as a useful outcome of treatment by patients, and the achievement of this degree of pain relief is associated with important beneficial effects on sleep interference, fatigue, and depression, as well as quality of life, function, and work.
Around 3 or 4 out of 10 participants achieved this degree of pain relief with gabapentin, compared with 1 or 2 out of 10 for placebo. Over half of those treated with gabapentin will not have worthwhile pain relief but may experience adverse events. Conclusions have not changed since the previous update of this review.
Gabapentin is a medication sometimes prescribed to people who have epileptic seizures. This drug also can be used to treat chronic pain, specifically neuropathic pain. Neuropathic pain is often described as a very sharp, shooting type of pain that stems from a problem with the central nervous system.
Using gabapentin for pain is just one of many options available to chronic pain patients. A person’s success level when it comes to using gabapentin for pain relief can depend on the type of medical condition causing the pain and other treatments he or she is undergoing.
Patients suffering from conditions such as diabetes, multiple sclerosis, fibromyalgia and shingles may have success with taking gabapentin for pain treatment. Some people may be prescribed gabapentin as their sole form of pain treatment, while others may take this medication in conjunction with narcotic pain relievers.
Gabapentin typically is given to those suffering from a life-long illness involving pain and is not an optimal pain treatment for short-term problems such as a broken bone.
This medication needs time to build up in the body and is not an overnight pain solution. A patient should not stop taking gabapentin abruptly just because he or she is not experiencing immediate positive results. A person who is concerned about whether gabapentin is helping his or her pain should consult a doctor.
If a patient who quits taking gabapentin does not do so properly, then he or she may experience withdrawal symptoms such as chest pain, insomnia and extreme anxiety.
Gabapentin capsules, tablets, and oral solution are used along with other medications to help control certain types of seizures in people who have epilepsy.
Gabapentin capsules, tablets, and oral solution are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles).
Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down). Gabapentin is in a class of medications called anticonvulsants.
Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.
What Should I Know Before I Take Gabapentin ?
Patients, their caregivers, and families should be counseled that AEDs, including Neurontin, may increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Behaviors of concern should be reported immediately to healthcare providers.
Patients should be advised that Neurontin may cause dizziness, somnolence, and other symptoms and signs of CNS depression. Accordingly, they should be advised neither to drive a car nor to operate other complex machinery until they have gained sufficient experience on Neurontin to gauge whether or not it affects their mental and/or motor performance adversely.
Patients who require concomitant treatment with morphine may experience increases in gabapentin concentrations. Patients should be carefully observed for signs of CNS depression, such as somnolence, and the dose of Neurontin or morphine should be reduced appropriately.
Patients should be encouraged to enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry if they become pregnant. This registry is collecting information about the safety of antiepileptic drugs during pregnancy. To enroll, patients can call the toll free number 1888-233-2334.
Prior to initiation of treatment with Neurontin, the patient should be instructed that a rash or other signs or symptoms of hypersensitivity (such as fever or lymphadenopathy) may herald a serious medical event and that the patient should report any such occurrence to a physician immediately.
To make sure this medicine is safe for you, tell your doctor if you have:
kidney disease;
liver disease;
heart disease; or
(for patients with RLS) if you are a day sleeper or work a night shift.
Some people have thoughts about suicide while taking this medicine. Your doctor will need to check your progress at regular visits while you are using gabapentin. Your family or other caregivers should also be alert to changes in your mood or symptoms.
FDA pregnancy category C. It is not known whether gabapentin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.
Pregnancy Category C
Gabapentin has been shown to be fetotoxic in rodents, causing delayedossification of several bones in the skull, vertebrae, forelimbs, and hindlimbs. These effects occurred when pregnant mice received oral doses of 1000 or 3000 mg/kg/day during the period of organogenesis, or approximately 1 to 4 times the maximum dose of 3600 mg/day given to epileptic patients on a mg/m² basis. The no-effect level was 500 mg/kg/day or approximately ½ of the human dose on a mg/m² basis.
When rats were dosed prior to and during mating, and throughout gestation, pups from all dose groups (500, 1000, and 2000 mg/kg/day) were affected. These doses are equivalent to less than approximately 1 to 5 times the maximum human dose on a mg/m² basis. There was an increased incidence of hydroureter and/or hydronephrosis in rats in a study of fertility and general reproductive performance at 2000 mg/kg/day with no effect at 1000 mg/kg/day, in a teratology study at 1500 mg/kg/day with no effect at 300 mg/kg/day, and in a perinatal and postnatal study at all doses studied (500, 1000, and 2000 mg/kg/day). The doses at which the effects occurred are approximately 1 to 5 times the maximum human dose of 3600 mg/day on a mg/m² basis; the no-effect doses were approximately 3 times (Fertility and General Reproductive Performance study) and approximately equal to (Teratogenicity study) the maximum human dose on a mg/m² basis. Other than hydroureter and hydronephrosis, the etiologies of which are unclear, the incidence of malformations was not increased compared to controls in offspring of mice, rats, or rabbits given doses up to 50 times (mice), 30 times (rats), and 25 times (rabbits) the human daily dose on a mg/kg basis, or 4 times (mice), 5 times (rats), or 8 times (rabbits) the human daily dose on a mg/m² basis.
