Context and a nutsell summary of the chapter
Gabapentin is an anticonvulsant from the gabapentinoid class, widely marketed as Neurontin and as generic products. In Australian clinical practice it is commonly prescribed to manage certain seizure disorders and to treat neuropathic pain when appropriate.
Typical product and formulation points include:
- Dosage strengths often found: 100 mg, 300 mg, 400 mg, 600 mg and 800 mg in capsules or tablets
- Pharmacologic category: antiepileptic / gabapentinoid
- Core active ingredient: gabapentin
Only use gabapentin under the direction of a qualified prescriber. This page is informational and cannot replace personalized medical advice.
What you should say to your prescriber before you begin
Give your doctor or pharmacist a complete medical history before starting gabapentin. Important items to mention are:
- Any kidney disease or if you receive dialysis
- Previous allergic reactions or intolerance to gabapentin or related drugs
- If you are pregnant, planning to conceive, or nursing
- Breathing problems and current use of opioids, benzodiazepines or other sedatives
- Personal or family history of mood disorders, depression or suicidal thoughts
These details help your clinician select a safe initial dose and an appropriate performance monitoring plan.
Instructions governing administration
Swallow tablets or capsules whole with water. Gabapentin can be taken with or without food; if stomach upset occurs, take it with a meal to reduce discomfort. Aim to space doses evenly across the day as directed by your prescriber.
- Do not stop gabapentin suddenly without advice from your prescriber. Abrupt cessation may trigger seizure worsening or withdrawal symptoms.
- If you break a scored 600 mg or 800 mg tablet, plan to use the remaining half at the next scheduled dose and discard any unused half after three days.
- The child cohort are dosed by weight and age; strictly follow pediatric directions from the prescriber or pharmacist.
- For suspected they overdosed or urgent poisoning concerns in Australia, call the Poisons Information Centre on 13 11 26 or attend the nearest emergency department. In life-threatening emergencies call 000.
Because renal function influences gabapentin clearance, dose adjustments may be necessary for reduced kidney function. Your prescriber will advise the right regimen for you.
Medication doses that slipped from schedule
If you miss one dose, take it as soon as you remember unless the next dose is due within four hours. If the next dose is near due, bypass the i failed to take my dose and proceed with your regular timing. Do not double up doses to compensate for a missed one.
Drugs and substances that could interact with gabapentin
Many prescription and over-the-counter medicines, plus supplements and recreational drugs, can alter gabapentin effects. Always provide a full list of what you take to your health professional.
- Opioids (for example morphine): combined use increases sedation and risk of breathing problems
- Antacids containing aluminium or magnesium: can reduce gabapentin absorption; separate dosing by about two hours
- Beverage that contains ethanol and other central nervous system depressants, including some antihistamines: may increase drowsiness and dizziness
- Phosphate binders such as sevelamer: can lower gabapentin absorption and require timing adjustments
- Some NSAIDs: in certain situations they may affect gabapentin exposure; monitor clinical response
Not all items are shown in this list. While you are getting used to gabapentin, avoid alcohol until you know how the medicine affects you.
Vigilant safety readiness and status monitoring preventive actions
- Avoid driving, operating heavy machinery or doing tasks that require full concentration until you know how gabapentin affects you.
- Stand up slowly from sitting or lying positions to reduce lightheadedness or fainting, especially in older adults.
- Arrange periodic reviews so your prescriber can assess seizure control, pain relief, detrimental outcomes and dosing.
- If seizure frequency increases or new types of seizures appear, contact your clinician immediately.
- Consider wearing medical identification and keep an up-to-date medication list if you use gabapentin for epilepsy.
- A dry mouth is a possible effect; sipping water or chewing sugar-free gum can help.
- A small percentage of people taking antiepileptic medicines may develop new or worsening depression or suicidal thoughts; seek urgent help if this occurs.
