How To Safely Stop Taking Gabapentin (Neurontin) - Healthline

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How to Safely Stop Taking Gabapentin (Neurontin)

Medically reviewed by Jenny Yu, MD FACS — Written by Malini Ghoshal, RPh, MS — Updated on March 20, 2023

How to stop
Risks of stopping suddenly
Off-label use
Why to stop taking it
Surgery and gabapentin
Outlook
Takeaway

Talk with a doctor before stopping gabapentin or any other prescribed medication. Stopping abruptly can be dangerous. You may need to taper off your dosage over time.

Have you been taking gabapentin and thought about stopping? Before you stop this medication, there’s some important safety and risk information for you to consider.

Abruptly stopping gabapentin could make your symptoms worse. It could even be dangerous. You might have a serious reaction like seizures if you stop suddenly.

Your doctor may have prescribed gabapentin to treat partial focal seizures for epilepsy, or for postherpetic neuralgia, a type of nerve pain that can happen from shingles.

You might be familiar with the popular brand of gabapentin called Neurontin. Another brand is Gralise.

Gabapentin enacarbil (Horizant) is approved for restless leg syndrome and postherpetic neuralgia. Gabapentin is also prescribed off-label for other conditions. Off-label prescribing is when a doctor prescribes a medication for a different use than its approval by the Food and Drug Administration.

Don’t stop taking gabapentin without first discussing it with your doctor. Your doctor can adjust dosing if you’re having problems. If you want to stop taking your medication, do it under a doctor’s supervision while gradually decreasing your dosage.

How do you ease off gabapentin?

Tapering or slowly reducing your dose is recommended to stop taking gabapentin.

Tapering off will help you avoid side effects. The timeline to reduce gabapentin depends on the individual and the current dose of the medication.

Your doctor will develop a plan to slowly take you off the medication. This could be lowering the dose over a week or over several weeks.

You may experience anxiety, agitation, or insomnia when your dose is reduced. It’s important to discuss any symptoms you’re experiencing with your doctor so that they can adjust your dosing schedule. Remember the schedule is flexible and your comfort is important.

If you experience seizures, shortness of breath, or other serious symptoms, call 911 or seek medical attention immediately.

Why it’s important to discuss dose changes with your doctor
Your doctor can monitor you while you taper off the drug and treat any symptoms, such as:
seizures
side effects like allergic reaction, fever, nausea, tremors, or double vision
withdrawal symptoms such as sweating, dizziness, fatigue, headaches, and others
worsening of your condition or symptoms

What happens if you suddenly stop gabapentin?

It’s important to discuss your concerns about gabapentin with your doctor or pharmacist first before you stop the medication.

You might have certain symptoms if you suddenly stop gabapentin:

withdrawal symptoms, such as agitation, restlessness, anxiety, insomnia, nausea, sweating, or flu-like symptoms
status epilepticus, which is a rapid cycle of seizure activity so that an individual experiences an almost constant seizure
irregular heart rate
confusion
headache
tiredness
weakness
return of nerve pain

The risks of withdrawal are higher if you’re taking high doses or have been on gabapentin for longer than 6 weeks. Withdrawal symptoms can start from 12 hours to 7 days after stopping the medication.

Off-label use of gabapentin

Gabapentin is prescribed off-label for several conditions including:

migraine
anxiety disorders
fibromyalgia
bipolar disorder
insomnia

Gabapentin is also used off-label to treat chronic pain (as an alternative to opioid medications), alcohol use disorder (AUD), and substance use disorder (SUD).

There’s growing concern about the misuse of gabapentin. The risk of misuse is higher among those who also misuse opioids — 15 to 22 percent. Overdose-related deaths have been reported when combined with other drugs.

Studies show an increase in the number of overall prescriptions of gabapentin. Certain drugs like opioids taken with gabapentin increase the danger of overdose.

Several states are considering legislation to help stop this misuse. Many have put special monitoring requirements in place for gabapentin.

Reasons you may choose to stop taking gabapentin

If you’ve been taking gabapentin, you and your doctor can discuss whether the medication works. This might include a conversation about reducing or stopping the medication for several reasons.

Side effects

Gabapentin has some side effects associated with it. Some might be serious or bothersome enough to stop taking the medication.

Side effects can include:

allergic reactions, such as swelling of hands or face, itching, chest tightness, or trouble breathing
suicidal thoughts or behavior
nausea and vomiting
fever or viral infection
lack of coordination and problems with movement, which can cause falls or injury
drowsiness, dizziness, or tiredness, which can affect driving or work activities
tremors
double vision
swelling of the feet or legs

If you’re having suicidal thoughts, seek medical help immediately by calling the 988 Suicide and Crisis Lifeline 24 hours a day or texting HOME to the Crisis Textline at 741741.

Drug interactions

Central nervous system (CNS) depressants like alcohol and opioids taken together with gabapentin can increase drowsiness and dizziness.

Harmful effects can also include problems with breathing and mental status changes. Risk of death with co-use of opioids and gabapentin is up to 60 percent greater with doses of gabapentin over 900 milligrams per day.

