If you’ve been prescribed gabapentin, you may have questions. What does it treat? How does it work? Is it safe? And what side effects should you expect?
While gabapentin was originally developed to treat seizures, it’s commonly prescribed for a range of symptoms, including chronic pain and nerve sensitivity. If you’ve been prescribed this medication, understanding how it works and what to expect can help you feel more confident using it.
We spoke with Matthew Makelky, PharmD, with Banner Pharmacy Services, to learn more.
What is gabapentin?
Gabapentin is a prescription drug that changes how nerves send signals in your body. Dr. Makelky explains that gabapentin calms overactive nerves.
“Gabapentin mimics a molecule that stops nerves from firing,” he said. “It reduces the excitability of the nerve and helps relax it.”
Your brain makes a natural chemical called GABA (gamma-aminobutyric acid). GABA acts like a brake on your nerves. It quiets signals so your brain doesn't get overwhelmed. Scientists designed gabapentin to look like GABA but they are not the same chemical and don't work in the same way.
You might see gabapentin sold under brand names like Neurontin, Gralise or Horizant. It comes in capsules, tablets or liquid.
What is gabapentin used for?
Gabapentin has a few main uses approved by the U.S. Food and Drug Administration (FDA). Health care providers also prescribe it “off label,” meaning for conditions the FDA has not officially listed.
Seizures
Gabapentin is approved to help treat certain types of seizures. It is usually used with other seizure medications. It does not cure epilepsy but it can help reduce how often seizures occur.
Nerve pain
Nerve pain happens when nerves are damaged or irritated. Unlike muscle soreness or joint pain, nerve pain often presents as burning, stabbing or shooting (electric-like) sensations.
“Gabapentin should take away the sharp, burning and shooting pains,” Dr. Makelky said. “These are the feelings most associated with neuropathy.”
Providers may prescribe this medication for nerve pain caused by diabetes, shingles, spinal cord injuries or other nerve conditions. But gabapentin is not meant for general pain.
“There are other medications that treat pain and its intensity better and with fewer side effects than gabapentin, which has been shown not to work well for generalized pain,” Dr. Makelky said.
Restless legs syndrome
Some forms of gabapentin are used to treat moderate-to-severe restless leg syndrome. This condition causes uncomfortable sensations in the legs and a strong urge to move them, especially at night. Gabapentin may help reduce these symptoms and improve sleep for some people.
Other conditions
Health care providers sometimes prescribe gabapentin for other conditions when they believe it may help. These may include:
- Certain chronic pain conditions
- Migraine prevention
- Anxiety, depression and bipolar disorder
- Hot flashes
Research on these uses varies. Gabapentin may not work the same way for everyone. Talk to your health care provider about whether this medication may help you.
How long does gabapentin take to work
Gabapentin doesn’t always work right away. Usually, it takes between one and four weeks of taking the medication regularly to see the full benefits. The drug needs time to work, although some people notice effects sooner.
What are the common side effects of gabapentin?
Like all medicines, gabapentin can cause side effects. Most are mild and improve as your body gets used to the medicine.
“The most common side effects of gabapentin include dizziness, drowsiness and tiredness," Dr. Makelky said. "These should get better as you keep taking the medication."
Other side effects may include:
- Swelling in the legs or feet
- Blurred vision
- Trouble with balance or coordination
- Nausea
Because gabapentin can affect alertness and coordination, your provider might suggest that you avoid driving or using heavy machinery until you see how the medicine affects you. Older adults might be more sensitive to side effects like dizziness and balance problems, which can increase the risk of falls.
When are side effects serious?
Some side effects need immediate medical attention. One serious side effect of gabapentin is ataxia, which affects coordination and movement.
“Ataxia, a condition where you can't control your movements fully, is serious and requires emergency care,” Dr. Makelky said.
Seek emergency care right away if you notice:
- Trouble breathing
- Swelling of the face or throat
- Extreme confusion
- Trouble walking
See your health care provider if you notice:
- New or worse mood changes or thoughts of harming yourself
- Severe drowsiness or trouble staying awake
- A loss of control over your movements
- Rash or allergic reaction
- A fever, swollen glands or yellowing of your skin or eyes
Who should be extra careful?
Gabapentin is not the right fit for everyone. Dr. Makelky said extra caution is needed for:
- Older adults (age 65 or older)
- People with kidney problems
- People with hepatic encephalopathy (a brain condition linked to liver disease)
- People with a history of substance misuse
- People with myasthenia gravis (a muscle weakness condition)
- People who have had bariatric (weight loss) surgery
- People taking another medicine that depresses the central nervous system
If you are pregnant, breastfeeding or have ongoing medical conditions, talk to your health care provider about the risks and benefits of treatment.
Can you stop taking gabapentin suddenly?
Stopping gabapentin all at once is not safe. Tapering matters because there are known withdrawal symptoms from stopping it without a slight decrease in dose over weeks.
Withdrawal symptoms may include:
- Confusion
- Irritability
- Rapid heart rate
- Sweating
- Seizures
“Slowly decreasing the dose with the help of a health care provider will ensure lower or no withdrawal effects,” Dr. Makelky said. “Always talk with your provider if you want to modify or change medication that they are prescribing.”
Is gabapentin addictive?
There is debate about whether gabapentin has the potential for addiction. Some states have classified it as a controlled substance because of this concern.
At the same time, health care providers sometimes use gabapentin to treat alcohol use disorder. Because of this, they carefully consider the risks and benefits before prescribing it, especially for people who have a history of substance abuse.
Tips for taking gabapentin safely
Taking medication safely can help lower the risk of side effects and improve treatment results. Here are a few helpful reminders:
- Follow your prescription instructions carefully
- Time your doses carefully
- Keep follow-up appointments
- Tell your provider about new symptoms
- Be careful with other medications and alcohol
- Avoid sharing medication
- Store medication safely away from children
- Ask questions if something is unclear
Bottom line
Gabapentin is a common medicine that can help treat nerve pain, seizures and restless leg syndrome. For many people, it can lessen sharp, burning and shooting pain caused by nerve damage.
Like all medications, gabapentin has risks and side effects. Taking it exactly as prescribed and staying in contact with your health care provider can help you use it safely.
If you have questions about gabapentin or your symptoms, talk to your provider, pharmacist or Banner Health specialist. They can explain your treatment options and what to expect.
Frequently asked questions
Is gabapentin a painkiller?
Gabapentin is not a traditional painkiller like ibuprofen or opioids. It’s mainly used to treat nerve-related pain.
Does gabapentin work right away?
Not always. Some people notice improvement within days, while others may need several weeks.
Can gabapentin make you sleepy?
Yes. Drowsiness is one of the most common side effects.
Is gabapentin safe for long-term use?
Some people take gabapentin long-term under medical supervision. Your provider will monitor how well it works and watch for side effects.
Can you drink alcohol while taking gabapentin?
Alcohol can increase drowsiness and dizziness. Talk to your health care provider about whether alcohol is safe while taking gabapentin.
What if I miss a dose?
If it has been one or two hours since you forgot, take it. Otherwise, skip it and take your next dose at the regular time. Do not double up. If dosed three times daily, do not have more than 12 hours between doses.
Can I stop gabapentin if I feel better?
Talk to your provider first. Stopping suddenly can cause withdrawal symptoms and may trigger seizures. Your provider can help you taper off safely.
