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Neurontin

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Generic Name: gabapentin
Product Name: Neurontin

Indication: What Neurontin is used for

Neurontin is used to control epilepsy. Epilepsy is a condition where you have repeated seizures (fits). There are many different types of seizures, ranging from mild to severe.

Neurontin is also used to treat neuropathic pain, a type of pain caused by damage to the nerves.

Your doctor may have prescribed Neurontin in addition to other medicines that you may be taking. This may be necessary if your current treatment is no longer working as well.

Your doctor may have prescribed Neurontin for another reason.

Neurontin may lead to dependence on this medicine.

Ask your doctor if you have any questions about why Neurontin has been prescribed for you.

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

There is not enough information to recommend the use of this medicine in children under the age of 3 years to control epilepsy, or under the age of 18 years to treat neuropathic pain.

Action: How Neurontin works

This medicine belongs to a group of medicines called anticonvulsants.

This medicine is thought to work by controlling brain chemicals which send signals to nerves to help control seizures or neuropathic pain.

Neurontin also has pain relieving effects.

The mechanism by which gabapentin exerts its anticonvulsant action is unknown. Gabapentin is structurally related to the neurotransmitter GABA (gamma-aminobutyric acid) but its mechanism of action is different from that of several other drugs that interact with GABA synapses including valproate, barbiturates, benzodiazepines, GABA transaminase inhibitors, GABA uptake inhibitors, GABA agonists, and GABA prodrugs.

Neurontin contains the active ingredient gabapentin:

  • Neurontin 100 mg contains 100 mg gabapentin;
  • Neurontin 300 mg contains 300 mg gabapentin;
  • Neurontin 400 mg contains 400 mg gabapentin;
  • Neurontin 600 mg contains 600 mg gabapentin;
  • Neurontin 800 mg contains 800 mg gabapentin.

Other capsule ingredients are lactose, talc-purified, starch maize, gelatin, titanium dioxide, Opacode Blue S-1-4118, iron oxide – yellow (300 mg / 400 mg), and iron oxide – red (400 mg).

Other tablet ingredients are poloxamer, copovidone, starch-maize, magnesium stearate, candelilla wax, and Opadry White YS-1-18111.

Neurontin does not contain sucrose, gluten, tartrazine or any other azo dyes.

Dose advice: How to use Neurontin

Before you take Neurontin

When you must not take it

Do not take Neurontin if you have an allergy to:

  • Any medicine containing gabapentin, the active ingredient in Neurontin;
  • Any of the ingredients listed here.

Some of the symptoms of an allergic reaction may include:

  • Shortness of breath;
  • Wheezing or difficulty breathing;
  • Swelling of the face, lips, tongue or other parts of the body;
  • Rash, itching or hives on the skin.

Do not take Neurontin after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.

If you are not sure whether you should start taking Neurontin, talk to your doctor or pharmacist.

Before you start to take it

Tell your doctor or pharmacist if you have allergies to:

  • Any other medicines, especially barbiturates or any other anticonvulsant medicines;
  • Any other substances, such as foods, preservatives or dyes.

Tell your doctor if you have or have had any of the following medical conditions:

  • Kidney problems;
  • Mixed seizure disorders that include absence seizures.

Tell your doctor if you are pregnant or plan to become pregnant. Neurontin may affect your developing baby if you take it during pregnancy. However, it is very important to control your fits while you are pregnant. If it is necessary for you to take Neurontin, your doctor can help you decide whether or not to take it during pregnancy.

Tell your doctor if you are breastfeeding or plan to breastfeed. Neurontin passes into breast milk. The effect on your breastfed baby is unknown. If you do breastfeed, watch your baby carefully. If your baby develops a skin rash, becomes sleepy or has unusual symptoms, don’t breastfeed again until you speak to your doctor. Your doctor can discuss the risks and benefits of breastfeeding with you.

If you have not told your doctor or pharmacist about any of the above, tell them before you start taking Neurontin.

Taking other medicines

Tell your doctor or pharmacist if you are taking any other medicines, including:

  • All prescription medicines;
  • All medicines, vitamins, herbal supplements or natural therapies you buy without a prescription from a pharmacy, supermarket, naturopath or health food shop.

Some medicines may be affected by Neurontin or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines. Your doctor or pharmacist will advise you accordingly.

Tell your doctor or pharmacist if you are taking any of the following:

  • Cimetidine, a medicine used to treat stomach or duodenal ulcers;
  • Antacids, medicines used to treat heartburn or reflux;
  • Opioids, medicines used to treat severe pain e.g. morphine.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking Neurontin.