Antacids with aluminum and magnesium like Maalox and Mylanta can reduce gabapentin’s effects. It’s best to take them separated by at least 2 hours.

You feel better

Remember, taking gabapentin might improve your nerve pain or seizure symptoms, but stopping the medication could bring symptoms back.

It’s important to talk with your doctor before you stop the medication on your own.

Gabapentin isn’t working

If your symptoms haven’t improved or you’re feeling worse, ask your doctor about other options to treat your condition.

It’s too expensive

If your medication costs are too high, ask your pharmacist or doctor about other medication choices.

These are all important reasons to consider stopping gabapentin. Remember, you and your healthcare professionals are partners. They need to know if you’re having difficulty taking gabapentin. They can create a safe plan to stop the medication and find an alternative that works better.

Surgery and gabapentin

Gabapentin can cause sedation and increase the effects of certain pain medications like opioids used before or after surgery. You might need to change the dose of your medications to avoid problems if you’re scheduled for surgery.

It’s important to let your doctors know about all your medications before surgery. This includes dental surgery, too.

Some doctors use gabapentin to reduce opioid use for surgery. A 2017 analysis found patients given gabapentin before surgery reported less opioid use after surgery and experienced fewer side effects.

Gabapentin is sometimes included for pain control before or after surgery to reduce the doses and side effects of opioids like morphine. One recent study found people used fewer opioids and recovered faster when taking gabapentin after surgery.

Ask your doctor about pain control options and let them know if you’re already taking gabapentin to avoid potential overdose.

When to see your doctor about stopping gabapentin
if your symptoms get worse or you aren’t feeling better
if you’re having any specific side effects
if you’re taking other medications like opioids or benzodiazepines
if you have a substance use disorder, you may need special monitoring

Outlook for stopping gabapentin

If you want to stop taking gabapentin but have concerns about withdrawal symptoms and other side effects, talk with your doctor and create a plan that works for you.

You may experience agitation, insomnia, or anxiety. Ask your doctor about how to handle these or other symptoms.

The level of discomfort you experience from withdrawal will depend on:

your age
the condition being treated
your dosage of gabapentin and how long you’ve been taking it
any other health conditions, including SUD

The takeaway

Gradually stopping gabapentin is important to avoid dangerous side effects and withdrawal symptoms. Don’t stop taking the medication on your own. Your doctor can supervise a tapering plan to successfully stop gabapentin use.

How long it takes you to stop the medication is completely up to you and your doctor. Stopping gabapentin is an individual process, and there’s no exact timeline. It might take a week or several weeks.

Ask about support services such as counseling or emotional support if you need help managing withdrawal symptoms.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Chiappini S, et al. (2016). A decade of gabapentinoid misuse: An analysis of the European Medicines Agency's 'Suspected Adverse Drug Reactions' Database. DOI: https://doi.org/10.1007/s40263-016-0359-y
Evoy KE, et al. (2017). Abuse and misuse of pregabalin and gabapentin. DOI: https://doi.org/10.1007/s40265-017-0700-x
Fan KL, et al. (2019). Gabapentin decreases narcotic usage: Enhanced recovery after surgery pathway in free autologous breast reconstruction. DOI:https://dx.doi.org/10.1097%2FGOX.0000000000002350
Gomes T, et al. (2017). Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case-control study. DOI:https://dx.doi.org/10.1371%2Fjournal.pmed.1002396
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Lennox R, et al. (2019). Gabapentin misuse.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333539
Lyndon A, et al. (2017). Risk to heroin users of polydrug use of pregabalin or gabapentin. DOI:https://dx.doi.org/10.1111%2Fadd.13843
Mersfelder TL, et al. (2016). Gabapentin: Abuse, dependence, and withdrawal. DOI: https://doi.org/10.1177/1060028015620800
Neurontin prescribing information. (2017).https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020235s064_020882s047_021129s046lbl.pdf
Peckham AM, et al. (2018). All-cause and drug-related medical events associated with overuse of gabapentin and/or opioid medications: A retrospective cohort analysis of a commercially insured US population. DOI: https://doi.org/10.1007/s40264-017-0595-1
Peckham AM, et al. (2018). Gabapentin use, abuse, and the US opioid epidemic: The case for reclassification as a controlled substance and the need for pharmacovigilance. DOI:https://dx.doi.org/10.2147%2FRMHP.S168504
Smith RV, et al. (2016). Gabapentin misuse, abuse, and diversion: a systematic review. DOI:https://dx.doi.org/10.1111%2Fadd.13324

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Medically reviewed by Jenny Yu, MD FACS — Written by Malini Ghoshal, RPh, MS — Updated on March 20, 2023

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How do you ease off gabapentin?

What happens if you suddenly stop gabapentin?

Off-label use of gabapentin

Reasons you may choose to stop taking gabapentin

Side effects

Drug interactions

You feel better

Gabapentin isn’t working

It’s too expensive

Surgery and gabapentin

Outlook for stopping gabapentin

The takeaway

How we reviewed this article:

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