Is Gabapentin ( Neurontin ) Addictive and How to Treat Gabapentin Addiction ?

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.

Gabapentin, also known by the brand name Neurontin, is a prescription painkiller belonging to its own drug class, Gabapentinoids. It is considered an anti-convulsant, and is most commonly used to treat epilepsy, restless leg syndrome, hot flashes, and neuropathic pain. It is often used as a less-addictive alternative to opioids; however, Gabapentin addiction and abuse still occur in many patients.

Gabapentin has a similar chemical structure to Gamma-aminobutyric acid (GABA), the brain chemical which affects the body’s nervous system. It can produce feelings of relaxation and calmness, which can help with nerve pain, anxiety, and even poor sleep.

Gabapentin is prescribed to treat nerve pain, alcohol and cocaine withdrawals, restless leg syndrome, diabetic neuropathy, fibromyalgia, and seizures. It works by altering one’s calcium channels to reduce seizures and ease nerve pain. Some brand names of Gabapentin are Neurontin and Gralise. The drug’s known street names are “gabbies” or “johnnies.”

Dosages of Gabapentin

Adult and pediatric dosages:

Capsule

      • 100 mg
      • 300 mg
      • 400 mg

Tablet

      • 300 mg (Gralise)
      • 600 mg (Gralise, Neurontin)
      • 800 mg (Neurontin)

Dosage Considerations – Should be Given as Follows:

Reducing the dose, discontinuing the drug, or substituting an alternative medication should be done gradually over a minimum of 1 week or longer.

Geritric dosing considerations:

Renal impairment is present, gabapentin dose reduction may be required, depending on renal function.

Partial Seizures

Neurontin

Adjunctive therapy for partial seizures with or without secondary generalization.

Initial: 300 mg orally every 8 hours.

May increase up to 600 mg orally every 8 hours; up to 2400 mg/day administered and tolerated in clinical studies; up to 3600 mg administered for short duration and tolerated

Post herpetic Neuralgia

Neurontin

Day 1: 300 mg orally once per day.

Day 2: 300 mg orally every 12 hours.

Day 3: 300 mg orally every 8 hours.

Maintenance: Subsequently titrate as needed up to 600 mg orally every 8 hours; doses greater than 1800 mg/day have demonstrated no additional benefit.

Gralise

Dose gradually to 1800 mg/day orally; take once a day with evening meal.

Day 1: 300 mg orally once a day.

Day 2: 600 mg orally once a day.

Days 3-6: 900 mg orally once a day.

Days 7-10: 1200 mg orally once a day.

Days 11-14: 1500 mg orally once a day.

Day 15 and after (maintenance): 1800 mg orally once a day.

Dosing considerations:

Gralise tablets swell in gastric fluid and gradually release gabapentin. Swallow Gralise tablets whole; do not cut, crush, or chew them.

Dosing Modifications:

Renal impairment (Neurontin)

Creatinine clearance greater than 60 mL/min: 300-1200 mg orally twice daily

Creatinine clearance 30-60 mL/min: 200-700 mg every 12 hours

Creatinine clearance 15-29 mL/min: 200-700 mg once per day

Creatinine clearance less than 15 mL/min: 100-300 mg once per day

Hemodialysis (Creatinine clearance less than 15 mL/min):

Administer supplemental dose (range 125-350 mg) post hemodialysis, after each 4 hour dialysis interval; further dose reduction should be in proportion to Creatinine clearance (a Creatinine clearance of 7.5 mL/min should receive one-half daily post hemodialysis dose)

Renal impairment (Gralise):

Creatinine clearance is greater than or equal to 60 mL/min: 1800 mg daily with evening meal

Creatinine clearance 30-59 mL/min: 600-1800 mg daily with evening meal

Creatinine clearance greater than 30 mL/min or hemodialysis: Do not administer

In addition its potentially addictive nature, Gabapentin can cause suicidal thoughts, moods swings, and abrupt changes in a user’s behavior. It can also cause elevated blood pressure, fever, sleep problems, appetite changes, and chest pain.

