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Gabapentin doesn’t hurt the liver or kidneys in most cases. However, taking a safe gabapentin dose is important to prevent potential side effects.
gabapentin
Used for Postherpetic Neuralgia
Used for Postherpetic Neuralgia
Gralise (gabapentin) is FDA-approved for treating nerve pain from shingles in adults. It belongs to the drug class called antiepileptics. Gralise (gabapentin) is an extended-release form of gabapentin, which means that the medication gets slowly released into the body from the tablet. Gralise (gabapentin) is taken by mouth once in the evening with food. The dosage is typically started low and slowly raised over a couple weeks. Side effects include dizziness, sleepiness, and headache. This medication is available under the brand name Gralise and as a lower-cost generic.
What is Gralise (gabapentin)?
What is Gralise (gabapentin) used for?
- Nerve pain from shingles in adults
How Gralise (gabapentin) works
Gralise (gabapentin) is an antiepileptic that's used to help with nerve pain from shingles. It has a similar structure to gamma-aminobutyric acid (GABA), a chemical in the body that calms nerves.
It's not completely known how Gralise (gabapentin) works to treat nerve pain, but it's thought to work by blocking the nerves that play a role in nerve pain.
Drug facts
| Common Brands | Gralise |
|---|---|
| Drug Class | Antiepileptic |
| Controlled Substance Classification | Controlled in some states. See FAQs below. |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Gralise (gabapentin) essentials
Side effects of Gralise (gabapentin)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness (11%)
- Sleepiness (5%)
Less Common Side Effects
- Headache
- Diarrhea
- Dry mouth
- Common cold symptoms
- Weight gain
- Swelling in the hands, feet, or ankles
- Pain in arm, leg, or back
Gralise (gabapentin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction or serious skin reaction: hives, rash, blisters, skin reddening, fever, swelling of the lips or tongue, difficulty breathing
- Suicidal thoughts or behaviors
- Breathing problems
More on Gralise (gabapentin) side effects
The following Gralise (gabapentin) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Clumsiness or unsteadiness
continuous, uncontrolled, back-and-forth, or rolling eye movements
More common in children
Aggressive behavior or other behavior problems
concentration problems and change in school performance
crying
false sense of well-being
hyperactivity or increase in body movements
rapidly changing moods
reacting too quickly, too emotional, or overreacting
restlessness
suspiciousness or distrust
Less common
Black, tarry stools
chills
depression, irritability, or other mood or mental changes
loss of memory
pain or swelling in the arms or legs
painful or difficult urination
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
unusual bleeding or bruising
unusual tiredness or weakness
Incidence not known
Abdominal or stomach pain
blistering, peeling, or loosening of the skin
clay-colored stools
coma
confusion
convulsions
dark urine
decreased urine output
difficult or troubled breathing
dizziness
fast or irregular heartbeat
headache
increased thirst
irregular, fast or slow, or shallow breathing
itching or skin rash
joint pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
loss of appetite
muscle ache or pain
pale or blue lips, fingernails, or skin
red skin lesions, often with a purple center
red, irritated eyes
unpleasant breath odor
vomiting of blood
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Blurred vision
delusions
hoarseness
lack or loss of strength
lower back or side pain
swelling of the hands, feet, or lower legs
trembling or shaking
Less common or rare
Accidental injury
appetite increased
back pain
bloated or full feeling
body aches or pain
burning, dry, or itching eyes
change in vision
change in walking and balance
clumsiness or unsteadiness
congestion
cough producing mucus
decrease in sexual desire or ability
dryness of the mouth or throat
excess air or gas in the stomach or intestines
excessive tearing
eye discharge
feeling faint, dizzy, or lightheadedness
feeling of warmth or heat
flushed, dry skin
flushing or redness of the skin, especially on the face and neck
fruit-like breath odor
impaired vision
incoordination
increased hunger
increased sensitivity to pain
increased sensitivity to touch
increased thirst
indigestion
noise in the ears
pain, redness, rash, swelling, or bleeding where the skin is rubbed off
passing gas
redness or swelling in the ear
redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
sweating
tender, swollen glands in the neck
tightness in the chest
tingling in the hands and feet
trouble sleeping
trouble swallowing
trouble thinking
twitching
unexplained weight loss
voice changes
vomiting
weakness or loss of strength
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Gralise (gabapentin)
Pros
- Works well to help with nerve pain from shingles
- Only need to take once a day
- Available as a lower-cost generic
Cons
- Can't crush or chew the tablets, so might not be a good option for people who have trouble swallowing
- Commonly causes dizziness
- Can raise the risk for suicidal thoughts or behavior
Pharmacist tips for Gralise (gabapentin)
- Take Gralise (gabapentin) with your evening meal; food helps your body absorb the medication better.
