Hey guys, yaseen arsalan, media pharmacist here on youtube, This weeks video is on gabapentin,
we’ll go over key facts about the medication, how and when to take it, side effects and
how to cope with them, as well as some overall facts you should know of to become an informed
consumer about your medicine.
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So without further ado, lets get straight into it.
Gabapentin is a epilepsy medication in the class of medicine known as anticonvulsants,
but it is so much more than that.
Its primarily used to treat partial seizures and neuropathic pain.And It is a first-line
medication for the treatment of neuropathic pain caused by diabetic neuropathy- nerve
damage that can occur if you have diabetes, postherpetic neuralgia- when you get chronic
pain after shingles, and central pain.But you also see it used for many other uses as
well such as restless leg syndrome, non neuropathic pain, anxiety, and bipolor disorder.
Common brands names include Gralise and Horizant- which are the extended release versions of
gabapentin, starting off with 300 or 600 mg’s, and are longer acting, requiring once or twice
a day dosing vs Neurontin, the more popular brand name, a version of gabapentin that is
immediate release: which comes in capsules of 100, 300, or 400 mg), tablets of 600, and
800 mg and as a liquid solution at (250 mg per 5 mL).
The main difference comes down to how fast they work and for how long they end up staying
in the body to do its job.
It also comes down usually to how many times you end up taking it per day.
Doses of the immediate release gabapentin are usually given three times per day for
seizures and postherpetic neuralgia and is available in generic forms, whereas for the
extended release version its common to take it as few as once a day and, currently at
the time of filming the video, there is no generic form of horizant or gralise available
as of yet.
It was first approved in 1993 and In 2018, it was the eleventh most commonly prescribed
medication in the United States, with more than 45 million prescriptions.
Which means there is a need to be educated on how to take gabepentin safely and effectively.
In terms of how gabapentin works: Scientists arent entirely sure how it works exactly but
It appears to work by altering electrical activity in the brain, at a specific site
(called the alpha2-delta site) located on voltage-gated calcium channels.
Doing so, relieves nerve-pain and lowers the risk of seizures by influencing the activity
of chemicals called neurotransmitters, which send messages between nerve cells in our brain.
Once they start to slow down, this lowers the excitement our neurons face thereby controlling
seizures as well as how we perceive pain.
And its usually one of those medicines that has to take time to build up in your body
for it to fully work.
It sometimes takes a few weeks for gabapentin to work properly.
So You may still have seizures or pain during this time, which doesnt mean that it doesnt
work, it simply means its not to its full working effects yet.
Some things you should keep in mind is that Gabapentin is usually well-tolerated but there
may be side effects that occur more commonly that I will get into, so definitely stay tuned
for that, especially at the beginning of treatment.
In an alarming report, it was noted that 1 in 5 opioid medication users may also be misusing
and abusing gabapentin.
Gabapentin can be abused to boost the high a person gets from opioid painkillers like
oxycodone, muscle relaxants like Soma, and anxiety medications, such as Valium and Xanax.
And In 2019, the FDA issued an alert that serious breathing problems have been reported
with gabapentin and other related medicines, like Lyrica or (pregabalin) in people at risk
of slowed breathing.
So if thats you or anyone you know, please have them get the help they need and contact
your doctor if you see a concern.
Take gabapentin exactly as your doctor has told you to take it, and follow the directions
on the bottle label and packaging.
If you're not sure, check with your doctor or pharmacist.
This is the best way for the medicine to be beneficial in controlling seizures and pain
as it has been shown to do so.
But it has to be taken correctly.
So Because gabapentin is used for so many different indications, its hard to say what
directions you need to follow.
But the golden rule is to follow the directions your doctor has prescribed you for the best
results in your treatment.
Its normal though at first for epilepsy,to take 300 milligrams (mg) three times per day.
Then Your doctor may adjust your dose as needed and tolerated.
However, the dose is usually not more than 2400 mg per day.
As far as: postherpetic neuralgia: Adults— At first, take 300 milligrams (mg) as a single
dose in the evening.
Then Your doctor may adjust your dose as needed and tolerated.
You can take gabapentin with or without food.
But wait at least two hours after taking an antacid that contains either magnesium, calcium
or aluminum before taking your gabapentin dose.