Gabapentin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

      • drowsiness
      • tiredness or weakness
      • dizziness
      • headache
      • uncontrollable shaking of a part of your body
      • double or blurred vision
      • unsteadiness
      • anxiety
      • memory problems
      • strange or unusual thoughts
      • unwanted eye movements
      • nausea
      • vomiting
      • heartburn
      • diarrhea
      • dry mouth
      • constipation
      • increased appetite
      • weight gain
      • swelling of the hands, feet, ankles, or lower legs
      • back or joint pain
      • fever
      • runny nose, sneezing, cough, sore throat, or flu-like symptoms
      • ear pain
      • red, itchy eyes (sometimes with swelling or discharge)

Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately:

      • rash
      • itching
      • swelling of the face, throat, tongue, lips, or eyes
      • hoarseness
      • difficulty swallowing or breathing
      • seizures
      • difficulty breathing; bluish-tinged skin, lips, or fingernails; confusion; or extreme sleepiness

Gabapentin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Gabapentin Abuse

Gabapentin abuse tends to occur in people who already have an addiction to opioids or other drugs. The effects of Gabapentin intoxication have been described as a sense of calm, euphoria, and a high similar to marijuana.

A 2013 study in Kentucky found that of the 503 participants reporting illegal drug use, 15% reported using Gabapentin in addition to other drugs to get high in the previous six months. Another study, working with a sample of participants meant to represent the national population, found almost a quarter of patients with co-prescriptions of opioids and Gabapentin were getting more than three times their prescribed amount to supply their addiction. People using the drug without a prescription is a growing problem in many areas. Due to the drug’s legal status, this is difficult to address from a policing standpoint. States where Gabapentin abuse is becoming more common are beginning to classify the drug as a more strictly controlled substance.

Signs of a Gabapentin Overdose

Effects of excessive Gabapentin use include:

      • Drowsiness
      • Coordination problems
      • Tremors
      • Dizziness
      • Depression
      • Suicidal thoughts/behaviors
      • Changes in mood
      • Dizziness
      • Poor coordination
      • Forgetfulness
      • Anxiety
      • Difficulty speaking
      • Inability to feel pleasure

It is important to try to recognize these symptoms and to be wary of other red flags, such as the presence or abundance of pill bottles. These effects can be detrimental to one’s health, livelihood, and overall safety.

Many Gabapentin users in early recovery abuse Gabapentin because at high doses (800mg or more), they may experience a euphoric-like high that does not show up on drug screens. Gabapentin abusers typically take the drug in addition to opioids to produce their desired high, a dangerous and potentially deadly combination. It is possible to fatally overdose on Gabapentin, both on its own or in conjunction with other drugs. However, there is currently no antidote that can be administered to someone in the case of a Gabapentin overdose as there is with opioid overdoses. If you find a loved one showing signs of an overdose–drowsiness, muscle weakness, lethargy and drooping eyelids, diarrhea, and sedation—seek medical attention immediately.

Signs of Gabapentin Addiction

      • Lying about or exaggerating symptoms to doctors
      • Seeking out multiple doctors to get extra doses
      • Switching doctors after the original doctor refuses to continue prescribing the medication
      • Changes in social habits and/or circles
      • Changes in personal hygiene and grooming habits
      • Constant preoccupation with the drug
      • Unease at the thought of the drug being unavailable
      • Refusal to quit despite social, financial, or legal consequences
      • Failed attempts to quit

Treating a Gabapentin Addiction

Frequent and excessive use of Gabapentin can lead to a physical and psychological dependence on the drug. This is when someone becomes so accustomed to taking a drug that they need it to feel and function normally. Quitting a drug like Gabapentin cold turkey can be dangerous and induce several withdrawal symptoms of varying severity.

These include anxiety, insomnia, nausea, pain, and sweating. Quitting also increases one’s likelihood of having a seizure which can lead to personal injury or the development of medical problems and life-threatening emergencies. Trying to quit should be done at a rehab facility or with the guidance and supervision of a professional during a medical detox.

Can you legally buy gabapentin online

Neurontin (gabapentin) prescription is not a controlled substance and you can legally buy Gabapentin online with a US licensed doctor prescription.

Our doctors are all US licensed doctors and it will be printed in the label of your prescription bottle.

What you need to do is to answer the questions very carefully and honestly and our USA licensed doctors will decide whether to send you Gabapentin prescription or not.

Yes, you can get a Neurontin (gabapentin) prescription online, in most states, following a virtual consultation with a doctor.

