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What is Neurontin?

Neurontin (gabapentin) is an anti-epileptic medication, also called an anticonvulsant. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain.

Neurontin is used alone or in combination with other medications to treat seizures caused by epilepsy in adults and children who are at least 12 years old. Neurontin is also used with other medications to treat partial seizures in children who are 3 to 12 years old.

Neurontin is also used in adults to treat nerve pain caused by herpes virus or shingles (herpes zoster).

Neurontin may also be used for purposes not listed in this medication guide.

Important information about Neurontin

You should not use Neurontin if you are allergic to gabapentin. Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking Neurontin

You should not use Neurontin if you are allergic to gabapentin.

To make sure Neurontin is safe for you, tell your doctor if you have:

  • kidney disease;

  • liver disease;

  • heart disease; or

  • (for patients with RLS) if you are a day sleeper or work a night shift.

Some people have thoughts about suicide while taking this medicine. Your doctor will need to check your progress at regular visits while you are using Neurontin. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. It is not known whether Neurontin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Gabapentin can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take Neurontin?

Take Neurontin exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Neurontin can be taken with or without food.

If you break a Neurontin tablet and take one half of it, take the other half at your next dose. Any tablet that has been broken should be used as soon as possible or within a few days.

Measure liquid Neurontin oral solution with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

If your doctor changes your brand, strength, or type of gabapentin, your dosage needs may change. Ask your pharmacist if you have any questions about the new kind of gabapentin you receive at the pharmacy.

Do not stop using Neurontin suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.

Wear a medical alert tag or carry an ID card stating that you take Neurontin. Any medical care provider who treats you should know that you take seizure medication.

This medication can cause you to have a false positive urine protein screening test. If you provide a urine sample for testing, tell the laboratory staff that you are taking Neurontin.

Store the tablets and capsules at room temperature away from light and moisture.

Store Neurontin oral solution in the refrigerator. Do not freeze.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Be sure to take the medicine with food. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Neurontin?

This medication may cause blurred vision or impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid taking an antacid within 2 hours before or after you take Neurontin. Antacids can make it harder for your body to absorb gabapentin.

Drinking alcohol can increase certain side effects of Neurontin.

Neurontin side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Neurontin: hives; fever; swollen glands; painful sores in or around your eyes or mouth; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • increased seizures;

  • fever, swollen glands, body aches, flu symptoms;

  • skin rash, easy bruising or bleeding, severe tingling, numbness, pain, muscle weakness;

  • upper stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);

  • chest pain, irregular heart rhythm, feeling short of breath;

  • confusion, nausea and vomiting, swelling, rapid weight gain, urinating less than usual or not at all;

  • new or worsening cough, fever, trouble breathing;

  • rapid back and forth movement of your eyes; or

  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Some side effects are more likely in children taking Neurontin. Contact your doctor if the child taking this medication has any of the following side effects:

  • changes in behavior;

  • memory problems;

  • trouble concentrating; or

  • acting restless, hostile, or aggressive.

Common Neurontin side effects may include:

  • dizziness, drowsiness;

  • dry mouth, blurred vision;

  • headache;

  • diarrhea; or

  • swelling in your hands or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Neurontin?

Taking Neurontin with other drugs that make you sleepy or slow your breathing can worsen these effects. Ask your doctor before taking Neurontin with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with this medicine, especially:

  • hydrocodone, (Lortab, Vicodin and others);

  • morphine (Kadian, MS Contin, Oramorph, and others); or

  • naproxen (Naprosyn, Aleve, Anaprox, and others).

This list is not complete and other drugs may interact with gabapentin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

For the Consumer

Applies to gabapentin: oral capsule, oral solution, oral suspension, oral tablet

Along with its needed effects, gabapentin (the active ingredient contained in Neurontin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking gabapentin:

More common
  • Clumsiness or unsteadiness
  • continuous, uncontrolled, back-and-forth, or rolling eye movements
More common in children
  • Aggressive behavior or other behavior problems
  • anxiety
  • concentration problems and change in school performance
  • crying
  • depression
  • false sense of well-being
  • hyperactivity or increase in body movements
  • rapidly changing moods
  • reacting too quickly, too emotional, or overreacting
  • restlessness
  • suspiciousness or distrust
Less common
  • Black, tarry stools
  • chest pain
  • chills
  • cough
  • depression, irritability, or other mood or mental changes
  • fever
  • loss of memory
  • pain or swelling in the arms or legs
  • painful or difficult urination
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • unusual bleeding or bruising
  • unusual tiredness or weakness
Incidence not known
  • Abdominal or stomach pain
  • blistering, peeling, or loosening of the skin
  • clay-colored stools
  • coma
  • confusion
  • convulsions
  • dark urine
  • decreased urine output
  • diarrhea
  • dizziness
  • fast or irregular heartbeat
  • headache
  • increased thirst
  • itching
  • joint pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • loss of appetite
  • muscle ache or pain
  • nausea
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • skin rash
  • unpleasant breath odor
  • vomiting of blood
  • yellow eyes or skin