The interaction between the antacid and gabapentin may prevent proper absorption and it lower
its effectiveness, so please be mindful of this.
Also : You should avoid or limit the use of alcohol (ethanol) while being treated with
gabapentin.
One more thing: You want to make sure you Swallow the gabapentin capsules and tablets
whole with a drink of water or juice.
Do not chew them..
Always check in with your doctor, to make sure you are taking them correctly.
Cant stress that enough.
Lets move onto the side effects and how to manage them, probably what you guys are all
here for.
Some common side effects that are usually mild and go away by themselves is: feeling
sleepy, tired, or dizzy, nauseous, vomiting or diarrhea, mood changes are another common
one, weight gain as gabapentin can make you feel more hungry, memory problems especially
with short term memory, dry mouth, and difficulty to maintain erections.
So lets address how to manage each of these and point you in the right direction: for
feeling sleepy/tired/dizzy: as your body gets used to gabapentin, these side effects should
wear off.
If they don't wear off within a week or two, your doctor may reduce your dose or increase
it more slowly.
If that doesn't work, you may need to switch to a different medicine.
This is also why its best to avoid alcohol as it can make you even more drowsy.
As for feeling nauseous: take gabapentin with or after a meal or snack.
It may also help if you don't eat rich or spicy food.
As for vomiting/diarrhea: drink plenty of water or other fluids to avoid dehydration.
Do not take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist
or doctor.
As far as mood changes: If you feel this medicine is causing mood changes, please talk to your
doctor.
You may be able to change to an alternative medicine.
For the memory problems, you want to: speak to your doctor as well.
They may want to try a different medicine.
As far as dry mouth: you can watch my video I made here on how to fix that, and as far
as maintaining erections: youll want to speak to your doctor again, as they may be able
to change your medicine or offer other treatments that might help as well.
As far as more serious side effects you should be aware of to let your doctor know are: Like
Similar to other anticonvulsant medicines, gabapentin may increase the risk of depression
and suicidal thoughts, particularly in young adults under the age of 24.
If you, your child, or your caregiver notice any of these side effects, tell your doctor
right away.
It hurts to see most people never bring this up to their doctor at all and go through this
alone, but feeling: agitated, irritable,feeling sad or hopeless, getting upset easily, or
feeling hostile are all real side effects, and its no shame to bring these up to your
doctor so please have these conversations and remember youre not alone.
Your doctor will check your progress at regular visits, especially in the first few months
if you have epilepsy to see if the medicine is working properly and to decide if you should
continue to take it.
This would be a good time to bring up any of these side effects.
Also another big one: Check with your doctor right away if you have a fever, rash, swollen,
painful, or tender lymph glands in the neck, armpit, or groin, unusual bleeding or bruising,
or yellow eyes or skin.
Gabapentin may also cause vision changes, clumsiness, sleepiness, or troubled thinking.
Make sure you know how you react to this medicine before you drive, use machines, or do anything
else that could be dangerous if you are not alert, well-coordinated, or able to think
or see well.
If these side effects are especially bothersome, check with your doctor too in that case as
well.
The best practices when it comes to gabapentin is being comfortable with your doctor to bring
up anything that you feel is necessary when youre on this medication.
As with any medication, gabapentin has interactions that you should know of as well, that ive
left in the description below for you to check out.
One of the biggest takeaways I would say is that you do not stop taking this abruptly.
Please please please, do not stop cold turkey.
Abruptly stopping any form of gabapentin can lead to worsened seizures and unpleasant withdrawal
side effects, so it's best to slowly stop taking it over a period of time and Your doctor
will direct you on how to do this gradually.
So please let them know before you try doing it yourself.
Now there you go: Youre now a gabapentin pro.
This isnt everything there is to know about this medicine and im sure your doctor will
explain more details to you guys, I only hope this was enough to point you in the right
direction.
I also hope this video was insightful to you guys, the only thing I ask in return is just
a simple like down below for the youtube algorithm.
It really means a lot, and if you guys like these types of videos, let me know in the
comments below.
I try my best to get back to all you guys.
Thanks for sticking tuned till the end, and as always, Ill see you, you on the next one.