Gabapentin (Neurontin) and other similar prescription drugs can help manage nerve pain, although it can sometimes take more than a week to feel the positive effects.
If you have nerve pain, over-the-counter (OTC) pain relievers such as ibuprofen and acetaminophen often have little or no effect.
Nerve pain can feel different to different people and can also vary depending on the cause of the nerve pain. It may feel like burning, tingling, or sharp pains that can affect your everyday life.
However, prescription drugs like gabapentin can help with nerve pain, so it is worth discussing pain management with a doctor or healthcare professional.
What is gabapentin?
Gabapentin belongs to a class of medications called anticonvulsants, so doctors often prescribe it to help manage seizures in people with epilepsy.
However, the medication reduces the sensitivity of certain nerve cells in your brain that not only play a role in seizures but also in transmitting pain signals.
Any other gabapentin use is currently considered off-label, but doctors may also recommend the medication for:
neuropathic or nerve pain, including that from diabetes and multiple sclerosis (MS)
moderate to severe restless leg syndrome (RLS)
fibromyalgia
bipolar disorder
anxiety
medication-resistant depression and other mood conditions
social phobia
post-traumatic stress disorder (PTSD)
postmenopausal hot flashes
migraine prevention
headaches
tremors
alcohol withdrawal
post-surgical pain
nausea and vomiting
itching, also known as pruritus
insomnia
stubborn, chronic cough
How does gabapentin work?
Gamma-aminobutyric acid (GABA) is one of the primary neurotransmitters of the central nervous system. It is an amino acid and is responsible for settling down nerve and brain activity.
Gabapentin (Neurontin) is immediate-release and works by imitating GABA. Experts believe this may be how it works to relieve pain due to increased GABA levels. Other brand-name versions of gabapentin include Horizant and Gralise, which are both extended-release (XL) forms of the drug.
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Gabapentin comes in capsules, tablets, or liquid form. The drug needs time to build up in your system, and it can take around 1 week to notice effects like pain relief. However, sometimes this can take up to 1 month.
The dosage will differ based on your condition and how you respond to the medication. Usually, a doctor or healthcare professional will start you on a lower dosage and increase it as needed.
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Is a specific time of day better for taking gabapentin?
The best time to take gabapentin (Neurontin) will depend on the recommendations from a doctor or healthcare team. If they suggest taking one tablet per day, you may consider taking this before you go to sleep, as one of the main side effects is drowsiness.
Gabapentin doses will vary depending on why you need it, how well you tolerate the drug, and how effective it is for you. You should take the first one before sleeping and evenly space the others throughout the day. This can ensure your body gets a regular dose to keep your symptoms manageable.
The extended-release versions of gabapentin have different instructions.
The FDA recommends taking Horizant once at around 5 p.m. or twice each day. This will depend on why you take the medication, and you should follow your healthcare team’s advice.
If your doctor prescribes Gralise, the FDA recommends taking this once daily with your evening meal.
Does gabapentin have side effects?
Gabapentin works for most people with minimal side effects, but they can include:
headaches
nausea
dry mouth
dizziness or unsteadiness
blurry vision
constipation
increased appetite
If you do experience side effects, you may notice that they improve or disappear with time.
Some symptoms may be medical emergencies. You should call a doctor immediately if you develop any of these symptoms:
rash
itching
difficulty breathing or swallowing
swelling of your face, throat, tongue, lips, or eyes
How long can I take gabapentin?
According to the UK National Health Service (NHS), if you take gabapentin (Neurontin) for seizures, you’ll usually need to take it until your condition is manageable. After this, you may need to continue taking it for many years.
If you take it for nerve pain, you can stop taking it a few months after the pain and discomfort subsides. This should ensure that the pain does not return.
What happens if I stop taking gabapentin suddenly?
If you stop taking gabapentin suddenly, you could have withdrawal symptoms. These may include anxiety, difficulty falling or staying asleep, nausea, sweating, and increased pain levels.
Even if you have side effects and would prefer to stop taking the medication, you should first discuss it with a doctor or healthcare team before stopping. They may decrease your dose gradually over the course of at least a week — known as tapering.
Summary
Doctors and healthcare professionals may prescribe gabapentin for seizures and nerve pain, but it also has many other “off-label” uses, including for RLS and MS-related nerve pain.
As the drug can make you drowsy when you first take it, you should consider taking it before you sleep.
Always talk with a healthcare team about your treatment options if you feel gabapentin is not right for you.