Possible adverse effects
Serious reactions that need urgent attention
- Allergic reactions: extensive rash, hives, facial or throat swelling, or breathing difficulty
- Severe sedation or respiratory depression, especially when combined with opioids or other sedatives
- Marked worsening of mood or emergence of suicidal thoughts or behavior
Standard, mild effects
- Swirling sensation or unsteady walking
- Visual fuzziness
- Tremor or problems with coordination
- Slurred articulation in speech
- Nausea, constipation or other gastrointestinal complaints
- An increase in weight in some patients
Many secondary consequences are mild and resolve with time. Report unexpected or severe symptoms to your prescriber or pharmacist without delay.
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- Keep medicines out of the reach of children and pets at all times.
- Store at normal room temperature, ideally between 15 and 30 degrees C, away from direct heat and humidity. Avoid bathrooms and hot cars.
- Do not use after the expiry date displayed on the package. Return unwanted or expired medicines to your pharmacy for safe disposal via the Return Unwanted Medicines (RUM) program.
Different medicines and related formulations
Choice of an a different option to consider depends on the condition, side effect profile, personal the process of interactions build trust and rapport. and cost. Common options prescribers may consider include:
- Pregabalin (for example Lyrica): another gabapentinoid used for neuropathic pain and sometimes for focal seizures
- Lamotrigine: an antiepileptic often selected for its tolerability across several seizure types
- Levetiracetam: a broad-spectrum anticonvulsant used for focal and other seizures
- Carbamazepine and oxcarbazepine: options for focal epilepsy and certain neuralgias
- Topiramate: used in some patients for seizures and migraine prevention
- For neuropathic pain: tricyclic antidepressants like amitriptyline, SNRIs such as duloxetine or venlafaxine, and topical agents such as lidocaine or capsaicin
For a short cost comparison see The cost of items in Australia. For prescribing rules and restrictions consult law and regulatory compliance governance guidance.
Approximate tariff schedule in Australia
Costs vary by brand, strength, pack size, pharmacy and whether PBS subsidy applies. The figures below are indicative only and will change over time.
- Gabapentin (brand or generic): if PBS-listed for your condition you usually pay the current PBS co-payment. As a general guide, general patients may pay around AUD 31.00 per PBS item and concession card holders about AUD 7.00, subject to annual updates. Private retail prices for individual packs commonly range from roughly AUD 10.00 up to AUD 45.00 depending on strength and pack size.
- Pregabalin: often available on PBS for neuropathic pain; private pack prices for a typical supply can be about AUD 15.00 to AUD 40.00, with PBS co-payments where eligible.
- Other antiepileptics such as carbamazepine, lamotrigine, levetiracetam and topiramate: many strengths are PBS-listed so most patients pay the applicable PBS co-payment.
Check with your pharmacist about the current PBS status for your indication, the availability of lower-cost generics and which pack size gives the best value for your regimen.
The status of being legally authorized and regulatory framework in Australia
- Scheduling: gabapentin is classed as Schedule 4 (S4) in the Australian Poisons Standard. It is a prescription-only medicine and cannot be supplied legally without a valid prescription.
- Dispensing: pharmacies dispense gabapentin only against a lawful prescription. Repeat supplies require prescriber authorisation and dispensing is recorded in line with state or territory rules.
- Driving: if gabapentin causes drowsiness, dizziness or affects vision you must not drive. People with epilepsy must follow Austroads guidance and state licensing rules; discuss your individual situation with your doctor.
- Personal importation: under the TGA Importation Blueprint for Personal Use you may bring up to a three month supply for personal use if you have a valid prescription besides the medicine remains in its original packaging; declare items at the border where required.
- Safe handling: do not share prescription medicines. Keep prescriptions secure and return unused medicines to a pharmacy for disposal.
Regulations, PBS listings and scheduling may change. Always follow current prescriber advice and local laws.
Need a hand with this?
- Call 000 immediately for emergency services for life-threatening emergencies.
- Poisons Information Centre in Australia: 13 11 26 - available 24 hours for suspected a fatal overdose or poisoning advice.
- Medication questions: consult your community pharmacist or the clinician who prescribed your medicine.
- Mental health crisis support: Lifeline on 13 11 14.
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