Does Gabapentin Have a Withdrawal Syndrome?

Gabapentin (marketed under the trade names Neurontin, Gralise, and Horizant) is an anticonvulsant medication used to treat partial seizures, postherpetic neuralgia, and other types of neuropathic pain.

The Horizant extended-release formulation is approved for the treatment of restless leg syndrome.

Though gabapentin abuse is relatively uncommon, studies have documented its misuse. Gabapentin abuse most often occurs in conjunction with other drugs, such as opioids, benzodiazepines, and alcohol.

Does Gabapentin Have a Withdrawal Syndrome?

Even those who take gabapentin as prescribed may develop some physical dependence; however, those who misuse it or abuse it recreationally may experience significant levels of dependence and withdrawal symptoms when they try to quit or slow its use. There are documented cases of withdrawal symptoms in people who took daily doses between 400mg to 8000mg for at least 3 weeks.

The gabapentin withdrawal syndrome may resemble some of the symptoms of alcohol and benzodiazepine withdrawal. This similarity may be due to the fact that gabapentin and these other substances all act on gamma-aminobutyric acid, or GABA, which is an inhibitory neurotransmitter in the brain.

The primary withdrawal symptoms associated with gabapentin use include:

- - Anxiety.
  - Agitation.
  - Insomnia.
  - Fatigue.
  - Restlessness.
  - Irritability.
  - Dizziness.
  - Headache.
  - Sensitivity to light.
  - Sweating.
  - Irregular heartbeat.
  - Nausea.
  - Pain.

In addition, people who are taking gabapentin for seizures and suddenly stop taking it may experience a rebound in or increased frequency of seizure activity, including continuous, uncontrollable seizures (status epilepticus).

Withdrawal usually occurs within 12 hours to 7 days after quitting the medication. Though a withdrawal timeline hasn’t been clearly documented, some studies have noted symptoms that last up to 10 days.

Factors that can affect withdrawal include:

- - Age.
  - Dose.
  - Length of use.
  - Medical or mental health problems.
  - Concurrent use of other drugs or alcohol.

In some cases, individuals who are at risk of or are already displaying severe withdrawal symptoms may require intensive inpatient monitoring and medical withdrawal management if complications arise.

Experts recommend gradually smaller doses of gabapentin to safely and comfortably wean a person off the medication. Such tapering schedules are commonly used with medications like gabapentin that have the potential to produce adverse withdrawal effects when being discontinued.

Side Effects of Gabapentin

Gabapentin oral capsule can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking gabapentin. This list does not include all possible side effects.

For more information on the possible side effects of gabapentin, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

Some of the more common side effects that can occur with use of gabapentin are listed below, along with their rates:

Also:

- viral infection
- fever
- nausea and vomiting
- trouble speaking
- hostility
- jerky movements

The side effect rates are based on patients over 12 years old, as reported in clinical trials for the brand equivalent, Neurontin. Certain rates vary by age. For example, pediatric patients 3 to 12 years of age most commonly experienced viral infection (11%), fever (10%), nausea and/or vomiting (8), tiredness (8%), and hostility (8%). There were no clinically significant differences in rates between men and women. For more information, see the FDA package insert.

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Changes in mood or anxiety. Symptoms can include:
- thoughts of suicide or dying
- attempts to commit suicide
- anxiety that’s new or gets worse
- crankiness that’s new or gets worse
- restlessness
- panic attacks
- trouble sleeping
- anger
- aggressive or violent behavior
- extreme increase in activity and talking
- unusual changes in behavior or mood
Changes in behavior and thinking, especially in children ages 3 to 12 years. Symptoms can include:
- emotional changes
- aggressiveness
- trouble concentrating
- restlessness
- changes in school performance
- hyper behavior
Serious and life-threatening allergic reaction. Symptoms can include:
- skin rashes
- hives
- fever
- swollen glands that do not go away
- swollen lips and tongue
- yellowing of your skin or the whites of your eyes
- unusual bruising or bleeding
- severe tiredness or weakness
- unexpected muscle pain
- frequent infections

Gabapentin may interact with other medications

Gabapentin oral capsule can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with gabapentin. This list does not contain all drugs that may interact with gabapentin.

Before taking gabapentin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Opioids

When used with gabapentin, opioids can cause dangerous effects in the body. Some examples of these drugs include morphine, hydrocodone, and oxycodone.