In a teratology study in rabbits, an increased incidence of postimplantation fetal loss occurred in dams exposed to 60, 300, and 1500 mg/kg/day, or less than approximately ¼ to 8 times the maximum human dose on a mg/m² basis. There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
To provide information regarding the effects of in utero exposure to Neurontin, physicians are advised to recommend that pregnant patients taking Neurontin enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. This can be done by calling the toll free number 1-888-233-2334, and must be done by patients themselves. Information on the registry can also be found at the website http://www.aedpregnancyregistry.org/.
Use in Nursing Mothers
Gabapentin is secreted into human milk following oral administration. A nursed infant could be exposed to a maximum dose of approximately 1 mg/kg/day of gabapentin. Because the effect on the nursing infant is unknown, Neurontin should be used in women who are nursing only if the benefits clearly outweigh the risks.
you should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while you are taking gabapentin for the treatment of epilepsy, mental illness, or other conditions.
A small number of adults and children 5 years of age and older (about 1 in 500 people) who took anticonvulsants such as gabapentin to treat various conditions during clinical studies became suicidal during their treatment. Some of these people developed suicidal thoughts and behavior as early as one week after they started taking the medication.
Mental Health
There is a risk that you may experience changes in your mental health if you take an anticonvulsant medication such as gabapentin, but there may also be a risk that you will experience changes in your mental health if your condition is not treated. You and your doctor will decide whether the risks of taking an anticonvulsant medication are greater than the risks of not taking the medication.
You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: panic attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling or staying asleep; aggressive, angry, or violent behavior; mania (frenzied, abnormally excited mood); talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; giving away prized possessions; or any other unusual changes in behavior or mood.
Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.
Gabapentin is a prescription drug. It comes as an oral capsule, an immediate-release oral tablet, an extended-release oral tablet, and an oral solution.
Gabapentin oral capsule is available as the brand-name drug Neurontin. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.
Why it’s used
Gabapentin oral capsule is used to treat the following conditions:
Seizures: Gabapentin is used to treat partial (focal) seizures. It’s taken together with other seizure medications in adults and in children 3 years of age and older who have epilepsy.
Postherpetic neuralgia: This is pain from nerve damage caused by shingles, a painful rash that affects adults. Shingles appears after infection with the varicella zoster virus. This virus occurs in people who have had chicken pox.
Gabapentin may be used as part of a combination therapy. This means you may need to take it with other drugs.
How to use Gabapentin
Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking gabapentin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food as directed by your doctor. Dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight.
If you are taking the tablets and your doctor directs you to split the tablet in half, take the other half-tablet at your next scheduled dose. Discard half tablets if not used within several days of splitting them. If you are taking the capsules, swallow them whole with plenty of water.
It is very important to follow your doctor’s dosing instructions exactly. During the first few days of treatment, your doctor may gradually increase your dose so your body can adjust to the medication. To minimize side effects, take the very first dose at bedtime.
Take this medication regularly to get the most benefit from it. This drug works best when the amount of medicine in your body is kept at a constant level. Therefore, take gabapentin at evenly spaced intervals at the same time(s) each day. If you are taking this medication 3 times a day to control seizures, do not let more than 12 hours pass between doses because your seizures may increase.
Do not take this medication more often or increase your dose without consulting your doctor. Your condition will not improve any faster and the risk of serious side effects may increase.
Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.
Antacids containing aluminum or magnesium may interfere with the absorption of this medication. Therefore, if you are also taking an antacid, it is best to take gabapentin at least 2 hours after taking the antacid.
Different forms of gabapentin (such as immediate-release, sustained-release, enacarbil sustained-release) are absorbed in the body differently. Do not switch from one form to the other without consulting your doctor.
Tell your doctor if your condition does not improve or if it worsens.
What Conditions does Gabapentin Treat?
nerve pain after herpes
additional medication to treat partial seizures
essential tremor
restless legs syndrome
an extreme discomfort in the calf muscles when sitting or lying down
neuropathic pain
acute pain following an operation
“change of life” signs
alcoholism
You are not allowed to buy gabapentin Online if you have following health conditions
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.
Gabapentin is used in adults to treat neuropathic pain (nerve pain) caused by herpes virus or shingles (herpes zoster).
