Gabapentine

Gabapentin is an anticonvulsant medication originally developed for epilepsy but now widely used for the treatment of neuropathic pain. It binds to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, modulating neurotransmitter release and reducing the abnormal nerve signalling that causes neuropathic pain. It is effective for conditions such as diabetic neuropathy, post-herpetic neuralgia, and other forms of nerve pain.

How to Take Gabapentin

Take gabapentin two to three times a day, with or without food. Treatment is always started at a low dose and increased gradually over days to weeks to reach the right level for you while keeping side effects to a minimum. Swallow capsules or tablets whole with water.

Do not stop taking gabapentin suddenly. Coming off it abruptly can cause withdrawal effects such as anxiety, insomnia, nausea, and in some cases seizures. If you want to stop, your dose should be reduced slowly under medical supervision over at least a week.

Neuropathic pain: start at 300 mg on day 1, 300 mg twice daily on day 2, 300 mg three times daily on day 3. Increase to a maximum of 3600 mg daily in divided doses. Epilepsy: similar titration, usual dose 900 to 3600 mg daily.

Common Side Effects

Common side effects include:

• Drowsiness and tiredness (very common, especially at the start)
• Dizziness and unsteadiness
• Swelling of the hands or feet
• Weight gain
• Blurred or double vision

Drowsiness and dizziness are most noticeable during the first few weeks and when the dose is being increased. Avoid driving or operating machinery until you know how gabapentin affects you. It is a controlled drug in the UK (Class C) and should only be used exactly as prescribed.

Gabapentin is a controlled substance (Class C in the UK) due to potential for misuse. Do not stop abruptly after prolonged use; taper over at least one week. May impair driving. Use with caution alongside opioids (increased CNS depression risk).

Contraindicated in known hypersensitivity to gabapentin. Dose reduction needed in renal impairment.