Taking gabapentin with an opioid increases your risk for severe sleepiness, respiratory depression, coma, and even death.

Stomach acid drugs

When used with gabapentin, certain drugs used to treat stomach acid problems can reduce the amount of gabapentin in your body. This can make it less effective. Taking gabapentin 2 hours after taking these drugs can help prevent this problem. Examples of these drugs include:

- aluminum hydroxide
- magnesium hydroxide

Gabapentin Can be Used for Restless Legs Syndrome

Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move the legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you’re sitting or lying down. Moving eases the unpleasant feeling temporarily.

Restless legs syndrome, also known as Willis-Ekbom disease, can begin at any age and generally worsens as you age. It can disrupt sleep, which interferes with daily activities.

Simple self-care steps and lifestyle changes may help relieve symptoms. Medications also help many people with RLS.

Risk factors of RLS

RLS can develop at any age, even during childhood. The condition is more common with increasing age and more common in women than in men.

RLS usually isn’t related to a serious underlying medical problem. However, it sometimes accompanies other conditions, such as:

- Peripheral neuropathy. This damage to the nerves in the hands and feet is sometimes due to chronic diseases such as diabetes and alcoholism.
- Iron deficiency. Even without anemia, iron deficiency can cause or worsen RLS. If you have a history of bleeding from the stomach or bowels, experience heavy menstrual periods, or repeatedly donate blood, you may have iron deficiency.
- Kidney failure. If you have kidney failure, you may also have iron deficiency, often with anemia. When kidneys don’t function properly, iron stores in the blood can decrease. This and other changes in body chemistry may cause or worsen RLS.
- Spinal cord conditions. Lesions on the spinal cord as a result of damage or injury have been linked to RLS. Having had anesthesia to the spinal cord, such as a spinal block, also increases the risk of developing RLS.
- Parkinson’s disease. People who have Parkinson’s disease and take certain medications called dopaminergic agonists have an increased risk of developing RLS.

Medications for RLS

Medication is a key treatment for moderate to severe RLS.

Dopaminergic drugs are typically the first medications prescribed. They’re effective in relieving RLS symptoms, but they can cause side effects and other problems .

Other types of drugs can also help relieve RLS symptoms without causing these same types of problems.

Dopaminergic drugs

Dopaminergic drugs increase the release of dopamine in your brain. Dopamine is a chemical that helps enable normal body movements .

Dopaminergic drugs likely help relieve RLS symptoms because the condition is associated with problems in the body’s production of dopamine.

Three dopaminergic medications have been approved by the U.S. Food and Drug Administration (FDA) to treat moderate to severe primary RLS:

- pramipexole (Mirapex)
- ropinirole (Requip)
- rotigotine (Neupro)

While dopaminergic drugs have been shown to help improve RLS symptoms, long-term use can actually worsen symptoms. This phenomenon is called augmentation. To help delay this problem, doctors typically prescribe the lowest possible dose of these drugs .

In addition, these drugs can become less effective over time. To help delay or prevent both of these problems, your doctor may prescribe a combination of dopaminergic drugs with other types of drugs to treat RLS .

Gabapentin

A fourth drug that’s been approved by the FDA to treat RLS is called gabapentin (Horizant). This is an antiseizure medication .

It’s not entirely understood how gabapentin works to relieve RLS symptoms, but studies show it to be effective.

In one study, 24 people with RLS were treated with gabapentin or a placebo for six weeks. Those treated with gabapentin had improved sleep and reduced leg movements from RLS, while those treated with a placebo did not.

Another study compared the use of gabapentin with the use of ropinirole (one of the drugs approved by the FDA to treat RLS). Eight people with RLS took each of the drugs for four weeks, and both groups achieved similar levels of relief from RLS symptoms .

Benzodiazepines

Benzodiazepines are drugs used to treat anxiety and sleep problems. Clonazepam (Klonopin) and other types of these drugs are often prescribed for people with RLS in combination with other drugs.

While these drugs may not relieve RLS symptoms themselves, their benefit of improved sleep can be very helpful for people with RLS.

Opioids

Opioids are typically used to treat pain. In some cases, usually when other medications aren’t helpful or cause augmentation, opioids can be used carefully in low doses to help treat RLS .

Prolonged-release oxycodone/naloxone (Targinact) is one opioid that could help relieve RLS symptoms and improve sleep . However, because of the newer guidelines being developed for the use of opioids, this should be a last resort.

