Gabapentin for facial pain

If you have chronic pain in the face, we might prescribe you a medicine called gabapentin. Chronic pain (also called persistent pain) is long-term pain that lasts for more than 3 months.

Gabapentin (Neurontin®) is used to treat epilepsy, or to treat nerve pain. Nerve pain can be caused by different illnesses, including diabetes and shingles, or it can happen after an injury. Sometimes, gabapentin is used to treat migraine headaches.

You do not need to have epilepsy for gabapentin to help with pain or migraine.

Gabapentin is only available on prescription. Always follow the amount (dose) prescribed by your doctor, and read the leaflet that comes with your medicine.

Taking an unlicensed medicine

The use of gabapentin for treating chronic facial pain is unlicensed. This means that the manufacturer of the medicine has not specified it can be used in this way, but there is evidence that it works to treat this particular condition.

Read more about unlicensed medicines, or you can contact the pharmacy medicines helpline if you have any questions or concerns.

Taking gabapentin

Gabapentin comes as capsules, tablets, or a liquid that you drink.

  • People usually take gabapentin 3 times each day.
  • Swallow gabapentin capsules and tablets whole with a drink of water or juice. Do not chew them.
  • You can take gabapentin with or without food.

Try to space your doses evenly through the day. For example, first thing in the morning, early afternoon and at bedtime.

To prevent side effects, your doctor will start you with a low dose, and then increase it over a few weeks.

When you find a dose that works for you, it will usually stay the same. The maximum dose is 1,200g, 3 times a day, but not everyone needs to take the maximum dose.

How much to take (dose)

Week Morning Lunchtime Evening
1 -- -- 300mg
2 300mg -- 300mg
3 300mg 300mg 300mg
4 300mg 300mg 600mg
5 600mg 300mg 600mg
6 600mg 600mg 600mg
7 to 14 600mg 600mg 800mg
15 to 21 800mg 600mg 800mg
22 to 28 800mg 800mg 800mg
29 onwards 800mg 1,200mg 800mg

If you forget to take the medicine

If you forget a dose, take it as soon as you remember. If it is within 2 hours of the next dose, it is better to leave out the missed dose, and take your next dose as normal.

  • Never take 2 doses at the same time.
  • Never take an extra dose to make up for a forgotten one.

If you often forget doses, it might help to set an alarm to remind you. You can ask your pharmacist for advice on other ways to help you to remember to take your medicine.

Side effects of gabapentin

Like all medicines, gabapentin can cause side effects in some people, but lots of people have no side effects or only minor ones.

Common side effects

These common side effects happen in more than 1 in 100 people. They're usually mild and go away by themselves.

If these side effects bother you or do not go away, keep taking the medicine, but talk to your doctor:

  • feeling sleepy, tired or dizzy
  • feeling sick (nausea) or being sick (vomiting)
  • diarrhoea
  • getting more infections than usual
  • mood changes
  • swollen arms and legs
  • blurred vision
  • dry mouth
  • difficulties getting an erection
  • weight gain (gabapentin can make you feel hungry)
  • memory problems
  • headaches

Serious side effects

Very few people taking gabapentin have serious problems.

Call your GP or go to A&E immediately if you:

  • have thoughts of harming or killing yourself (a few people taking gabapentin have had suicidal thoughts, which can happen after only 1 week of treatment)
  • get yellowing of your skin or whites of your eyes (these might be warning signs of jaundice)
  • get unusual bruises or bleeding (these might be warning signs of a blood disorder)
  • are feeling sick, being sick, or long-lasting stomach pain (these might be warning signs of an inflamed pancreas)
  • have muscle pain or weakness and you're having dialysis treatment because of kidney failure
  • are seeing things that are not there (hallucinations)

Serious allergic reaction

In rare cases, it is possible to have a serious allergic reaction to gabapentin.

Call your GP or go to A&E immediately if:

  • you get a skin rash that might include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

These are not all the side effects of gabapentin. For a full list see the leaflet inside your medicine packet. You can report any suspected side effect to the UK safety scheme.

Is gabapentin addictive?

There is a risk that you might become dependent on gabapentin. Withdrawal symptoms (nervousness, mood disturbances, flu-like symptoms) have been seen when treatment is stopped suddenly.

If you have been taking gabapentin for a while and want to stop, your hospital doctor or GP will recommend that you reduce your dose slowly to avoid the risk of these effects.

Pregnancy and breastfeeding

Gabapentin is not generally recommended in pregnancy. There is no evidence that it is harmful to an unborn baby but, for safety, pregnant women are usually advised to take it only if the benefits of the medicine outweigh the risks.

Usually, you can breastfeed while taking gabapentin.

Taking gabapentin with other medicines

There usually are no problems if you mixing gabapentin with other medicines.

Some indigestion remedies (antacids) reduce the amount of gabapentin that the body absorbs, so it might not work as well. To stop this happening, take the antacid at least 2 hours before or after your dose of gabapentin.

Repeat prescriptions

Your GP will give you a repeat prescription for gabapentin, which you can take to your local pharmacy.

Make sure you ask for your repeat prescription early so that you do not run out of medicine or miss any doses. 

Resource number: 4831/VER1
Last reviewed: October 2019
Next review: October 2022

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