Nerve pain, also called “neuropathic pain,” is difficult to live with. But for most people, nerve pain can be reduced. It’s usually caused by chronic, progressive nerve disease, and it can also occur as a result of injury or infection.
If you have chronic nerve pain, it can flare up at any time without an obvious pain-inducing event or factor. Acute neuropathic pain, while uncommon, can occur as well.
Typically, non-neuropathic pain (nociceptive pain) is due to an injury or illness. For example, if you drop a heavy book on your foot, your nervous system sends signals of pain immediately after the book hits. With neuropathic pain, the pain isn’t typically triggered by an event or injury. Instead, the body just sends pain signals to your brain unprompted.
People with this painful condition may experience shooting and burning pain. The pain may be constant or may occur intermittently. A feeling of numbness or a loss of sensation is common, too. Nerve pain tends to get worse over time.
About 1 in 3 Americans experience chronic pain. Of those, 1 in 5 experience neuropathic pain. A 2014 study estimated that as many as 10 percent of Americans experience some form of neuropathic pain. Understanding the possible causes can help you find better treatments and ways to prevent the pain from getting worse over time.
What is gabapentin?
Gabapentin is a prescription drug that belongs to a class of drugs called anticonvulsants. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain. Gabapentin is used together with other medicines to treat partial seizures in adults and children at least 3 years old.
Gabapentin is also used to treat neuropathic pain (nerve pain) caused by herpes virus or shingles (herpes zoster) in adults. Gabapentin is not an addictive medication.
Use only the brand and form of gabapentin your doctor has prescribed. Check your medicine each time you get a refill to make sure you receive the correct form.
The Gralise brand of gabapentin is indicated for the management of neuropathic pain only. It is not used for epilepsy. Horizant is used to treat nerve pain and restless legs syndrome (RLS). Both medications contain the same active ingredient gabapentin. However, they are not the same thing, and can’t be used interchangeably. Taking 300 mg of Gralise (gabapentin) is not the same as 300 mg of gabapentin (Neurontin).
The Neurontin brand is used to treat seizures in adults and children who are at least 3 years old, in addition to neuropathic pain.
It’s not fully understood how gabapentin works. For postherpetic neuralgia, it seems to prevent the increase in sensitivity to pain that occurs. For seizures, it may alter the effect of calcium (low levels of calcium may cause seizures).
Is gabapentin good for nerve pain?
Theoretically, gabapentin works for nerve pain by calming nerve activity to reduce seizure intensity or occurrence. Gabapentin can also help reduce post-herpetic neuralgia, which refers to a burning or stabbing nerve pain that is a common complication of shingles.
According to one 2017 review, oral gabapentin can reduce moderate or severe nerve pain that results from shingles or diabetes at a minimum daily dosage of 1,200 milligrams.
Extended-release gabapentin (Horizant) tablets can treat RLS, which is a condition characterized by uncomfortable sensations in the legs and a strong or irresistible urge to move the lower limbs.
A 2016 study also suggests that gabapentin combined with oxycontin, which is an opioid pain reliever, can help control pain and increase the quality of life for people with severe cancer pain. However, doctors do not typically prescribe gabapentin for this purpose.
How long does it take for gabapentin to start working for nerve pain?
People taking Gralise (gabapentin) for nerve pain reported feeling pain relief within 1 week after starting the medication. However, it might take longer for some people, especially if it takes more time to reach the target dose of 1800 mg. Gralise (gabapentin) works differently than other pain medications like ibuprofen (Advil, Motrin) or morphine, which provide pain relief within a few hours. Medications for nerve pain are different because they have to be taken every day in order to work.
What is the normal dosage of gabapentin for nerve pain?
The starting dose of Gralise (gabapentin) for nerve pain is 300 mg by mouth once a day with evening meals. It is available as a starter pack where the dose is raised every few days until the target dose of 1800 mg once a day is reached.
