Gabapentin

The usual recommended adult dose of gabapentin begins with 300 mg 3 times daily. Your doctor may increase your dosage depending on how well it works and how well you tolerate it. The usual maximum daily dose is a total of 1,800 mg to 2,400 mg taken in 3 equal doses. Gabapentin may be taken with or without food.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Gabapentin should not be stopped suddenly, as seizures may return. If you feel it is necessary to stop Gabapentin, discuss the most appropriate schedule with your doctor.

It is important that Gabapentin be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is less than 4 hours until your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. To prevent breakthrough seizures, no more than 12 hours should pass between doses. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Gabapentin at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause drowsiness or dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause unusual tiredness; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun; it may cause weight gain, mostly with prolonged use; it may cause shakiness; it may cause double vision (diplopia). Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Capsules

100 mg
Each hard gelatin capsule with white opaque body and cap, printed with "Gabapentin 100 mg" on the cap, contains gabapentin 100 mg. Nonmedicinal ingredients: cornstarch, lactose, and talc; shell: gelatin and titanium dioxide.

300 mg
Each hard gelatin capsule with yellow opaque body and cap, printed with "Gabapentin 300 mg" on the cap, contains gabapentin 300 mg. Nonmedicinal ingredients: cornstarch, lactose, and talc; shell: gelatin, titanium dioxide, and yellow iron oxide.

400 mg
Each hard gelatin capsule with orange opaque body and cap, printed with "Gabapentin 400 mg" on the cap, contains gabapentin 400 mg. Nonmedicinal ingredients: cornstarch, lactose, and talc; shell: gelatin, titanium dioxide, red iron oxide, and yellow iron oxide.

Tablets

600 mg
Each white-to-off-white, film-coated, elliptical-shaped tablet, imprinted "G" over "600" on one side and plain on the other, contains gabapentin 600 mg. Nonmedicinal ingredients: carnauba wax, copovidone, hydroxypropyl cellulose, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, sodium starch glycolate, and talc.

800 mg
Each white-to-off-white, film-coated, elliptical-shaped tablet, imprinted "G" over "800" on one side and "P" on the other, contains gabapentin 800 mg. Nonmedicinal ingredients: carnauba wax, copovidone, hydroxypropyl cellulose, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, sodium starch glycolate, and talc.

Do not take gabapentin if you are allergic to gabapentin or any ingredients of Gabapentin.

There may be an interaction between gabapentin and any of the following:

• alcohol
• antacids containing magnesium or aluminum
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• azelastine
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• brimonidine
• Buprenorphine
• Buspirone
• calcium carbonate
• cannabis
• chloral hydrate
• efavirenz
• Entacapone
• general anesthetics (medications used to put people to sleep before surgery)
• Mefloquine
• Methadone
• Mirtazapine
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine)
• Nabilone
• narcotic pain relievers (e.g., Codeine, Hydrocodone, Morphine, Oxycodone)
• Olopatadine
• Orlistat
• Pramipexole
• Ropinirole
• Rotigotine
• scopolamine
• other seizure medications (e.g., Carbamazepine, Clobazam, Ethosuximide, Levetiracetam, Phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• sodium bicarbonate
• sodium oxybate
• suvorexant
• Tapentadol
• thalidomide
• tolcapone
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Imipramine)
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Gabapentin. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Gabapentin.

HEALTH CANADA ADVISORY

September 17, 2019

Health Canada has issued new restrictions concerning the use of gabapentin. To read the full Health Canada Advisory, visit Health Canada's web site at healthycanadians.gc.ca.

Alcohol and other medications that cause drowsiness: People taking Gabapentin should not combine it with alcohol and avoid combining it with other medications, such as narcotic pain relievers, that cause drowsiness. Doing so can cause additional drowsiness and reduced breathing as well as increase the risk of opioid overdose, which can be dangerous and possibly life threatening.

Difficulty breathing: Gabapentin can cause serious and life-threatening breathing problems. If you have breathing or lung problems, decreased kidney function, are taking other medications that can slow breathing, or if you are a senior, you are more at risk of experiencing breathing difficulties. If you experience slowed breathing or difficulty breathing, seek immediate medical attention.

Drowsiness/reduced alertness: If you have uncontrolled epilepsy, do not drive or handle potentially dangerous machinery. Gabapentin may cause drowsiness, dizziness, or problems with coordination. Avoid any activity requiring mental alertness or physical coordination until you determine how gabapentin affects you.

Hypersensitivity syndrome: A Anaphylaxis (severe allergic reaction) called hypersensitivity syndrome has occurred for some people with the use of gabapentin. Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.

Kidney function: Kidney Disease or reduced kidney function may cause Gabapentin to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how Gabapentin may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Gabapentin, and whether any special monitoring is needed.

Stopping the medication: As with other medications used to control seizures, stopping gabapentin suddenly could increase the risk of seizures. Do not stop gabapentin suddenly. Ask your doctor how to safely and gradually stop the medication.

Suicidal or agitated behaviour: People taking Gabapentin may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. If you experience these side effects or notice them in a family member who is taking Gabapentin, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking Gabapentin.

Pregnancy: Gabapentin crosses the placenta and may harm the developing baby if it is taken by the mother while she is pregnant. It should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Gabapentin, contact your doctor immediately.

Breast-feeding: Gabapentin passes into breast milk. If you are a breast-feeding mother and are taking gabapentin, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Gabapentin have not been established for children.

Seniors: Seniors are at an increased risk of side effects and may require a dose of Gabapentin that is lower than usual due to reduced kidney function.

This medication is typically used 3 times a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose and there is more than 4 hours left before the next dose, take immediately the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food. Consuming alcohol may intensify the effect of this product. Limit alcohol consumption to occasional small quantities.