Some side effects of gabapentin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Blurred vision
  • cold or flu-like symptoms
  • delusions
  • dementia
  • hoarseness
  • lack or loss of strength
  • lower back or side pain
  • swelling of the hands, feet, or lower legs
  • trembling or shaking
Less common or rare
  • Accidental injury
  • appetite increased
  • back pain
  • bloated or full feeling
  • body aches or pain
  • burning, dry, or itching eyes
  • change in vision
  • change in walking and balance
  • clumsiness or unsteadiness
  • congestion
  • constipation
  • cough producing mucus
  • decrease in sexual desire or ability
  • dementia
  • difficulty with breathing
  • dryness of the mouth or throat
  • earache
  • excess air or gas in the stomach or intestines
  • excessive tearing
  • eye discharge
  • feeling faint, dizzy, or lightheadedness
  • feeling of warmth or heat
  • flushed, dry skin
  • flushing or redness of the skin, especially on the face and neck
  • frequent urination
  • fruit-like breath odor
  • impaired vision
  • incoordination
  • increased hunger
  • increased sensitivity to pain
  • increased sensitivity to touch
  • increased thirst
  • indigestion
  • low blood pressure
  • nervousness
  • noise in the ears
  • pain, redness, rash, swelling, or bleeding where the skin is rubbed off
  • passing gas
  • redness or swelling in the ear
  • redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
  • runny nose
  • sneezing
  • sweating
  • tender, swollen glands in the neck
  • tightness in the chest
  • tingling in the hands and feet
  • troubled breathing
  • trouble with sleeping
  • trouble with swallowing
  • trouble with thinking
  • twitching
  • unexplained weight loss
  • voice changes
  • vomiting
  • weakness or loss of strength
  • weight gain
  • wheezing

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Applies to gabapentin: compounding powder, oral capsule, oral solution, oral tablet, oral tablet extended release

Nervous system

Nervous system side effects have been common. Somnolence, dizziness, ataxia, headache, and fatigue have been reported to occur in more than 10% of treated patients. Vertigo, hyperkinesia, paresthesia, decreased or absent reflexes, increased reflexes, anxiety, and hostility have been reported frequently. CNS tumors, syncope, dreaming abnormal, aphasia, hypesthesia, intracranial hemorrhage, hypotonia, dysesthesia, paresis, dystonia, hemiplegia, facial paralysis, stupor, cerebellar dysfunction, positive Babinski sign, decreased position sense, subdural hematoma, apathy, hallucination, decrease or loss of libido, agitation, paranoia, depersonalization, euphoria, feeling high, doped-up sensation, suicide attempt, and psychosis have been reported infrequently. Choreoathetosis, orofacial dyskinesia, encephalopathy, nerve palsy, personality disorder, increased libido, subdued temperament, apraxia, fine motor control disorder, meningismus, local myoclonus, hyperesthesia, hypokinesia, mania, neurosis, hysteria, antisocial reaction, and suicide have been reported rarely. Nystagmus, tremor, nervousness, amnesia, dysarthria and depression have also been reported. A small number of cases of absence status and status epilepticus have occurred in patients taking gabapentin (the active ingredient contained in Neurontin) Cases of delirium tremens have been reported upon gabapentin withdrawal.

Gastrointestinal

Gastrointestinal side effects have been reported in one to three percent of treated patients. Anorexia, flatulence, and gingivitis have been reported frequently. Glossitis, gum hemorrhage, thirst, stomatitis, increased salivation, gastroenteritis, hemorrhoids, bloody stools, and fecal incontinence have been reported infrequently. Dysphagia, eructation, pancreatitis, peptic ulcer, colitis, blisters in mouth, tooth discoloration, salivary gland enlarged, lip hemorrhage, esophagitis, hiatal hernia, hematemesis, proctitis, irritable bowel syndrome, rectal hemorrhage, and esophageal spasm have been reported rarely. Dyspepsia, dry mouth, constipation, dental abnormalities, flatulence, increased appetite, breast enlargement, and weight gain have also been reported.

Other

Other side effects have been reported to include withdrawal effects. Withdrawal of gabapentin (the active ingredient contained in Neurontin) therapy has been reported to cause the following effects in less than 2% of treated patients: somnolence, ataxia, fatigue, nausea, vomiting, and dizziness.

Hearing loss, earache, tinnitus, inner ear infection, otitis, taste loss, unusual taste, ear fullness, perforated ear drum, sensitivity to noise, eustachian tube dysfunction, otitis externa, odd smell, and labyrinthitis have also been reported.