But our website require that you should have already taken Gabapentin before. If it is your first time to take Gabapentin, we will not send you Gabapentin prescription.

You must have your local doctor prescribed a Gabapentin prescription and you think Gabapentin is good for your disease and you can refill your Gabapentin here in our website.

 

If you have shingles pain or seizures, Neurontin may be able to help you and thanks to modern technology you can get a Neurontin prescription online.

Let’s talk about how you can get a Neurontin prescription online as well as what it is, what it does, what side effects or complications you could experience, and our Neurontin prescription policy.

Where Can I Not Get Neurontin Prescribed Online?

It’s important to note that Neurontin (gabapentin) has been classified as a controlled substance in 5 states and therefore cannot be prescribed online in these locations.

These states are:

      • Kentucky
      • West Virginia
      • Virginia
      • Tennessee
      • Michigan

 

The Role of Gabapentin in Pain Management

Opioids, non‐steroidal anti‐inflammatory drugs (NSAIDs), antidepressants, and anticonvulsants are used as pharmacological agents to treat pain. However, no single class of drugs has been found to be effective in all types of pain, presumably because pain syndromes involve different mechanisms.

In addition, each of the currently available drugs is associated with adverse effects, some of which are potentially serious or life‐threatening such as idiosyncratic or toxic reactions.

Traditionally, the treatment of neuropathic pain has involved anticonvulsants, such as carbemazepine, valproic acid and phenytoin, and tricyclic antidepressants, such as amitriptyline and nortriptyline and doxepin. The main disadvantages of the anticonvulsants are their potential for drug interactions via the induction of hepatic enzymes, or resulting from inhibition of hepatic enzymes by other drugs. Minor side‐effects such as sedation, ataxia, vertigo and diplopia are associated with carbemazepine and phenytoin, whereas, anorexia, nausea, vomiting and tremor are associated with valproic acid. Chronic phenytoin use may cause peripheral neuropathy (30%) and gingival hyperplasia (20%), and fetal hydantoin syndrome if administered during pregnancy. Carbemazepine can cause chronic diarrhoea or the syndrome of inappropriate ADH secretion, and rarely aplastic anaemia, thrombocytopaenia, hepatocellular jaundice and cardiac arrhythmias.

Tricyclic antidepressants also cause side‐effects that can be troublesome or potentially dangerous, such as anticholinergic effects (dry mouth, blurred vision, urinary retention, ileus), sedation, orthostatic hypotension, tachycardia and atrio‐ventricular conduction disturbances. Such adverse effects are likely to reduce the tolerance of this group of drugs in elderly or unwell patients. Some subgroups of patients with painful neuropathy such as diabetes may also have autonomic neuropathy and may not tolerate the orthostatic hypotension associated with tricyclic antidepressants.

With increasing evidence of the efficacy of gabapentin in a wide variety of pain syndromes, especially neuropathic pain, gabapentin may be potentially useful because of its relative freedom from serious adverse effects, its lack of interactions with other drugs and its lack of potential for causing drug dependence.

A comparison of the evidence available of efficacy and toxicity for anticonvulsants (gabapentin, phenytoin and carbemazepine) and antidepressants (tricyclic antidepressants and SSRIs) in patients with diabetic neuropathy and postherpetic neuralgia has recently been made by Collins et al. [129] These two neuropathic pain conditions were chosen according to strict diagnostic criteria. Although two previous systematic reviews of anticonvulsants and antidepressants in diabetic neuropathy showed no significant difference in efficacy or adverse effects between the two drug classes [130, 131], Collins et al. found that when data from randomised controlled trials for both diabetic neuropathy and postherpetic neuralgia were pooled, the NNT for at least 50% pain relief was identical for both classes of drugs. When gabapentin was compared with other anticonvulsants, there was no significant difference in efficacy.

The NNT for gabapentin was 3.4 compared with 2.2 for phenytoin/carbemazepine. The number needed to harm (NNH, defined as the number needed to harm one patient from the therapy) for minor adverse effects was 2.7 for both antidepressants and anticonvulsants. Collins et al. used two trials to provide data on minor adverse effects for gabapentin and two trials for phenytoin. The NNH (minor adverse effects) was 2.6 similar to that of gabapentin and 3.2 for phenytoin. The NNH (major adverse effects) for the tricyclic antidepressants was 17, and no significant difference in the incidence of major adverse effects was found between anticonvulsants and placebo.

