Medication Profile - Gabapentin Used Off-Label for Migraine

Nancy Harris Bonk Health Guide
  • There's a wide variety of medications used for the prevention of Migraine and headache, most of which are prescribed off-label. If gabapentin has been prescribed for you, or if you and your doctor have been considering it, here's some information that should be helpful.

     

    Type of medication:

     

    Gabapentin, brand name Neurontin, is a neuronal stabilizing agent (anticonvulsant medication) used to treat seizure disorders and prescribed off-label for Migraine and headache prevention. It is also used to manage a condition called postherpetic neuralgia, pain that can occur after shingles. Its extended release form can be used to treat restless leg syndrome (RLS), a sleep disorder, and is sometimes used for neuropathic pain.

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    Precautions:

    • Certain test results may be affected by this medication. If you are having medical tests, inform the doctor in charge that you taking gabapentin.
    • Do not stop this medication abruptly, as you may have an increase in seizure activity, even if you do not have a seizure disorder. Your doctor will want to taper you off this medication.
    • Do not take antacids within 2 hours before or after you take gabapentin because these can make it more difficult for your body to absorb it.
    • If you develop a rash; fever; swollen painful or tender lymph glands in the neck, groin or armpit; bruising or bleeding; or yellowing of the eyes of skin, stop using this medication and check with your doctor. This could be a series and fatal condition called Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS).
    • If you use the liquid form of gabapentin, make certain you use the special dose-measuring spoon or cup that comes with your prescription and take exactly as directed by your doctor. If you split a pill, use it as soon as possible or within a few days.
    • It is extremely important that your doctor check your progress at regular visits, especially when starting gabapentin. He/she can make dose changes if necessary, which may reduce unwanted potential side effects. Blood tests may be performed to check for any of these effects.
    • Gabapentin may cause vision problems, dizziness, clumsiness, drowsiness or trouble thinking. Before you drive, operate machinery, or anything else that might put you or anyone else in danger, know how you react to this medication.
    • The Horizant brand of gabapentin cannot be taken during the day. The best time to take it is with food at 5:00 p. m. in the evening.
    • This medication may make people have suicidal tendencies or thoughts and/or become more depressed. Talk to your doctor right away if you feel like this.
    • This medication may add to the effects of alcohol and other central nervous system (CNS) depressants.
    • When taking gabapentin, it is recommended that you wear a medical ID tag or an ID card. Be sure to tell your dentist, other doctors and emergency personal that you are taking it.
    • Some people taking this medication may become agitated, irritable or exhibit other behavior that is not normal. These behaviors include feeling sad or hopeless, anxious or worried, hostile, restless and getting easily agitated.

    Pregnancy and Breastfeeding:

    • Gabapentin is FDA pregnancy category C. This generally means there are no sufficient studies done on pregnant women OR no animal studies have been conducted. Taking gabapentin during pregnancy is only advised when there are no other options and the benefits outweigh the risks.
    • There are no adequate studies in women to determine what the infant risk is when using gabapentin while breastfeeding, but gabapentin is secreted in breast milk. It is important to weigh the potential benefits again the potential risks before taking gabapentin if you plan on breastfeeding.
    • Doctors are encouraged to recommend any patients taking gabapentin while pregnant to enroll in the American Antiepileptic Drug Pregnancy Registry (NAAED).

    Other medical conditions:
    Be sure your doctor knows of other medical issues you may have including: 

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    • any type of mental illness of history of (use with caution).
    • cancer or tumors or a history of.
    • depression or family history of depression.
    • allergy to gabapentin.
    • working night and /or if you are a day sleeper if you are using gabapentin for RLS.
    • kidney dialysis or severe kidney dysfunction.
    • thoughts of suicide or increased depression (make sure to contact your doctor at once, a dose change may be needed).
    • liver, kidney or heart disease.

     

    Other medications:

     Make sure your doctor know about ALL the medications you take, especially:

    • aluminum carbonate, aluminum hydroxide and aluminum phosphate
    • Antihistamines
    • dihydroxyaluminum aminoacetate and sodium carbonate
    • Drugs with acetaminophen in them
    • ginkgo biloba
    • hydrocodone
    • ketorolac
    • magaldrate
    • magnesium carbonate, magnesium hydroxide, magnesium oxide, magnesium trisilicate
    • morphine, morphine sulfate liposome
    • naproxen

    Potential side effects:

    • Contact your doctor right away if you have any of the following potential side effects: 
      • confusion
      • dark urine; urinating less than normal or not at all
      • fever; hives; swollen glands; painful sores in or around your eyes or mouth; difficulty breathing; swelling of your face, lips, tongue or throat.
      • increased seizure activity
      • irregular heartbeat, chest pain or shortness of breath
      • jaundice
      • loss of appetite
      • mood or behavior changes or depression, anxiety; if you feel angry, hostile, manic, agitated or have thoughts of hurting yourself, others or suicide.
      • nausea
      • new or worsening cough
      • pain in upper stomach
      • rapid or back and forth eye movement
      • severe numbness or tingling, pain muscle weakness
      • skin rash, easy bleeding or bruising
      • swelling, rapid weight gain
      • vomiting 
    • Children: Parents should contact their child's doctors if their child is taking gabapentin and has any of these potential side effects: 
      • behavior changes
      • memory issues and trouble concentrating
      • restless, aggressive or hostile 
    • Less serious side effects include:
      • blurred vision
      • drowsiness
      • dry mouth
      • feeling dizzy
      • feeling tired, weakness
      • headache
      • loss of coordination
      • nausea, diarrhea, constipation
      • swelling of breast

    Brand names:

    • Gabarone 
    • Graslise
    • Horizant
    • Neurontin 

     

    Related Information:

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    Resources:

    Wolters Kluwer. "Gabapentin." Drugs.com. Last revised April 1, 2012.

     

    Cerner Multum, Inc. "Gabapentin." Epocrates.com. Last revised September 16, 2011.

     

    Material on this page is for informational purposes only, and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications.

     

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    © The HealthCentral Network, 2012
    Last Updated April 4, 2012.

Published On: April 04, 2012