How does Neurontin work?

Scientists believe that Neurontin (gabapentin) possibly has inhibitory effects on nerve function.

What drugs should not be taken with Neurontin

You may need to adjust the timing of your doses if you take Neurontin and Maalox or other drugs containing magnesium or aluminum hydroxide. Wait two hours after taking one of these antacids before taking your Neurontin dose.

How long does Neurontin stay in your system?

The half-life is five to seven hours, which means that half of the last dose should be eliminated from your body (if you have perfectly healthy kidneys) in that time. However, the remaining half takes longer than five to seven hours to be eliminated. You might have small amounts of gabapentin in your system for several days after your last dose.

How do I safely stop taking Neurontin?

You should stop this medication gradually and under the guidance of a medical provider, as stopping it suddenly can cause withdrawal seizures. Your provider will give you a dosing schedule to reduce your dose gradually.

Why does Neurontin cause weight gain?

Neurontin can cause an increased appetite and edema (swelling), which can lead to weight gain . If you are experiencing weight gain due to edema, you should talk to your healthcare provider about potential treatment options. If you have weight gain due to an increased appetite, consider strategies like eating healthier (avoiding foods with preservatives, high-fat foods, and sugar-added foods) and adding more exercise to your weekly routine.

Neurontin (Gabapentin) Oral: Uses, Side Effects, Dosage

What Is Neurontin?

Neurontin (gabapentin) is an antiepileptic drug (AED), also called an anticonvulsant, that can help treat epilepsy or postherpetic neuralgia.

Despite the name, it does not affect gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter of the central nervous system. Gabapentin binds with voltage-activated calcium channels, which normally mediate nerve activity. However, it is not clear how this action impacts the clinical effects of the medication.

Gabapentin is the generic formulation of the drug, and there are several brand-name versions, including Neurontin. It is available as a tablet, a capsule, and an oral solution.

Drug Facts

Generic Name: Gabapentin

Brand Name(s): Neurontin

Drug Availability: Prescription

Therapeutic Classification: Anticonvulsant

Available Generically: Yes

Controlled Substance: N/A

Administration Route: Oral

Active Ingredient: Gabapentin

Dosage Form(s): Tablet, extended-release 24-hour tablet, capsule, solution

What Is Neurontin Used For?

The Food and Drug Administration (FDA) approved Neurontin for:

Add-on (adjunctive) treatment to prevent partial-onset seizures (also called focal seizures), which are seizures from epilepsy that begin in a specific region of the brain, in adults and children over the age of 3
Adults with postherpetic neuralgia, a chronic pain condition that can develop after an acute bout of shingles (viral infection causing painful rash) has resolved

Healthcare providers usually prescribe Neurontin along with one or more AEDs for seizure prevention. It is not approved for use as a single therapy (monotherapy).

In postherpetic neuralgia, shingles causes a rash with severe superficial and deep pain along a skin patch that corresponds to a sensory spinal nerve. Postherpetic neuralgia can develop after the shingles rash has resolved and may remain for months or years, with persistent pain along the same affected patch of skin. Gabapentin can be prescribed to take daily to control and prevent postherpetic neuralgia pain.

Verywell / Zoe Hansen

How to Take Neurontin

You should swallow gabapentin tablets, capsules, or oral solution with water. You can take this medication with or without food. Take your dose at bedtime to allow the body to get used to the side effect of drowsiness.

If you take an antacid containing aluminum, you should wait at least two hours before taking your next dose of Neurontin.

You should swallow the capsules whole. If you can't swallow the capsules whole, you can open them and sprinkle the contents onto soft food, such as applesauce or pudding. If needed, you can cut the scored tablets, but you should take the remaining portion of the tablet at your next dose.

Take your Neurontin as prescribed. The time between doses should not be greater than 12 hours when on multiple daily dosing regimens. Do not change your dose without talking to your healthcare provider first.

Storage

You should store gabapentin tablets or capsules at room temperature, ideally at 77 degrees Fahrenheit.

Keep the oral solution refrigerated at a temperature between 36 degrees and 46 degrees.

Off-Label Uses

Healthcare providers sometimes prescribe neurontin for conditions that the FDA has not approved. This is called off-label use.

Neurontin is prescribed for several off-label uses, including:

Peripheral neuropathy pain (diabetic neuropathy and other types of nerve damage)
Radiculopathy pain (caused by pinching a nerve root in the spine)
Pain during an episode of shingles
Fibromyalgia pain (widespread pain)
Bipolar disorder (mental health disorder causing unusual shifts in mood, energy, and activity levels, as well as concentration and performing tasks)
Migraine prophylaxis (treatment for severe headaches)
Anxiety disorders
Restless legs syndrome (condition causing an uncontrollable urge to move the legs)
Substance use disorder
Depression
Post-traumatic stress disorder

There are varying levels of evidence for efficacy for the above conditions and limited dosing guidance for using gabapentin in off-label indications.

How Long Does Neurontin Take to Work?

You might start to have beneficial effects within days of beginning Neurontin, but it may take several months to reach its full effect.

What Are the Side Effects of Neurontin?

Neurontin is associated with several side effects. Some are mild and may resolve when the medication dose is reduced or discontinued shortly after, or after the body has acclimated to the target dose.

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects in adults taking Neurontin can include:

Dizziness
Tiredness
Peripheral edema (swelling of the legs or arms): Reported only in patients taking Neurontin for the treatment of postherpetic neuralgia
Ataxia (diminished balance) or nystagmus (jerking eyes): Reported only in adult patients taking gabapentin for the treatment of epilepsy

Common side effects in children can include:

Viral infections
Fevers
Tiredness
Nausea or vomiting
Hostility and aggression
Behavioral problems
Restlessness
Trouble concentrating

Severe Side Effects

Some of the side effects that can occur due to taking Neurontin are severe and can be life-threatening. Severe side effects are not as common as the milder side effects of Neurontin. Still, you should be aware that they may develop at any time—shortly after you start taking gabapentin or after taking the medication for a long time. Gabapentin is not associated with long-term side effects when used as directed.

You can develop somnolence (extreme tiredness) when taking gabapentin. Somnolence is not necessarily harmful, but it can pose a danger during certain activities, such as when climbing a ladder, driving, or using equipment that could lead to accidental harm. Abuse or misuse of Neurontin has also been reported.

Severe side effects associated with Neurontin include:1

Drug reaction with eosinophilia and systemic symptoms (DRESS), including a rash, wheezing, difficulty breathing, fevers, and organ failure
Anaphylaxis (severe allergic reaction), with swelling of the lips, tongue, and/or throat, difficulty breathing, low blood pressure
Suicidal ideation (thinking about suicide, with or without a plan)
Slowed and/or shallow breathing

If you have any signs of these side effects, you should seek urgent medical attention, as they can progress rapidly and may be life-threatening.

Report Side Effects

Neurontin may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

(800) 332-1088

Dosage: How Much Neurontin Should I Take?

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage forms (capsules, liquid, and tablets):
- For epilepsy:
  - Adults and children 12 years of age and older—At first, 300 milligrams (mg) three times per day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 1800 mg per day (600 mg three times per day).
  - Children 3 to 11 years of age—Dose is based on body weight and must be determined by your doctor. The starting dose is 10 to 15 milligrams (mg) per kilogram (kg) of body weight per day and divided in 3 doses. Your doctor may adjust your dose as needed and tolerated.
  - Children younger than 3 years of age—Use and dose must be determined by your doctor.
- For postherpetic neuralgia:
  - Adults— At first, 300 milligrams (mg) as a single dose in the evening. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 1800 mg per day.
  - Children—Use and dose must be determined by your doctor.

Modifications

Certain factors may require healthcare providers to prescribe you a different dose for Neurontin.

You may need a lower dosage of Neurontin if you have kidney disease or are getting hemodialysis (procedure in which a machine filters the blood of wastes and water), or rely on hemodialysis due to kidney failure. Your healthcare provider will adjust your dosage based on creatinine clearance, a measure of kidney function.