Other side effects reported postmarketing have included angioedema, blood glucose fluctuation, breast enlargement, elevated creatine kinase, elevated liver function tests, erythema multiforme, fever, hyponatremia, jaundice, movement disorder, and Stevens-Johnson syndrome.

Hematologic

The patients reported to have decreased white blood cell counts were also taking carbamazepine.

Hematologic side effects have frequently been reported to include purpura. Anemia, thrombocytopenia, and lymphadenopathy have been reported infrequently. Increased WBC count, lymphocytosis, non-Hodgkin's lymphoma, and increased bleeding time have been reported rarely. Isolated cases of decreased white blood cell counts have also been reported.

Cardiovascular

Cardiovascular side effects including hypertension have been reported to occur in more than one percent of patients taking gabapentin (the active ingredient contained in Neurontin) Hypotension, angina pectoris, peripheral vascular disorder, palpitation, tachycardia, and murmur have been reported infrequently. Atrial fibrillation, heart failure, thrombophlebitis, deep thrombophlebitis, myocardial infarction, cerebrovascular accident, pulmonary thrombosis, ventricular extrasystoles, bradycardia, premature atrial contraction, pericardial rub, heart block, pulmonary embolus, hyperlipidemia, hypercholesterolemia, pericardial effusion, and pericarditis have been reported rarely. A case of gabapentin induced edema has also been reported.

Ocular

Ocular side effects including abnormal vision have been reported frequently. Cataract, conjunctivitis, dry eyes, eye pain, visual field defect, photophobia, bilateral or unilateral ptosis, eye hemorrhage, hordeolum, eye twitching, diplopia and blurred vision have been reported infrequently. Eye itching, abnormal accommodation, eye focusing problem, watery eyes, retinopathy, glaucoma, iritis, corneal disorders, lacrimal dysfunction, degenerative eye changes, blindness, retinal degeneration, miosis, chorioretinitis, and strabismus have been reported rarely. A case of oculogyric crisis has also been reported.

Psychiatric

Psychiatric side effects including two cases of intolerable aggressive behavior have been reported. One case of hypomania has also been reported.

Dermatologic

Dermatologic side effects including alopecia, eczema, dry skin, increased sweating, urticaria, hirsutism, seborrhea, cyst, and herpes simplex have been reported infrequently. Herpes zoster, skin discolor, skin papules, photosensitive reaction, leg ulcer, scalp seborrhea, psoriasis, desquamation, maceration, skin nodules, subcutaneous nodule, melanosis, skin necrosis, and local swelling have been reported rarely. One case of alopecia and one case of leukocytoclastic vasculitis have been reported.

Hypersensitivity

Hypersensitivity side effects including a case of hypersensitivity syndrome have been reported.

Genitourinary

Genitourinary side effects including hematuria, dysuria, urination frequency, cystitis, urinary retention, urinary incontinence, vaginal hemorrhage, amenorrhea, dysmenorrhea, menorrhagia, breast cancer, inability to climax, and abnormal ejaculation have been reported infrequently. Kidney pain, leukorrhea, pruritus genital, renal stone, acute renal failure, anuria, glycosuria, nephrosis, nocturia, pyuria, urination urgency, vaginal pain, breast pain, and testicle pain have been reported rarely.

Musculoskeletal

Musculoskeletal side effects including arthralgia have been reported frequently. Tendinitis, arthritis, joint stiffness, joint swelling, and positive Romberg test have been reported infrequently. Costochondritis, osteoporosis, bursitis, and contracture have been reported rarely. Myoclonus has also been reported. Postmarketing reports have included rhabdomyolysis and elevated creatine kinase.

General

General side effects have included asthenia, malaise, and facial edema which have been reported frequently. Generalized edema, weight decrease, and chill have been reported infrequently. Lassitude, "strange feelings", alcohol intolerance, and hangover effect have been reported rarely.

Endocrine

Endocrine side effects including hyperthyroid, hypothyroid, swollen testicle, goiter, hypoestrogenism, ovarian failure, epididymitis, and cushingoid appearance have been reported rarely. Endocrine side effects reported postmarketing have included breast enlargement.

Respiratory

Respiratory side effects including pneumonia have been reported frequently. Epistaxis, dyspnea, and apnea have been reported infrequently. Mucositis, aspiration pneumonia, hyperventilation, hiccup, laryngitis, nasal obstruction, snoring, bronchospasm, hypoventilation, and lung edema have been reported rarely.

Hepatic

Hepatic side effects including hepatomegaly have been reported infrequently. Several cases of hepatotoxicity have also been reported.

Oncologic

Male rats receiving doses of gabapentin (the active ingredient contained in Neurontin) of up to 2000 mg/kg for 2 years have developed acinar cell carcinoma of the pancreas.

Oncologic side effects have been reported in animal studies.

Renal

Renal side effects including two cases of marked increase in serum creatinine measurements following the introduction of gabapentin (the active ingredient contained in Neurontin) have been reported.