- Swallow the Gralise (gabapentin) tablet whole with a full glass of water. Don't chew, break, or crush it. Otherwise, the film coating around the tablet can get damaged and cause the medication to get released into the body too quickly, which can raise your risk for side effects.
- Dizziness and sleepiness are common side effects of Gralise (gabapentin). The side effects can affect your ability to think clearly and react quickly. Don't drive or do anything that requires concentration until you know how this medication affects you.
- Avoid drinking alcohol with Gralise (gabapentin). Mixing alcohol with the medication can make side effects like sleepiness, dizziness, and slowed breathing more intense.
- Gralise (gabapentin) can raise the risk of having suicidal thoughts. Seek medical help right away if you or your loved ones notice any new or worsening changes in your behavior or mood while you're taking this medication.
- Tell your care team about all of the medications you're taking or planning to take. Gralise (gabapentin) can interact with many medications, such as anxiety medications and opioids. These particular interactions can raise your risk for side effects, such as sleepiness, dizziness, and dangerously slow breathing. Your care team can check that your medications are safe to take together.
- If you need heartburn relief while you're taking Gralise (gabapentin), take Gralise (gabapentin) at least 2 hours after any antacids that contain magnesium or aluminum, such as Mylanta Maximum Strength. These antacids can lessen the amount of Gralise (gabapentin) that's absorbed into your body.
- Take Gralise (gabapentin) exactly as prescribed. Never change your dose or stop taking the medication suddenly without talking to your prescriber first. Doing so can cause withdrawal symptoms like anxiety and sleeping problems. Contact your prescriber for instructions on how to lower your dose or stop the medication if that's what you'd like to do.
- Talk with your care team about the benefits and risks of taking Gralise (gabapentin) if you're pregnant or thinking about becoming pregnant. There's limited research on how safe the medication is during pregnancy. You're recommended to enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry if you choose to take Gralise (gabapentin) while pregnant. This registry helps researchers learn more about your health and your baby's health if you take the medication while expecting.
- Talk to your baby's primary care provider or pediatrician about whether it's safe to take Gralise (gabapentin) while you're breastfeeding. Research shows that some medication can get into breast milk. Tell your baby's care team if you see that your baby is sleepier than usual or missing developmental milestones if you're taking this medication and breastfeeding.
More on Gralise (gabapentin) tips
Risks and warnings for Gralise (gabapentin)
Gralise (gabapentin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Difficulty concentrating, sleepiness, and dizziness
- Risk factors: Taking high doses of Gralise (gabapentin) | Drinking alcohol | Taking other medications that can cause sleepiness
Gralise (gabapentin) can sometimes make you dizzy or sleepy. This can lower your ability to think, react, and focus. These side effects should get better after a few weeks. Note that your risk for these side effects might be higher if you're also taking other medications that can make you feel sleepy, such as benzodiazepines, muscle relaxants, and sleep medications. Make sure you know how Gralise (gabapentin) affects you before driving a car or doing activities that require your concentration. Talk to your prescriber right away if you feel too sleepy from the medication.
Suicidal thoughts or behavior
- Risk factors: Depression
Gralise (gabapentin) can raise the risk of having thoughts of suicide or harming yourself. Sometimes, this can happen as early as 1 week after you start taking Gralise (gabapentin). Get medical help right away if you or anyone around you notices that you have suicidal thoughts or unusual behavior (e.g., symptoms of depression, anxiety, panic attacks, feeling angry or irritated, restlessness) while you're taking this medication.
Dangerously slow breathing (respiratory depression)
- Risk factors: Taking medications that can cause slow breathing | Drinking alcohol | Medical conditions that cause breathing problems (e.g., COPD, asthma)
Your breathing can get dangerously slow if you take Gralise (gabapentin) with other medications that can slow your body down, such as benzodiazepines and opioids. This can also happen if you drink alcohol with Gralise (gabapentin). Call 911 as soon as possible if you or your loved ones notice that you're having trouble breathing or that you have bluish-colored lips, fingers, or toes while you're taking this medication.