As with all opioids, use of these drugs should be carefully overseen by a doctor, due to their risk of misuse and dependence.

The Alternative Medicines of Gabapentin

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

What is Gralise?

Gralise is a prescription medicine that affects chemicals in the body that are involved in some types of pain.

Gralise is used in adults to treat pain from damaged nerves (neuropathic pain) that follows healing of shingles (a painful rash that comes after a herpes zoster infection).

It is not known if Gralise is safe and effective in people with seizure problems (epilepsy).

Gralise is not interchangeable with other gabapentin products.

Dosing information

Usual Adult Dose for Postherpetic Neuralgia:

-Gralise should be titrated to 1800 mg orally once daily with the evening meal.
-Recommended titration schedule:
Day 1: 300 mg orally with the evening meal
Day 2: 600 mg orally with the evening meal
Days 3 through 6: 900 mg orally with the evening meal
Days 7 through 10: 1200 mg orally with the evening meal
Days 11 through 14: 1500 mg orally with the evening meal
Day 15: 1800 mg orally with the evening meal
COMMENT:
-Gralise is not interchangeable with other gabapentin products because of differing pharmacokinetic profiles that affect the frequency of administration.

Lidocaine (Topical Application Route)

US Brand Name

Anestacon
Burnamycin
Burn-O-Jel
Lida Mantle
Lidoderm
LidoRx
LMX 4
LMX 5
Senatec
Solarcaine Cool Aloe
Xylocaine

Canadian Brand Name

Topicaine
Solarcaine First Aid Lidocaine Spray
Solarcaine Lidocaine First Aid Spray

Descriptions

Lidocaine topical jelly or ointment is used on different parts of the body to cause numbness or loss of feeling for patients having certain medical procedures. It is also used to relieve pain and itching caused by conditions such as sunburn or other minor burns, insect bites or stings, poison ivy, poison oak, poison sumac, minor cuts, or scratches. Xylocaine® jelly is used to treat painful urethritis (inflammation of the urethra). It is also used to prevent and control pain in procedures involving the male and female urethra. Xylocaine® jelly is also used to lubricate the nose, mouth, and throat for intubation.

Lidocaine viscous topical solution is also used to treat sore mouth or throat and also reduce gagging during the taking of X-ray pictures and dental impressions.

Lidocaine skin patch is used to relieve nerve pain caused by herpes zoster or shingles (postherpetic neuralgia).

Lidocaine belongs to the family of medicines called local anesthetics. This medicine prevents pain by blocking the signals at the nerve endings in the skin. This medicine does not cause unconsciousness as general anesthetics do when used for surgery.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

Spray
Patch, Extended Release
Gel/Jelly
Cream
Ointment
Lotion
Pad
Swab
Powder
Solution

Important Considerations for Taking Gabapentin

Keep these considerations in mind if your doctor prescribes gabapentin oral capsule for you.

General

Gabapentin oral capsules can be taken with or without food. Taking them with food can help to reduce upset stomach.

Storage

Store gabapentin at room temperature between 68°F and 77°F (20°C and 25°C).
Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

Always carry your medication with you, such as in your carry-on bag.
Don’t worry about airport X-ray machines. They can’t hurt your medication.
You may need to show airport staff the pharmacy label for your medication. Be sure to carry with you the prescription-labeled box that your medication came in.
Do not put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Kidney function. Your doctor will monitor your kidney function during your treatment with this drug. If your kidneys aren’t working well, your doctor may lower your dosage of this drug.

Mental health and behavioral problems. You and your doctor should watch for any changes in your behavior and mood. This drug can cause new mental health and behavior problems. It may also worsen problems you already have.

Insurance

Many insurance companies require a prior authorization for gabapentin. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Gabapentin Warnings

Gabapentin oral capsule comes with several warnings. Call your doctor if you start having more seizures or a different kind of seizure while taking this drug.

Drowsiness warning

Gabapentin can slow your thinking and motor skills and cause drowsiness and dizziness. It’s not known how long these effects last. You should not drive or use heavy machinery while taking this drug until you know how it affects you.

Depression warning

Using this drug increases your risk of suicidal thoughts and behavior. Talk to your doctor if you feel depressed or notice any changes in your mood or behavior. Also talk to your doctor if you are having thoughts of harming yourself, including suicide.