Collins et al. suggested that the difference in the incidence of major adverse effects can be compared by using the ratio between treatment specific benefit and treatment specific harm (defined as the number of patients needed to experience at least 50% benefit for one to experience a major adverse effect that warranted discontinuation of treatment). The ratio for gabapentin was 6 compared with an average of 8 for all anticonvulsants, and 6 for all antidepressants. As adverse data were pooled from both diabetic and postherpetic neuralgia studies, methodological factors and heterogenicity in these data may limit the validity and robustness of these ratios. The spectrum of the pain and short study duration tend to underestimate the treatment effect, whereas the small sample size of the studies overestimate the treatment effect.

The above evidence suggests that gabapentin is as efficacious at treating neuropathic pain with no significant difference in minor adverse effects and a low propensity for serious adverse effects compared with other anticonvulsants and antidepressants. Therefore, gabapentin is a useful agent in the multimodal approach in the management of neuropathic pain.

How is Gabapentin Supplied and Stored ?

NEURONTIN (gabapentin) capsules, tablets, and oral solution are supplied as follows:

100 mg capsules:

White hard gelatin capsules printed with “PD” on the body and “Neurontin/100 mg” on the cap; available in:
Bottles of 100: NDC 0071-0803-24

300 mg capsules:

Yellow hard gelatin capsules printed with “PD” on the body and “Neurontin/300 mg” on the cap; available in:
Bottles of 100: NDC 0071-0805-24
Unit dose 50’s: NDC 0071-0805-40

400 mg capsules:

Orange hard gelatin capsules printed with “PD” on the body and “Neurontin/400 mg” on the cap; available in:
Bottles of 100: NDC 0071-0806-24
Unit dose 50’s: NDC 0071-0806-40

600 mg tablets:

White elliptical film-coated scored tablets debossed with “NT” and “16” on one side; available in:
Bottles of 100: NDC 0071-0513-24

800 mg tablets:

White elliptical film-coated scored tablets debossed with “NT” and “26” on one side; available in:
Bottles of 100: NDC 0071-0401-24

250 mg per 5 mL oral solution:

Clear colorless to slightly yellow solution; each 5 mL of oral solution contains 250 mg of gabapentin; available in:
Glass bottles containing 470 mL: NDC 0071-2012-23
Bottles containing 470 mL: NDC 0071-2012-44

Store NEURONTIN Tablets and Capsules at 25°C (77°F); excursions permitted between 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature].

Store NEURONTIN Oral Solution refrigerated, 2°C to 8°C (36°F to 46°F).

Gabapentin 800mg with G13 imprint

Gabapentin 800mg with G13 label
Gabapentin 800mg with G13 label

Labelers / Repackagers

Labelers / Repackagers

NDC Code Labeler / Repackager
68462-0127 Glenmark Pharmaceuticals Inc.
54868-5195 Physicians Total Care Inc. (repackager)

Gabapentin

Imprint
G 13
Strength
800 mg
Color
White
Size
19.00 mm
Shape
Elliptical / Oval
Availability
Prescription only
Drug Class
Gamma-aminobutyric acid analogs
Pregnancy Category
C – Risk cannot be ruled out
CSA Schedule
Not a controlled drug
Labeler / Supplier
Glenmark Generics Inc.
Inactive Ingredients
corn starch, copovidone, poloxamer 407, magnesium stearate, titanium dioxide, magnesium silicate, polysorbate 80, water

Note: Inactive ingredients may vary.

What is gabapentin?

Gabapentin is an anti-epileptic drug, also called an anticonvulsant. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain.

Gabapentin is used together with other medicines to treat partial seizures in adults and children at least 3 years old.

Gabapentin is also used to treat neuropathic pain (nerve pain) caused by herpes virus or shingles (herpes zoster) in adults.

Use only the brand and form of gabapentin your doctor has prescribed. Check your medicine each time you get a refill to make sure you receive the correct form.

The Gralise brand of gabapentin is indicated for the management of neuropathic pain only. It is not used for epilepsy.

Horizant is used to treat nerve pain and restless legs syndrome (RLS).

The Neurontin brand is used to treat seizures in adults and children who are at least 3 years old, in addition to neuropathic pain.