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Gabapentin is a prescription medication known as a gamma aminobutyric acid (GABA) analogue. GABA reduces the excitability of nerve cells (neurons) in the brain, which play a role in seizures and the transmission of pain signals. Gabapentin mirrors the effects of GABA calming excited neurons. Gabapentin, available in doses like 600 mg and 800 mg, is primarily prescribed for managing certain types of nerve pain (neuropathic pain) and as an adjunctive therapy for seizures.

How Gabapentin (Neurontin) Works ?

Gabapentin (Neurontin) is an antiepileptic that’s also used to help with nerve pain. It has a similar structure to gamma-aminobutyric acid (GABA), a chemical in the brain that calms nerves. It’s not completely known how gabapentin (Neurontin) works to treat seizures or nerve pain, but it’s thought to work by lowering the activation of nerves involved with causing nerve pain and seizures.

Here’s a closer look at how these doses work and what to keep in mind:

Uses

Nerve Pain: Often prescribed for conditions like postherpetic neuralgia (nerve pain following shingles) or diabetic neuropathy.
Seizure Control: Used as an adjunctive treatment for partial seizures in adults and children over a certain age.
Off-Label Uses: Sometimes used to manage generalized anxiety, certain types of headaches, and fibromyalgia, though this varies by individual and physician.

Differences Between 600 mg and 800 mg

Strength and Dosing: The main difference lies in the strength, with 800 mg providing a higher dose. A doctor will determine the appropriate dose based on the condition being treated, patient tolerance, and medical history.
Dosing Schedule: Gabapentin is often started at a lower dose and gradually increased. The maximum daily dose can go up to 3600 mg (split across the day), but this depends on individual tolerance and needs.

How It Works

Gabapentin affects the way nerves transmit pain and seizure signals by acting on certain neurotransmitters, though it’s not fully understood. This action helps to stabilize nerve activity, which can alleviate pain or reduce seizure frequency.

Possible Side Effects

Common Side Effects: Drowsiness, dizziness, fatigue, and sometimes swelling in the extremities.
Serious Side Effects: Some may experience mood changes, respiratory issues, or severe allergic reactions. It’s crucial to monitor for any sudden changes, especially when starting or adjusting the dose.
Addicted to gabapentin: Some people can become addicted to gabapentin. If this happens, you’ll have withdrawal symptoms after you stop taking the medicine. When you stop taking gabapentin, you’ll need to reduce your dose gradually to avoid withdrawal symptoms. Do not stop taking gabapentin without talking to your doctor. You can also talk to your doctor if you’re concerned you are becoming physically dependant on gabapentin.

Important Considerations

Gradual Tapering: Gabapentin should not be stopped abruptly. Stopping suddenly can increase the risk of withdrawal symptoms and potentially trigger seizures in susceptible individuals.
Drug Interactions: Gabapentin can interact with other medications, particularly those that depress the central nervous system, like opioids or alcohol, which can amplify side effects.

If you’re considering Gabapentin or adjusting the dose, consult your healthcare provider for a safe and effective treatment plan based on your specific needs.

What is Gabapentin Approved For?

Gabapentin is used to:

Prevent and control partial seizures. Gabapentin can be used in adults and children age 3 and older who have partial seizures.
Relieve nerve pain following shingles in adults. Shingles is a painful rash that develops many years after you’ve had chickenpox. The virus that causes chickenpox stays dormant in a portion of your spinal nerve root called the dorsal root ganglion. For whatever reason, this otherwise dormant virus gets reactivated — usually by stress — causing a shingles rash. Nerve pain following a case of shingles is called postherpetic neuralgia (PHN).
Treat moderate-too-severe primary restless legs syndrome.

The branded gabapentin products Neurontin and Gralise are approved for partial seizures and PHN. The branded gabapentin enacarbil product Horizant is approved for restless legs syndrome and PHN.

How Should Gabapentin be Used?

Gabapentin comes as a capsule, a tablet, an extended-release (long-acting) tablet, and an oral solution (liquid) to take by mouth. Gabapentin capsules, tablets, and oral solution are usually taken with a full glass of water (8 ounces [240 milliliters]), with or without food, three times a day.

These medications should be taken at evenly spaced times throughout the day and night; no more than 12 hours should pass between doses. The extended-release tablet (Horizant) is taken with food once daily at about 5 PM. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take gabapentin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Gabapentin extended-release tablets cannot be substituted for another type of gabapentin product. Be sure that you receive only the type of gabapentin that was prescribed by your doctor. Ask your pharmacist if you have any questions about the type of gabapentin you were given.

Swallow the extended-release tablets whole; do not cut, chew, or crush them.

If your doctor tells you to take one-half of a regular tablet as part of your dose, carefully split the tablet along the score mark. Use the other half-tablet as part of your next dose. Properly throw away any half-tablets that you have not used within several days of breaking them.

If you are taking gabapentin to control seizures or PHN, your doctor will probably start you on a low dose of gabapentin and gradually increase your dose as needed to treat your condition. If you are taking gabapentin to treat PHN, tell your doctor if your symptoms do not improve during your treatment.

Gabapentin may help to control your condition but will not cure it. Continue to take gabapentin even if you feel well. Do not stop taking gabapentin without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood.

If you suddenly stop taking gabapentin tablets, capsules, or oral solution, you may experience withdrawal symptoms such as anxiety, difficulty falling asleep or staying asleep, nausea, pain, and sweating. If you are taking gabapentin to treat seizures and you suddenly stop taking the medication, you may experience seizures more often. Your doctor may decrease your dose gradually over at least a week.

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with gabapentin and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs) or the manufacturer’s website to obtain the Medication Guide.

What dosage strengths and forms does gabapentin come in?

Gabapentin is available as:

Gabapentin tablets. It’s available as 300- and 600-milligram tablets (Gralise) and 600- and 800-milligram tablets (Neurontin or generic gabapentin).
Gabapentin oral solution. The oral solution contains 250 millgrams of gabapentin per 5 milliliter (50 mg per mL) Neurontin or generic gabapentin.
Gabapentin capsules. It’s available as 100-, 300- or 400-milligram gelatin capsules (Neurontin or generic gabapentin).
Gabapentin enacarbil, 300- and 600-milligram extended-release tablets (Horizant).

Off-Label Usages of Gabapentin

What should I know about storage and disposal of Gabapentin?

Keep Gabapentin in the container it came in, tightly closed, and out of reach of children. Store the tablets, extended-release tablets, and capsules at room temperature, away from excess heat and moisture (not in the bathroom). Store the oral solution in the refrigerator. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include the following:

double vision
slurred speech
drowsiness
diarrhea