Multiorgan hypersensitivity/DRESS warning

This medication can cause multiorgan hypersensitivity. This is also known as a drug reaction with eosinophilia and systemic symptoms (DRESS). This syndrome can be life-threatening. Call your doctor right away if you have symptoms such as a rash, a fever, or swollen lymph nodes.

Allergy warning

Gabapentin can cause a severe allergic reaction. Symptoms can include:

- trouble breathing
- swelling of your throat or tongue
- hives
- rash

Don’t take this drug again if you have ever had an allergic reaction to it before. Taking it a second time after any allergic reaction to it could be fatal (cause death).

Alcohol interaction warning

Avoid drinking alcohol while taking gabapentin. Gabapentin can cause sleepiness, and drinking alcohol can make you even more sleepy. Alcohol can also make you more likely to feel dizzy and have trouble concentrating.

Severe breathing problems warning

Severe breathing problems can occur if you take gabapentin with opioids, such as oxycodone or hydrocodone. Taking gabapentin with an opioid increases your risk for sleepiness, breathing problems, and even death. You’re at higher risk if you already have breathing problems. Get help right away if breathing problems occur

Warnings for people with certain health conditions

For people with epilepsy: Don’t stop taking gabapentin suddenly. Doing this can increase your risk of having a condition called status epilepticus. This is a medical emergency during which short or long seizures occur for 30 minutes or more.

Gabapentin can cause problems in children aged 3–12 years who have epilepsy. It raises their risk of thought problems as well as behavioral problems, such as being hyper and acting hostile or restless.

For people with kidney problems: Your body processes this drug more slowly than normal. This may cause the drug to increase to dangerous levels in your body. Talk to your doctor about whether this drug is safe for you.

Warnings for other groups

For pregnant women: The use of gabapentin has not been studied in humans during pregnancy. Research in animals has shown negative effects to the fetus when the mother takes the drug. However, animal studies don’t always predict the way humans would respond.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus. Call your doctor if you become pregnant while taking this drug.

If your doctor prescribes gabapentin for you while you’re pregnant, ask about the NAAED Pregnancy Registry. This registry tracks the effects of anti-seizure drugs on pregnancy. Information can be found at aedpregnancyregistry.org.

For women who are breastfeeding: Gabapentin may pass into breast milk and cause serious side effects in a breastfeeding child. Tell your doctor if you are breastfeeding. You should decide together if you should stop taking this drug or stop breastfeeding.

For seniors: Kidney function may decrease with age. You may process this drug more slowly than younger people. Your doctor may start you on a lowered dose so that too much of this drug does not build up in your body. Too much of the drug in your body can be dangerous.

For children: Gabapentin has not been studied in children for the management of postherpetic neuralgia. It should not be used in people younger than 18 years. This drug should not be used to treat partial seizures in children younger than 3 years.

Which Medicines Interacted With Gabapentin ?

Gabapentin (Neurontin) is a medication approved to treat certain seizures and nerve pain. It’s typically taken 3 times daily by mouth, and is available as pills and a liquid.

Common side effects include dizziness and sleepiness.

Below is a list of medications that can interact with gabapentin. This list does not contain all drugs that may interact with gabapentin.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Opioids

When used with gabapentin, opioids can cause dangerous effects in the body. Some examples of these drugs include morphine, hydrocodone, and oxycodone.

Taking gabapentin with an opioid increases your risk for severe sleepiness, respiratory depression, coma, and even death.

Stomach acid drugs

aluminum hydroxide
magnesium hydroxide

What is the Side Effects of Fioricet ?

For more information on the possible side effects of gabapentin, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

Some of the more common side effects that can occur with use of gabapentin are listed below, along with their rates:

Also:

- viral infection
- fever
- nausea and vomiting
- trouble speaking
- hostility
- jerky movements

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Changes in mood or anxiety. Symptoms can include:
- thoughts of suicide or dying
- attempts to commit suicide
- anxiety that’s new or gets worse
- crankiness that’s new or gets worse
- restlessness
- panic attacks
- trouble sleeping
- anger
- aggressive or violent behavior
- extreme increase in activity and talking
- unusual changes in behavior or mood
Changes in behavior and thinking, especially in children ages 3 to 12 years. Symptoms can include:
- emotional changes
- aggressiveness
- trouble concentrating
- restlessness
- changes in school performance
- hyper behavior
Serious and life-threatening allergic reaction. Symptoms can include:
- skin rashes
- hives
- fever
- swollen glands that do not go away
- swollen lips and tongue
- yellowing of your skin or the whites of your eyes
- unusual bruising or bleeding
- severe tiredness or weakness
- unexpected muscle pain
- frequent infections

What is Gabapentin?

