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Gabapentin (GA ba PEN tin) has been approved by the FDA as adjunctive therapy in the treatment of focal onset seizures, with and without secondary generalization, in pediatric patients 3 years and older with epilepsy.

Your epilepsy treatment should always be discussed with your health and care provider before use. Based on their judgment and knowledge, a drug may be prescribed for other epilepsy types not included in the indications. For more information, please see the prescribing information.

How can you take gabapentin? (Available formulations)

Gabapentin is available as a tablet, taken split or whole and with or without food, a capsule, or oral solution.

Who should not take gabapentin?

If you are allergic to gabapentin or any of the inactive ingredients, then you should not take it.

Other considerations may influence whether you should take gabapentin. Tell your healthcare provider if you:

  • have or have had depression, mood problems, or suicidal thoughts or behavior.
  • have kidney problems or are on hemodialysis.
  • have diabetes.
  • have breathing problems.
  • are pregnant or plan to become pregnant.
  • are breastfeeding or plan to breastfeed.

What is important to know about taking gabapentin?

Do not stop taking gabapentin suddenly unless directed to do so by your healthcare provider.

As with all antiseizure medications, gabapentin should be withdrawn gradually to minimize the risk of causing or worsening seizures or status epilepticus. You should not stop using gabapentin suddenly unless your healthcare provider tells you to stop the medicine because of a serious side effect.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Taking gabapentin with certain other medicines may cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider. Especially tell your healthcare provider if you take: opioid pain medicine, any medicines for anxiety or insomnia, or any medicines that make you sleepy.

Women or those who are/plan to become pregnant
Use in pregnancy

At this time, there is not enough evidence regarding developmental risks associated with the use of gabapentin in pregnant people. In animal studies, there were instances of developmental issues at clinically relevant doses. However, having a seizure during pregnancy could harm both the pregnant individual and the baby. Tell your healthcare provider right away if you become pregnant. Do not start or stop taking seizure medication during pregnancy without your healthcare provider’s advice.

If you become pregnant while taking gabapentin, talk to your healthcare provider about registering with the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The purpose of this registry is to collect information about the safety of antiseizure medicine during pregnancy. You can enroll in this registry by calling 1-888-233-2334.

Use during breastfeeding

Gabapentin is present in breast milk. It is unknown if there are effects on the breastfed infant, or if gabapentin impacts milk production. Talk to your healthcare provider about the risks. Your healthcare provider will consider the developmental and health benefits of breastfeeding along with your need for gabapentin and the potential effect on the infant from gabapentin or from your epilepsy.

What are the side effects of gabapentin?

Gabapentin is approved by the FDA because it is safe and effective for the majority of people who take it. However, there are risks associated with all medicines. Some side effects caused by gabapentin can be very serious, and even life-threatening. It is important to be informed about these serious reactions and to be aware of their symptoms.

Common side effects

The most common side effects that were reported in studies of gabapentin are drowsiness (somnolence), dizziness, problems with movement and balance (ataxia), fatigue, and rapid and uncontrolled eye movement (nystagmus) in patients with epilepsy >12 years of age and viral infection, fever, nausea and/or vomiting, somnolence, and hostility in patients with epilepsy 3 to 12 years of age.

Rare, but serious side effects
Other serious reactions, including serious blood or liver problems

Rare but life-threatening reactions involving the immune system or multi-organ hypersensitivity, which can cause serious blood or liver problems have been reported with gabapentin use. You may or may not have a rash with these types of reactions. Call your healthcare provider right away if you experience fever, frequent infections, severe muscle pain, swelling of your face, eyes, lips, or tongue, swollen lymph glands, unusual bruising or bleeding, weakness, fatigue, yellowing of your skin, or the white part of your eyes, trouble walking or seeing, seizures happening more often, or pain/tenderness in the area toward the top of your stomach (enlarged liver/spleen).

Suicidal thoughts or behaviors

Studies have found that people who take antiseizure medications including gabapentin may have suicidal thoughts or behaviors, which occur in approximately 1 in 500 patients. If you experience any thoughts or impulses to hurt yourself, you should contact your healthcare provider immediately.

Driving impairment; somnolence/sedation and dizziness

Gabapentin may cause dizziness or drowsiness (somnolence). Do not drive, operate heavy machinery, or do other dangerous activities until you know how gabapentin affects you.

Do not drive or operate machinery until you have gained sufficient experience on gabapentin to gauge whether it adversely affects your abilities.

Respiratory depression

Breathing problems may occur with gabapentin when used at the same time with central nervous system depressants, including opioids, or in the setting of underlying respiratory impairment. Be observant of the symptoms and note that your dosage may need adjusting.

Neuropsychiatric adverse reactions in children 3 to 12 years of age

Gabapentin uses in pediatric patients with epilepsy 3 to 12 years of age has been associated with neuropsychiatric problems including emotional liabilities, hostility/aggressive behaviors, concentration issues, changes in school performance, restlessness, and hyperactivity.