The recommended starting for gabapentin (Neurontin) for nerve pain from shingles is 300 mg by mouth a day for 1 day, followed by 600 mg (300 mg twice a day) on day two, and then 900 mg (300 mg three times a day) on day 3. The dose can be raised or lowered depending on the balance between side effects and pain relief. The maximum total dose per day is 1800 mg.
The usual adult dose of Horizant for postherpetic neuralgia is 600 mg orally 2 times a day. Therapy should be initiated at a dose of 600 mg orally in the morning for 3 days of therapy, then increased to 600 mg 2 times a day (1200 mg/day) on day four.
In general typical starting dose of gabapentin for nerve pain can vary depending on the condition being treated and the individual patient’s response. However, a common dosing regimen for adults may start with 300 mg taken orally, usually once daily at bedtime. The dose may be increased gradually based on your response and tolerance, and it can range from 300 mg to 600 mg taken two or three times a day. In some cases, higher doses may be used, but this should be done under close medical supervision. It’s essential to work with your healthcare provider to find the most effective and safe dosage for your specific condition and needs. They will monitor your response to the medication and make necessary adjustments. It’s also crucial to follow the prescribed schedule and not to increase or decrease the dose on your own, as gabapentin can have side effects and withdrawal symptoms if not used correctly.
Remember that individual responses to medication can vary, so what works for one person may not be suitable for another. Always consult with your healthcare provider to determine the appropriate dose and duration of treatment for your specific situation.
| Nerve Pain Condition | Starting Dose | Common Dose Range |
| Neuropathic Pain | 300 mg once daily | 300 mg – 1800 mg daily |
| Postherpetic Neuralgia (PHN) | 300 mg once daily | 300 mg – 1800 mg daily |
| Diabetic Neuropathy | 300 mg once daily | 900 mg – 1800 mg daily |
| Restless Legs Syndrome (RLS) | 300 mg once daily | 300 mg – 600 mg daily |
| Trigeminal Neuralgia | 100 mg once daily | 100 mg – 1200 mg daily |
How long should I take gabapentin for nerve pain?
Unlike epilepsy which requires taking gabapentin for many years, nerve pain management with the medication is different. Generally, doctors advise those using gabapentin for nerve pain, to continue using the medication for several months after the pain has gone to prevent it from coming back.
Do not stop taking gabapentin without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood. If you suddenly stop taking gabapentin tablets, capsules, or oral solutions, you may experience withdrawal symptoms such as anxiety, difficulty falling asleep or staying asleep, nausea, pain, and sweating. If you are taking gabapentin to treat seizures and you suddenly stop taking the medication, you may experience seizures more often. Your doctor may decrease your dose gradually over at least a week.
Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with gabapentin each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website or the manufacturer’s website to obtain the Medication Guide.
How To Get the Best Result When Using Gabapentin For Nerve Pain
Here are some tips to help you get the best results when using gabapentin for nerve pain:
- Follow your doctor’s instructions: Your doctor will prescribe the right dose of gabapentin for you based on your condition and medical history. Be sure to follow their instructions carefully and take the medication as directed.
- Start with a low dose: Gabapentin can cause side effects, so it’s important to start with a low dose and gradually increase it until you find the right dose for you.
- Take the medication at the same time every day: Taking gabapentin at the same time every day can help you remember to take it and keep a steady level of the medication in your system.
- Be patient: It may take some time for gabapentin to start working for nerve pain, so be patient and give it a chance to work.
- Keep track of your symptoms: Keep a diary of your symptoms and how they change over time. This can help you and your doctor adjust your medication dose as needed.
- Be aware of potential side effects: Gabapentin can cause side effects such as dizziness, drowsiness, and nausea. Be sure to talk to your doctor if you experience any side effects.
- Consider complementary therapies: In addition to taking gabapentin, complementary therapies such as physical therapy, massage, and acupuncture may also help relieve nerve pain.
Remember to always consult with your doctor before making any changes to your medication or treatment plan.