Gabapentin is used to help control partial seizures (convulsions) in the treatment of epilepsy. This medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to take it.

Gabapentin is also used to manage a condition called postherpetic neuralgia, which is pain that occurs after shingles.

Gabapentin works in the brain to prevent seizures and relieve pain for certain conditions in the nervous system. It is not used for routine pain caused by minor injuries or arthritis. Gabapentin is an anticonvulsant.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

- - Capsule
  - Tablet
  - Tablet, Extended Release, 24 HR
  - Solution
  - Suspension

Why it’s used

Gabapentin oral capsule is used to treat the following conditions:

Seizures: Gabapentin is used to treat partial (focal) seizures. It’s taken together with other seizure medications in adults and in children 3 years of age and older who have epilepsy.
Postherpetic neuralgia: This is pain from nerve damage caused by shingles, a painful rash that affects adults. Shingles appears after infection with the varicella zoster virus. This virus occurs in people who have had chicken pox.

Gabapentin may be used as part of a combination therapy. This means you may need to take it with other drugs.

How to take gabapentin ?

The gabapentin dosage your doctor prescribes will depend on several factors. These include:

- the type and severity of the condition you’re using gabapentin to treat
- your age
- the form of gabapentin you take
- other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Forms and strengths

Generic: Gabapentin

Form: oral capsule
Strengths: 100 mg, 300 mg, 400 mg

Brand: Neurontin

Form: oral capsule
Strengths: 100 mg, 300 mg, 400 mg

Dosage for postherpetic neuralgia

Adult dosage (ages 18–64 years)

Typical starting dosage: Day 1, 300 mg; day 2, 600 mg (300 mg two times per day, spaced evenly throughout the day); day 3, 900 mg (300 mg, three times per day, spaced evenly throughout the day). Your doctor may further increase your dosage after day 3.
Maximum dosage: 1,800 mg per day (600 mg, three times per day, spaced evenly throughout the day)

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years has not been established.

Senior dosage (ages 65 years and older)

Your kidney function may decrease with age. Your body may get rid of this drug more slowly. Your doctor may start you on a lower dose so that too much of this drug does not build up in your body. Too much of the drug in your body can be dangerous. Your doctor may change your dose based on how well your kidneys are working.

Dosage for partial-onset seizures

Adult dosage (ages 18–64 years)

Typical starting dosage: 900 mg per day (300 mg, three times per day, spaced evenly throughout the day). Your doctor may increase your dose to 2,400–3,600 mg per day.

Child dosage (ages 12–17 years)

Typical starting dosage: 900 mg per day (300 mg, three times per day, spaced evenly throughout the day). The usual maintenance dose is 900–1,800 mg per day, divided into three doses daily. Your doctor may increase this dose to 2,400–3,600 mg per day.

Child dosage (ages 3–11 years)

Typical starting dosage: 10–15 mg/kg/day, divided into three doses, spaced evenly throughout the day. Your child’s doctor may increase the dosage to meet your child’s needs.

Child dosage (ages 0–2 years)

Dosage for people younger than 3 years has not been established.

Senior dosage (ages 65 years and older)

Special considerations

Kidney problems: If you are older than 12 years and have kidney problems or are on hemodialysis, your dose of gabapentin will need to be changed. This will be based on how well your kidneys are working.

What Health Conditions Should I tell My Physicians when I buy Fioricet and Gabapentin Online

When you buy fioricet online or buy Gabapentin online, you should have known the side effects and precautions of fioricet and gabapentin. Normally we suggest you refill your fioricet and gabapentin online. You already have your local doctor checked your health conditions and have bought fioricet or Gabapentin in your local pharmacies. Actually online Fioricet pharmacy and online Gabapentin Pharmacy are for prescription refilled customers only.

When you refill your fioricet and gabapentin online, your doctors may ask you a lot of health questionnaires, they may also phone you to ask your health questions. Please be honest to complete all your health questions, the health questions may include:

your Weight;
your Height;
The reasons to order fioricet or gabapentin online;
list your current medical conditions;
any related health and medical history;
do you have any drug allergy;
do you have any allergy;
do you have blood pressure …

For detail health questionnaires, please see following pictures: