Can I drive or ride a bike after I take Gabapentin ?

Gabapentin is used with other medications to prevent and control seizures. It is also used to relieve nerve pain following shingles (a painful rash due to herpes zoster infection) in adults.

Gabapentin is known as an anticonvulsant or antiepileptic drug.

You may feel sleepy, tired or dizzy when you first start taking gabapentin. This may also happen if your dose has increased.

If this happens to you, do not drive or ride a bike until you feel better.

It’s an offence to drive a car if your ability to drive safely is affected. It’s your responsibility to decide if it’s safe to drive. If you’re in any doubt, do not drive.

If you have epilepsy, you are generally not allowed to drive until:

    • you have not had any seizures (while awake) for 1 year
    • you have only had seizures while you’re asleep

If you change your epilepsy medicine, your doctor will tell you whether you need to stop driving and for how long.

Do I need to stay on the same brand of Gabapentin?

Gabapentin capsules, tablets, and oral solution are used along with other medications to help control certain types of seizures in people who have epilepsy.

Gabapentin capsules, tablets, and oral solution are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles).

Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down).

Gabapentin is in a class of medications called anticonvulsants. Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.

Most people do not have to stay on the same brand of gabapentin as there’s very little difference between brands.

Talk to your doctor if you have been asked to switch to a different brand and are worried about that.

If your epilepsy has been hard to control in the past and the brand you’re now taking is working well for you, your doctor may recommend you stay on the same one.

How and when to take Gabapentin ?

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

Dosage and strength

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.

Dosage for epilepsy

The usual dose for:

    • adults and older children (aged 12 and over) is 900mg to 3,600mg a day, split into 3 doses
    • younger children (aged 6 to 12) – varies depending on their weight

Dosage for nerve pain

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

Changes to your dose

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.

How to take Gabapentin ?

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 or your child 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.

How long to take it for

If you have epilepsy, it’s likely that once your condition is under control you’ll still need to take gabapentin for many years.

If you have nerve pain, once your pain has gone you’ll continue to take gabapentin for several months or longer to stop it coming back.

If you forget to take it

If you forget a dose, take it as soon as you remember. If it’s within 2 hours of the next dose, it’s better to leave out the missed dose and take your next dose as normal.

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

If you have epilepsy, it’s important to take this medicine regularly. Missing doses may trigger a seizure.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking too much gabapentin can cause unpleasant side effects.

Urgent advice: Contact 111 for advice or go to A&E now if:

you take more than your prescribed dose of gabapentin and:

    • you feel dizzy or sleepy
    • you have double vision
    • you start slurring your words
    • you have diarrhoea
    • you pass out (faint)

If you need to go to A&E, take the gabapentin packet or leaflet inside it, plus any remaining medicine, with you.

Stopping gabapentin

It’s important not to stop taking gabapentin suddenly, even if you feel fine. Stopping gabapentin suddenly can cause serious problems.

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

If you’re taking it for any reason and stop suddenly, you may have a 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 gabapentin.

Do not stop taking gabapentin without talking to your doctor – you’ll need to reduce your dose gradually.

Risks of taking Gabapentin during pregnancy and when breastfeeding

Risks during pregnancy and when breastfeeding

People who are pregnant and those who intend to become pregnant should tell a doctor before taking gabapentin.

Research from 2020 suggests that taking this drug during pregnancy may be associated with a higher risk of cardiac malformations in the fetus, a condition called small for gestational age, and preterm birth.

However, it is also essential to control seizures during pregnancy, so pregnant people should only take the drug if it is absolutely necessary.

People should never start or stop taking gabapentin for seizure control before talking with a doctor. They will assess the potential risks and benefits.

After childbirth, gabapentin passes into breast milk. At low levels, it may not affect the infant. However, it is best to discuss this issue with a doctor before breastfeeding.

Presence of other health conditions that affect Gabapentin

To ensure that gabapentin is safe to take, a person should tell a doctor if they also currently have or have ever had:

    • diabetes
    • dialysis treatment
    • drug or alcohol misuse issues
    • heart disease
    • kidney disease
    • liver disease
    • seizures (if taking gabapentin for conditions unrelated to seizures)

Gabapentin Interactions with other medications and substances

Gabapentin can interact with other prescription and over-the-counter medications, vitamins, and herbal supplements.

People should be sure to give a doctor a full list of their current medications and supplements before taking gabapentin.