Neurontin 600mg
The Gralise brand of gabapentin is indicated for the management of neuropathic pain only. It is not used for epilepsy.
The Horizant brand of gabapentin, in addition to treating neuropathic pain, is also used to treat restless legs syndrome (RLS).
The Neurontin brand of gabapentin is also used to treat seizures in adults and children who are at least 3 years old, in addition to neuropathic pain.
Use only the brand and form of gabapentin your doctor has prescribed. Check your medicine each time you get a refill to make sure you receive the correct form.
Normally Gabapentin is suitable for all adult and children bigger than six years old.
But you are not allowed to order Gabapentin online if you have any of following health conditions
You are younger than 18 years old;
You have kidney disease;
You have diabete disease;
lung disease, such as chronic obstructive pulmonary disease (COPD)
a seizure (unless you take gabapentin to treat seizures);
are taking an anti-depressant or sedating medication;
liver disease and heart diseases;
a history of depression, mood disorder, drug abuse;
(for patients with RLS) if you are a day sleeper or work a night shift;
You are breastfeeding mother or you are pregnant;
have thoughts about suicide or actions
Stop immediately if you have any thoughts about suicide. Donot order Gabapentin online if you have suicide thoughts. Please go to your doctor to have your completely checked.
We do not mean you can not buy gabapentin if you have above health situations, and you should go to your local doctor to have your health conditions checked and prescribe you gabapentin.
We also listed some situations that cannot order in our websites
We only sell gabapentin online to patients that have taken gabapentin before and know the side effects of gabapentin.
You are new patient and first time to take gabapentin;
You have the history of clicking “Place order now” button but not picked up the order;
You have the records of bounced check payment;
Your local doctor have sent us a letter to cancel your prescription;
You refill too soon;
You have charge-back history
What are the risk to take gabapentin ?
All medicines have side effects even when used correctly as prescribed, but in general the benefits of taking a medicine outweigh these risks.
It is important to know that people respond differently to all medicines depending on their health, other medicines they are taking, the diseases they have, genetics, and many other factors.
As a result, we cannot determine the likelihood that someone will experience these side effects when taking gabapentinoids.
Your personal health care professional knows you best, so always tell them about all other medicines you are taking and if you experience any side effects while taking your medicines.
How to take gabapentin ?
The gabapentin dosage your doctor prescribes will depend on several factors. These include:
the type and severity of the condition you’re using gabapentin to treat
your age
the form of gabapentin you take
other medical conditions you may have
Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.
Forms and strengths
Generic: Gabapentin
Form: oral capsule
Strengths: 100 mg, 300 mg, 400 mg
Brand: Neurontin
Form: oral capsule
Strengths: 100 mg, 300 mg, 400 mg
Dosage for postherpetic neuralgia
Adult dosage (ages 18–64 years)
Typical starting dosage: Day 1, 300 mg; day 2, 600 mg (300 mg two times per day, spaced evenly throughout the day); day 3, 900 mg (300 mg, three times per day, spaced evenly throughout the day). Your doctor may further increase your dosage after day 3.
Maximum dosage: 1,800 mg per day (600 mg, three times per day, spaced evenly throughout the day)
Child dosage (ages 0–17 years)
Dosage for people younger than 18 years has not been established.
Senior dosage (ages 65 years and older)
Your kidney function may decrease with age. Your body may get rid of this drug more slowly. Your doctor may start you on a lower dose so that too much of this drug does not build up in your body. Too much of the drug in your body can be dangerous. Your doctor may change your dose based on how well your kidneys are working.
Dosage for partial-onset seizures
Adult dosage (ages 18–64 years)
Typical starting dosage: 900 mg per day (300 mg, three times per day, spaced evenly throughout the day). Your doctor may increase your dose to 2,400–3,600 mg per day.
Child dosage (ages 12–17 years)
Typical starting dosage: 300 mg, three times per day, spaced evenly throughout the day. This can increase to 2,400–3,600 mg per day.
Child dosage (ages 3–11 years)
Typical starting dosage: 10–15 mg/kg/day, divided into three doses, spaced evenly throughout the day. Your child’s doctor may increase the dosage to meet your child’s needs.
Maximum dosage: 50 mg/kg/day.
Child dosage (ages 0–2 years)
Dosage for people younger than 3 years has not been established.
Senior dosage (ages 65 years and older)
Your kidney function may decrease with age. Your body may get rid of this drug more slowly. Your doctor may start you on a lower dose so that too much of this drug does not build up in your body. Too much of the drug in your body can be dangerous. Your doctor may change your dose based on how well your kidneys are working.
Special considerations
Kidney problems: If you are older than 12 years and have kidney problems or are on hemodialysis, your dose of gabapentin will need to be changed. This will be based on how well your kidneys are working.