How to take Neurontin

Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained here.

If you do not understand the instructions on the pack, ask your doctor or pharmacist for help.

How much to take

Your doctor will tell you how many capsules/tablets you need to take each day. This may depend on your age, your condition and whether or not you are taking any other medicines.

Your doctor may recommend that you start with a low dose of Neurontin and slowly increase the dose to the lowest amount needed to control your epilepsy/convulsions or neuropathic pain.

How to take it

Swallow Neurontin whole with a full glass of water.

Neurontin tablets can be divided in half along the breakline, if advised by your doctor or pharmacist.

When to take it

Take Neurontin at about the same time each day. Taking Neurontin at the same time each day will have the best effect. It will also help you remember when to take the capsules/tablets.

If you are taking Neurontin three times a day, do not allow more than 12 hours between doses.

It does not matter if you take Neurontin before or after food.

How long to take it

Continue taking your medicine for as long as your doctor tells you to.

Neurontin helps control your condition but does not cure it. Therefore you must take your medicine every day, even if you feel well.

Do not stop taking Neurontin, or lower the dose, without checking with your doctor. Do not let yourself run out of medicine over the weekend or holidays. Stopping Neurontin suddenly may cause unwanted side effects or make your condition worse. Your doctor will slowly reduce your dose before you can stop taking it completely.

If you forget to take it

If it is almost time for your next dose (within 4 hours), skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember, and then go back to taking Neurontin as you would normally.

Do not take a double dose to make up for the dose that you missed. This may increase the chance of you getting an unwanted side effect.

If you are not sure what to do, ask your doctor or pharmacist. If you have trouble remembering to take Neurontin, ask your pharmacist for help.

If you take too much (overdose)

Immediately telephone your doctor or Poisons Information Centre (telephone Australia 13 11 26 or New Zealand 0800 POISON or 0800 764 766) for advice, or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much Neurontin. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

Symptoms of an overdose may include you falling unconscious, feeling drowsy, weak, unsteady when walking, having double vision, slurred speech or diarrhoea.

While you are taking Neurontin

Things you must do

If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking Neurontin.

Tell any other doctors, dentists, and pharmacists who treat you that you are taking Neurontin.

If you are going to have surgery or emergency treatment, tell the surgeon or anaesthetist that you are taking Neurontin.

Tell your doctor immediately if you have any thoughts of suicide or self-harm, any unusual changes in mood or behaviour, or show signs of depression. Some people being treated with antiepileptics, such as Neurontin, have had thoughts of harming or killing themselves.

Patients and caregivers should be alert and monitor for signs and symptoms of suicide, these include:

  • Thoughts or talk of death or suicide;
  • Thoughts or talk of self-harm or harm to others;
  • Any recent attempts at self-harm;
  • New or an increase in aggressive behaviour, irritability or agitation;
  • New onset of or worsening of depression.

Mention of suicide or violence must be taken seriously. If you or someone you know is demonstrating these warning signs and symptoms of suicide while taking Neurontin, contact your doctor or a mental health professional right away.

Tell your doctor if you feel Neurontin is not helping your condition. Your doctor may need to change your medicine.

Tell your doctor if, for any reason, you have not taken Neurontin exactly as prescribed. Otherwise, your doctor may change your treatment unnecessarily.

If you become pregnant while taking Neurontin, tell your doctor immediately.

If you need to have any medical tests while you are taking Neurontin, tell your doctor. It may interfere with the results of some tests.

If you are going to have any surgery or procedure, including dental surgery, tell your surgeon, doctor or dentist that you are taking this medicine.

Keep all of your doctor’s appointments so that your progress can be checked. Your doctor will check your progress and may want to take some tests from time to time. This helps to prevent unwanted side effects.

Things you must not do

Do not take Neurontin to treat any other complaints unless your doctor tells you to.

Do not give Neurontin to anyone else, even if their symptoms seem similar to yours or they have the same condition as you.

Do not stop taking Neurontin or lower the dose without checking with your doctor. Stopping Neurontin suddenly, if you have epilepsy, may cause unwanted side effects or make your condition worse. Your doctor will slowly reduce your dose before you can stop taking it completely.

Things to be careful of

Be careful driving or operating machinery until you know how Neurontin affects you. As with other anticonvulsant medicines, Neurontin may cause drowsiness, dizziness, lightheadedness or sleepiness in some people. Make sure you know how you react to Neurontin before you drive a car, operate machinery, or do anything else that could be dangerous if you are dizzy or light-headed. If this occurs do not drive.