The results of another 2017 review suggest that the following are some of the main substances that interact with the drug:

    • caffeine, which is present in tea, coffee, and cola
    • ethacrynic acid, which is a diuretic
    • losartan, which is a medication for high blood pressure
    • magnesium oxide, which is a mineral supplement and antacid
    • mefloquine, which is an antimalarial drug
    • morphine, which is an opioid pain medication
    • phenytoin, which is an anti-seizure medication

If gabapentin causes sleepiness, a person should speak with a doctor before taking other medications that can also cause drowsiness, including:

    • antianxiety medications
    • antidepressants
    • antihistamines
    • cold and flu medications
    • muscle relaxers
    • narcotics, which are pain medications
    • sleeping pills

Presence of other health conditions

To ensure that gabapentin is safe to take, a person should tell a doctor if they also currently have or have ever had:

    • diabetes
    • dialysis treatment
    • drug or alcohol misuse issues
    • heart disease
    • kidney disease
    • liver disease
    • seizures (if taking gabapentin for conditions unrelated to seizures)

What is the maximum daily dosage of Gabapentin?

I’m taking 800mg three times a day for anxiety. It works great. The max recommended dose is 3600mg daily, but I’ve read where some people take up to 4800mg a day. I guess it depends on the person and how they metabolize it.

Although the FDA says 3600mg/day in most places, they have a more extensive doc about gabapentin/neurontin usage and bioavailability. First, your body can only process a certain amount taken and the rest is excreted, so large doses over their bioavailablity chart don’t give larger effects.

Lyrica and other meds have different bioavailability, so use smaller dosages. Since your kidneys do much of the work with gaba/neurontin, you want to make sure you do not have any kidney problems.

A person may need lower doses or not use it due to that. Second, calcium channel meds like gabapentin are nonlinear, so side effects and benefits vary from person to person.

What works or doesn’t work for one, may be the opposite for another. That is why dosage benefits and side effects vary so much from person to person. Even a small dose might make you sleep, but not to another person.

I have heard from some people their doc may prescribe smaller doses during the day and a larger dose at the time of day more problems appear such as at night.

Gaba/neurontin has a short half life so needs doses spread out during the day. One challenging thing is that people that are on gaba are also on other meds too, so there is going to be confusion about what caused what and if there are interactions.

After a couple years, I was only on gaba. For me on maximum dose, I did sleep more, plus several other side effects. It all comes down to finding the most benefit with the least negatives including cost or as docs say, benefits outweigh the risks. Suggest reading more of this forum for a patient viewpoint.

Does Gabapentin cause constipation?

Gabapentin may cause constipation, but it is not a common side effect. In clinical trials of adults taking gabapentin for nerve pain, only about 4% of people reported constipation.

Who may not be able to take gabapentin

Gabapentin is not suitable for some people.

To make sure it’s safe for you, tell your doctor if you:

    • have ever had an allergic reaction to gabapentin or any other medicine
    • have ever misused or been addicted to a medicine
    • are trying to get pregnant or are already pregnant
    • are on a controlled sodium or potassium diet, or your kidneys do not work well (gabapentin liquid contains sodium and potassium, so speak to your doctor before taking it)

Some people in these trials took an inactive medicine (placebo). About 2% of people taking a placebo also reported constipation, so the actual percentage of people with constipation while taking gabapentin is probably less than 4%.

In clinical trials of people aged 12 and over taking gabapentin for seizure disorder, about 2% reported constipation as a side effect. Out of people taking a placebo, 1% also reported constipation.

In the clinical trials of gabapentin to treat nerve pain in adults, the most common side effects were:

  • Dizziness
  • Sleepiness
  • Swelling in the hands or feet (peripheral edema)

In clinical trials of people older than 12 taking gabapentin to treat a seizure disorder, the most common side effects were sleepiness and clumsiness (ataxia).

Thoughts of death or suicide is another rare but important side effect of gabapentin, occurring in about 1 in 500 people. These thoughts can happen within one week of starting gabapentin. Call your doctor right away if you have any unusual changes in mood or behavior, or any of these symptoms:

  • Thoughts about suicide or dying
  • Suicide attempt
  • Depression, new or worsening
  • Anxiety, new or worsening
  • Panic attacks

In 2019, the U.S. Food and Drug Administration (FDA) added another important warning about gabapentin: When this drug is taken with opioid pain medication or used by a person with chronic lung disease like chronic obstructive pulmonary disease (COPD), it may cause severe and possibly fatal difficulty breathing (respiratory depression). Before starting gabapentin, let your doctor know if you are taking any opioid drug, or if you have been diagnosed with a lung disease.

Even if you have side effects from gabapentin, it is important not to stop taking it suddenly on your own. This medication must be reduced over time (tapered) by your doctor. Stopping suddenly can lead to withdrawal symptoms such as:

  • Anxiety
  • Insomnia
  • Nausea
  • Pain

If you are taking gabapentin to control seizures, stopping suddenly may increase your risk of a seizure.