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Gabapentin and Pregabalin

This guide takes you through the different types of medications that may be prescribed following your consultation with the LBSM physicians.

If you have any further questions or are unsure about the medication you have been prescribed, please do not hesitate to contact us.

Key facts 

  • You’ll usually take gabapentin or pregabalin 2 or 3 times a day. You can take them with or without food. 
  • Gabapentin and Pregabalin are often used for epilepsy, but you can also take it to help with nerve related pain if you do not have epilepsy. 
  • It takes at least a few weeks for gabapentin or pregabalin to work. 
  • The side effects of gabapentin and pregabalin are usually mild and go away by themselves. The most common ones are feeling sleepy, dizziness and headaches. 

Summary

  1. How does gabapentin and pregabalin work
  2. Who can and cannot take gabapentin and pregabalin
  3. How and when to take gabapentin and pregabalin
  4. What are the side effects of pregabalin and gabapentin
  5. How do I stop taking pregabalin and gabapentin
  6. Pregnancy and breastfeeding
  7. Cautions with other medicines and substances

How does gabapentin and pregabalin work 

These drugs are thought to block pain by interfering with pain messages travelling through the brain and down the spine and the nervous system.  

Who can and cannot take gabapentin and pregabalin

Gabapentin and Pregabalin are suitable for adults.  

Gabapentin and Pregabalin are not suitable for some people. To make sure it’s safe for you, tell your doctor if you: 

  • over 65 or under 18 years old 
  • have ever had an allergic reaction to either medication 
  • have ever abused or been addicted to any medicine 
  • are trying to get pregnant, already pregnant or breastfeeding 
  • are on a controlled sodium diet, or your kidneys do not work well – some brands of medication liquid contain sodium, so speak to your pharmacist or doctor before taking it 
  • have any problems that affect your breathing 

How and when to take gabapentin and pregabalin 

Gabapentin 

Gabapentin is a prescription medicine. It’s important to take it as instructed by your doctor. 

Each capsule of gabapentin contains 100mg, 300mg or 400mg of gabapentin. Each tablet contains 600mg or 800mg of gabapentin. 

If you’re taking gabapentin as a liquid, 2ml is usually the same as taking a 100mg tablet or capsule. Always check the label. 

The usual dose to treat nerve pain in adults is 900mg to 3,600mg a day, split into 3 doses. 

To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few days. Once you find a dose that suits you, it will usually stay the same. 

Swallow gabapentin capsules and tablets whole with a drink of water or juice. Do not chew them. 

You can take gabapentin with or without food, but it’s best to do the same each day. 

Try to space your doses evenly through the day. For example, you could take it first thing in the morning, early afternoon and at bedtime. 

If you are taking a liquid, it will come with a plastic syringe or spoon to measure your dose. If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen spoon, as it will not measure the right amount. 

Pregabalin 

Pregabalin is a prescription medicine. It’s important to take it as instructed by your doctor. 

The usual dose of pregabalin is between 150mg and 600mg a day, split into 2 or 3 separate doses. 

If you are taking pregabalin as a liquid, 2.5ml is usually the same as taking a single 50mg capsule. Always check the label. 

You can take pregabalin with or without food, but it’s best to take it in the same way each day. Try to space your doses evenly through the day. 

Swallow pregabalin tablets or capsules whole with a drink of water or juice. Do not chew them. 

If you are taking pregabalin as a liquid, it will come with a syringe or spoon to measure your dose. If you do not have a measuring spoon or syringe, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount. 

If you’re taking pregabalin for nerve pain or anxiety it’s likely that once your symptoms have gone you will continue to take it for several months to stop them coming back. 

To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few days. 

Once you find a dose that suits you, it will usually then stay the same. 

If you forget a dose, take it as soon as you remember. If it’s within 2 hours of your next dose, skip the missed dose and take your next dose at the usual time. 

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one. 

What are the side effects of pregabalin and gabapentin 

Like all medicines, pregabalin can cause side effects although not everyone gets them. 

Common side effects 

These common side effects may happen in more than 1 in 100 people. They are usually mild and go away by themselves. 

Keep taking the medicine but tell your doctor if these side effects bother you or do not go away: 

  • headaches 
  • feeling sleepy, tired or dizzy 
  • diarrhoea 
  • mood changes 
  • feeling sick 
  • swollen hands, arms, legs and feet 
  • blurred vision 
  • difficulties with getting an erection 
  • weight gain – because pregabalin can make you feel hungry 
  • memory problems 

If you have diabetes, gabapentin and pregabalin can upset your blood sugar control. Monitor your blood sugar more often for the first few weeks of treatment with gabapentin or pregabalin and adjust your diabetes treatment if you need to. Talk to your doctor or diabetes nurse if you want more advice on what to do. 

Do not drive a car or ride a bike if pregabalin or gabapentin makes you sleepy, gives you blurred vision or makes you feel dizzy, clumsy or unable to concentrate or make decisions. This may be more likely when you first start taking gabapentin or pregabalin but it could happen at any time, for example when starting another medicine. 

Serious side effects 

Very few people taking gabapentin or pregabalin have serious problems. Call a doctor or contact 111 straight away if you get: 

  • thoughts of harming or killing yourself – a small number of people taking pregabalin have had suicidal thoughts, sometimes after only a week of treatment 
  • severe dizziness or you pass out 
  • hallucinations (seeing or hearing things that are not real) 
  • problems going to the toilet, including blood in your pee, needing to pee more often, or constipation 

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to pregabalin and gabapentin. 

 These are not all the side effects of gabapentin or pregabalin. For a full list see the leaflet inside your medicines packet. 

How to cope with side effects of pregabalin 

What to do about: 

  • headaches – make sure you rest and drink plenty of fluids. Try not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking pregabalin. Talk to your doctor if they last longer than a week or are severe. 
  • feeling sleepy, tired or dizzy – do not drive, cycle or use machinery until you feel better. As your body gets used to the medication, these side effects should wear off. If they do not wear off within a week or 2, your doctor may reduce your dose or increase it more slowly. If that does not work you may need to switch to a different medicine. 
  • diarrhoea – drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor. 
  • mood changes – if you feel this medicine is causing mood changes, speak to your doctor as you may need a change of medicine.
  • feeling sick – take pregabalin with or after a meal or snack to ease your symptoms. It may also help if you avoid rich or spicy food. 
  • swollen hands, arms, legs and feet – if your feet are swollen, try sitting with your feet up on a chair or bed and try not to stand for a long time. Exercise might help if your arms are swollen. If that does not help or it becomes painful, contact your doctor. 
  • blurred vision – do not drive, cycle or use tools or machinery while this is happening. If it lasts for more than a day or 2 speak to your doctor as they may need to change your treatment. 
  • difficulties with getting an erection – speak to your doctor, as they may be able to change your medicine or offer other treatments that might help with this problem. 
  • weight gain – gabapentin and pregabalin can make you hungrier so it can be quite a challenge to stop yourself putting on weight. Try to eat well without increasing your portion sizes. Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets. If you’re hungry between meals, eat fruit and vegetables and low-calorie foods. Increasing your level of exercise will also help to keep your weight stable. 
  • memory problems – if you’re having problems with your memory, speak to your doctor. They may want to try a different medicine. 

How do I stop taking pregabalin and gabapentin 

There’s no evidence that pregabalin and gabapentin has lasting harmful effects, even if you take it for many months or years. 

However, some people have become addicted to pregabalin after taking it for a long time. If this happens, you will have withdrawal symptoms after you stop taking the medicine. 

Talk to your doctor if you’re concerned you are becoming physically dependent on pregabalin. 

Do not stop taking pregabalin and gabapentin suddenly, even if you feel fine. Stopping suddenly can cause serious problems. 

If you have epilepsy, stopping pregabalin suddenly can cause seizures that will not stop. 

If you are taking it for any reason and stop suddenly, you may have severe withdrawal syndrome. This can have unpleasant symptoms, including: 

  • anxiety 
  • difficulty sleeping 
  • feeling sick 
  • pain 
  • sweating 

It’s possible to prevent withdrawal seizures and other symptoms by gradually reducing the dose of pregabalin and gabapentin. 

Do not stop taking pregabalin and gabapentin without talking to your doctor. 

Pregnancy and breastfeeding 

Taking pregabalin and gabapentin during pregnancy may slightly increase the chance of birth defects in the baby. 

You’ll usually only be advised to take it if your doctor thinks the benefits of the medicine outweigh the risks. 

If you take pregabalin and gabapentin and become pregnant, do not stop taking the medicine without talking to your doctor first.

It’s recommended to use effective contraception while taking pregabalin. If you plan to get pregnant, talk to your doctor first, as they may want to review your treatment. 

If you’re trying to get pregnant or have become pregnant while taking pregabalin or gabapentin, it is recommended to take high dose folic acid (5mg a day). You can get this from your doctor or midwife. 

If you take pregabalin around the time of giving birth, your baby may need extra monitoring for a few days after they’re born. This is because they may have pregabalin withdrawal symptoms. 

If your doctor or health visitor says your baby is healthy, you can take pregabalin or gabapentin while breastfeeding. It’s important to keep taking pregabalin to keep you well. 

Pregabalin and gabapentin passes into breast milk in small amounts, and it’s unlikely to cause side effects in your baby. 

If you’re breastfeeding or planning to breastfeed, talk to your doctor or pharmacist, as other medicines we know more about might be better while you’re breastfeeding, but they will help you decide. 

If your baby is not feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor or midwife. 

Cautions with other medicines and substances 

You are allowed to drink alcohol whilst taking gabapentin and pregabalin but it may make you sleepy. It is also recommended to drink safely and sensibly. 

Gabapentin and Pregabalin can usually be taken safely with other medicines. 

For safety, tell your doctor if you’re taking any of these medicines before you start taking pregabalin: 

  • strong painkillers such as morphine 
  • medicines that make you feel sleepy or dizzy – pregabalin can make these side effects worse 

Mixing pregabalin with herbal remedies and supplements 

There are no known problems with taking herbal remedies and supplements with these medications. 

However there’s not enough information to say that complementary medicines and herbal remedies are always safe to take with gabapentin and pregabalin. They’re not tested in the same way as pharmacy and prescription medicines. 

Please feel free to contact us if you have any queries about your medication. Look forward to seeing you at your next appointment.  

Wishing you a speedy recovery 

The LBSM team. 

The information in this article has been cited from www.nhs.uk to align with best clinical practice standards.

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