For example, people who have a creatinine clearance of between 30 and 59 milliliters per minute (mL/min, normal is over 60 mL/min), should receive approximately two-thirds of the daily dose of gabapentin that they would have received with normal creatinine clearance.

People who rely on hemodialysis due to kidney failure should receive a single dose equal to approximately one-third of the recommended daily dose immediately after treatment.

If you are older (over 65) or have a chronic disease, you might have impaired kidney function. Your provider may check your kidney function before prescribing gabapentin to make dosing adjustments if necessary.

Missed Dose

You should talk to your healthcare provider about what to do if you miss a dose of Neurontin or any of your other medications.

If you take Neurontin for pain control and miss your dose, you can take it when you remember, unless it is almost time for your next dose. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not take double your medication dose, as this can increase your risk of side effects. You might experience pain if you miss your dose, but missing one dose is not dangerous.

If you take Neurontin for seizure control and miss your dose, take the missed dose, and then resume your regular schedule. Do not double up on your dose. Remember that your Neurontin schedule is probably the same as your schedule for your other antiepileptics.

Missing a dose can cause you to have a seizure. Be especially careful about this until you take your medication. Keep in mind that it can take time to work, so you should be cautious about the possibility of having a seizure until several hours after you have caught up. If you have missed multiple doses, you should call your healthcare provider for guidance.

Overdose: What Happens If I Take Too Much Neurontin?

Accidental or deliberate overdose of gabapentin can be dangerous. Overdose can cause symptoms such as:

Dizziness
Loss of balance
Diminished coordination
Tremors
Eye problems, including double vision
Sleepiness
Hyperactivity
Confusion
Diarrhea

You may experience difficulty breathing, which can be life-threatening. Neurontin overdose can be treated with respiratory support. If necessary, the medication can be removed with an urgent hemodialysis procedure.

What Happens If I Overdose on Neurontin?

If you think you or someone else may have overdosed on Neurontin (gabapentin), call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Neurontin, call 911 immediately.

911

Precautions

It is very important that your doctor check your progress at regular visits, especially in the first few months if you have epilepsy. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Check with your doctor right away if you have a fever, rash, swollen, painful, or tender lymph glands in the neck, armpit, or groin, unusual bleeding or bruising, or yellow eyes or skin. These may be symptoms of a serious and life-threatening allergic reaction called drug reaction with eosinophilia and systemic symptoms (DRESS) or multiorgan hypersensitivity.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema. These can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Gabapentin may cause vision changes, clumsiness, unsteadiness, dizziness, drowsiness, sleepiness, or trouble with thinking. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert, well-coordinated, or able to think or see well. If these side effects are especially bothersome, check with your doctor.

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors, such as feeling sad or hopeless, getting upset easily, or feeling nervous, restless, or hostile. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor right away.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicines, prescription pain medicine or narcotics, other medicines for seizures (eg, barbiturates), muscle relaxants, or anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you or your child are using gabapentin.

This medicine may cause respiratory depression, a serious breathing problem that can be life-threatening, when used together with narcotic pain medicines. Check with your doctor right away if you have pale or blue lips, fingernails, or skin, difficult or troubled breathing, or irregular, fast or slow, or shallow breathing.

Do not stop using gabapentin without checking with your doctor. Stopping the medicine suddenly may cause seizures. Your doctor may want you or your child to gradually reduce the amount you are taking before stopping it completely.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Neurontin?

You should not take Neurontin if you have ever had an adverse reaction to gabapentin.

Neurontin is not recommended for people who are pregnant or breastfeeding. If you take Neurontin and plan to become pregnant, discuss your treatment options with your healthcare provider. If you are taking Neurontin and have become pregnant, do not stop taking it, but call your provider to discuss whether you should continue to use Neurontin.

What Medications Interact With Neurontin?

Neurontin can interact with the following medications:

Maalox or other drugs containing magnesium or aluminum hydroxide
Hydrocodone
Morphine

Maalox or other antacids containing magnesium or aluminum hydroxide, which are often used to treat heartburn or indigestion, may interact with Neurontin. These medications can lower the absorption of gabapentin. Wait at least two hours after a dose of an antacid containing magnesium or aluminum hydroxide before taking your Neurontin.

Certain opioids can also interact with gabapentin. Taking hydrocodone with Neurontin can decrease hydrocodone exposure (efficacy). If taking Neurontin with morphine, you may need to be observed for central nervous system depression signs.

You also avoid certain herbal supplements, such as kratom, when taking gabapentin. Before starting Neurontin, make a list of the OTC supplements you take and review them with your healthcare provider.

Be cautious about mixing Neurontin with recreational alcohol use, as this can increase the central nervous system depressant effects of the medication.

What Medications Are Similar?

Gabapentin is the generic version of Neurontin and Horizant (an extended-release formulation).

Other commonly used AEDs for treating partial seizures in combination with gabapentin include:

Tegretol (carbamazepine)
Keppra, Keppra XR, Elepsia XR (levetiracetam)
Mysoline (primidone)
Dilantin, Phenytek (phenytoin)
Topamax, Topiragen, Eprontia, Qudexy XR, Trokendi XR (topiramate)

Lyrica (pregabalin) is another medication with a similar mechanism of action to Neurontin. It is also used to help treat seizures and postherpetic neuralgia.

Frequently Asked Questions

What is Neurontin used for?

The FDA approved Neurontin (gabapentin) to prevent partial-onset seizures and treat postherpetic neuralgia pain. It is sometimes prescribed off-label to manage chronic pain conditions and mood disorders.
How does Neurontin work?

Scientists believe that Neurontin (gabapentin) possibly has inhibitory effects on nerve function.
What drugs should not be taken with Neurontin

You may need to adjust the timing of your doses if you take Neurontin and Maalox or other drugs containing magnesium or aluminum hydroxide. Wait two hours after taking one of these antacids before taking your Neurontin dose.
What are the side effects of Neurontin?

The most common side effects include tiredness and balance problems, but severe side effects, including allergies and organ failure, can also occur.
How long does Neurontin stay in your system?

The half-life is five to seven hours, which means that half of the last dose should be eliminated from your body (if you have perfectly healthy kidneys) in that time. However, the remaining half takes longer than five to seven hours to be eliminated. You might have small amounts of gabapentin in your system for several days after your last dose.
How do I safely stop taking Neurontin?

You should stop this medication gradually and under the guidance of a medical provider, as stopping it suddenly can cause withdrawal seizures. Your provider will give you a dosing schedule to reduce your dose gradually.
Why does Neurontin cause weight gain?

Neurontin can cause an increased appetite and edema (swelling), which can lead to weight gain. If you are experiencing weight gain due to edema, you should talk to your healthcare provider about potential treatment options.
If you have weight gain due to an increased appetite, consider strategies like eating healthier (avoiding foods with preservatives, high-fat foods, and sugar-added foods) and adding more exercise to your weekly routine.

How Can I Stay Healthy While Taking Neurontin?

Neurontin is generally safe when taken as prescribed, but it can cause side effects. Be sure to monitor the symptoms that emerge while taking your medication so you can talk to your healthcare provider about whether it is effective.

Epilepsy and postherpetic neuralgia can both be difficult conditions to manage. Treatments can help improve quality of life, so following your prescribed treatment regimen is important. In addition to taking your medication, you can try different strategies to help cope with your condition.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

3 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Food and Drug Administration. Neurontin label.
Peckham AM, Evoy KE, Ochs L, Covvey JR. Gabapentin for off-label use: Evidence-based or cause for concern? Subst Abuse. 2018. doi: 10.1177/1178221818801311
Iwaki H, Jin K, Sugawara N, Nakasato N, Kaneko S. Perampanel-induced weight gain depends on level of intellectual disability and its serum concentration. Epilepsy Res. 2019. doi: 10.1016/j.eplepsyres.2019.02.011

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.

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Neurontin (Gabapentin) – Oral