Children should not ride a bike, climb trees or do anything else that could be dangerous if they are feeling drowsy or sleepy.

Be careful when drinking alcohol while you are taking Neurontin. Combining Neurontin and alcohol can make you more sleepy, dizzy or light-headed. Your doctor may suggest you avoid alcohol while you are being treated with Neurontin.

After taking Neurontin

Storage

Keep your capsules/tablets in the pack until it is time to take them. If you take the capsules/tablets out of the pack they may not keep well.

Keep your capsules in a cool dry place where the temperature stays below 30°C.

Keep your tablets in a cool dry place where the temperature stays below 25°C.

Do not store Neurontin or any other medicine in the bathroom or near a sink. Do not leave it on a windowsill or in the car. Heat and dampness can destroy some medicines.

Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal

If your doctor or pharmacist tells you to stop taking Neurontin or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over.

Schedule of Neurontin

Neurontin is a Schedule 4 – prescription only medicine.

Side effects of Neurontin

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Neurontin. All medicines can have side effects. Sometimes these are serious, but most of the time these are not. You may need medical attention if you get some side effects.

It can be difficult to tell whether side effects are the result of taking Neurontin; of your condition; or side effects of other medicines you may be taking, for this reason, it is important to tell your doctor of any change in your condition.

If you are over 65 years of age you may have an increased chance of getting side effects.

Ask your doctor or pharmacist to answer any questions you may have.

If you get any side effects, do not stop taking Neurontin without first talking to your doctor or pharmacist.

Tell your doctor if

Tell your doctor or pharmacist if you notice any of the following and they worry you:

  • Dizziness* or light-headedness;
  • Feeling tired or drowsy*;
  • Unfriendliness*;
  • Unusually overactive*;
  • Forgetfulness, loss of concentration or confusion;
  • Difficulty speaking;
  • Changes in your weight*;
  • Constipation, diarrhoea;
  • Nausea and/or vomiting*, indigestion;
  • Dry mouth, red swollen gums;
  • Muscle pain or cramps, back pain;
  • Swelling of the hands or feet;
  • Runny or blocked nose;
  • Fever*;
  • Bronchitis*, lung infection*;
  • Sore throat and discomfort when swallowing, coughing.

The above list includes the more common side effects of Neurontin. They are usually mild and shortlived.

Tell your doctor as soon as possible if

Tell your doctor as soon as possible if you notice any of the following:

  • Weakness, unsteadiness when walking including falling, reduced coordination or slowed reactions;
  • Unusual changes in mood* or behaviour such as restlessness, nervousness, or excitement;
  • Signs of new onset of, or increased irritability or agitation;
  • Signs of depression;
  • Seeing or hearing things that are not there, irrational thinking;
  • Blurred or double vision, uncontrollable jerky eye movements, difficulty seeing;
  • Signs of frequent infections such as fever, severe chills, sore throat or mouth ulcers;
  • Trouble breathing or shallow breaths (respiratory depression);
  • Loss of consciousness.

The side effects in the above lists marked * have been specifically reported in children taking Neurontin.

Go to hospital if

Tell your doctor immediately or go to Accident and Emergency at your nearest hospital if you notice any of the following:

  • More frequent or more severe seizures (fits);
  • Chest pain, a very fast heart rate;
  • Sudden signs of allergy such as rash, itching or hives, fever, swollen lymph glands, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or difficulty breathing.

The above list includes very serious side effects. You may need urgent medical attention or hospitalisation. These side effects are very rare.

Tell your doctor or pharmacist if you notice anything else that is making you feel unwell. Other side effects not listed above may also occur in some people.

Some of these side effects (for example, changes in thyroid function, structures of bones, high cholesterol, levels of sugar in your blood or blood pressure) can only be found when your doctor does blood tests from time to time to check your progress.

Do not be alarmed by the list of possible side effects. You may not experience any of them.

For further information talk to your doctor.

References

  1. Neurontin Consumer Medicine Information (CMI). West Ryde, NSW: Pfizer Australia Pty Ltd. November 2017. [PDF]
  2. Neurontin Product Information (PI). West Ryde, NSW: Pfizer Australia Pty Ltd. January 2018. [PDF]
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Dates

Posted On: 22 July, 2003
Modified On: 16 April, 2018
Reviewed On: 16 April, 2018

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Created by: myVMC