Severe allergic reactions and skin reactions
Severe allergic reactions to Gralise (gabapentin) are possible, including life-threatening reactions like facial swelling and anaphylaxis (e.g., closing of the throat). Although rare, Gralise (gabapentin) can also cause serious skin reactions, such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome. Stop taking this medication and get medical attention right away if you have a fever, swelling in your face, trouble breathing, or changes in your skin (e.g., rash, blisters, swollen lymph nodes, skin reddening or peeling).
Risk for withdrawal symptoms
Suddenly stopping Gralise (gabapentin) can sometimes cause withdrawal symptoms to happen. These symptoms can include nausea, anxiety, nervousness, and irregular heart rhythm. Withdrawal symptoms might be more likely to happen if you've taken the medication for a long time and you suddenly stop treatment. Don't change your dose or stop taking Gralise (gabapentin) without talking to your prescriber first. They'll help you lower your dose slowly over time before you can stop the medication completely.
Gralise (gabapentin) dosage
The average cost for 90 tablets of 600mg of Gralise (gabapentin) is $20.15 with a free GoodRx coupon. This is 91.15% off the average retail price of $227.60. 
Tablet
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 600mg | 90 tablets | $20.15 | $0.22 |
| 300mg | 30 tablets | $53.14 | $1.77 |
| 450mg of | 30 tablets | $61.72 | $2.06 |
| 750mg of | 30 tablets | $87.57 | $2.92 |
| 900mg of | 30 tablets | $87.57 | $2.92 |
Typical dosage for Gralise (gabapentin)
The typical starting dose is 300 mg by mouth once a day with your evening meal. The dose is then slowly raised over 2 weeks until you reach the goal dose of 1,800 mg by mouth once a day with your evening meal.
Your dose might differ if you have kidney problems.
More on Gralise (gabapentin) dosage
Interactions between Gralise (gabapentin) and other drugs
Gralise (gabapentin) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Gralise (gabapentin). Please note that only the generic name of each medication is listed below.
More on Gralise (gabapentin) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acepromazine
- Alfentanil
- Alprazolam
- Amobarbital
- Anileridine
- Aripiprazole
- Asenapine
- Baclofen
- Benperidol
- Benzhydrocodone
- Bromazepam
- Buprenorphine
- Buspirone
- Butabarbital
- Butorphanol
- Calcifediol
- Calcium Oxybate
- Cannabidiol
- Carbinoxamine
- Carisoprodol
- Carphenazine
- Chloral Hydrate
- Chlordiazepoxide
- Chlorpromazine
- Chlorzoxazone
- Clobazam
- Clonazepam
- Clorazepate
- Clozapine
- Codeine
- Cyclobenzaprine
- Dexmedetomidine
- Diacetylmorphine
- Diazepam
- Dichloralphenazone
- Difenoxin
- Dihydrocodeine
- Diphenhydramine
- Diphenoxylate
- Doxylamine
- Droperidol
- Enflurane
- Esketamine
- Estazolam
- Eszopiclone
- Ethchlorvynol
- Ethopropazine
- Ethylmorphine
- Fentanyl
- Flibanserin
- Flunitrazepam
- Fluphenazine
- Flurazepam
- Fluspirilene
- Fospropofol
- Gabapentin Enacarbil
- Halazepam
- Haloperidol
- Halothane
- Hexobarbital
- Hydrocodone
- Hydromorphone
- Hydroxyzine
- Isoflurane
- Ketamine
- Ketazolam
- Ketobemidone
- Levocetirizine
- Levorphanol
- Lorazepam
- Loxapine
- Magnesium Oxybate
- Meclizine
- Melperone
- Meperidine
- Mephobarbital
- Meprobamate
- Meptazinol
- Mesoridazine
- Metaxalone
- Methadone
- Methdilazine
- Methocarbamol
- Methohexital
- Methotrimeprazine
- Methylene Blue
- Midazolam
- Molindone
- Moricizine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Nicomorphine
- Nitrazepam
- Nitrous Oxide
- Olanzapine
- Opium
- Opium Alkaloids
- Orlistat
- Orphenadrine
- Oxazepam
- Oxycodone
- Oxymorphone
- Papaveretum
- Paregoric
- Pentazocine
- Pentobarbital
- Perampanel
- Perazine
- Periciazine
- Perphenazine
- Phenobarbital
- Pimozide
- Piperacetazine
- Pipotiazine
- Piritramide
- Potassium Oxybate
- Prazepam
- Pregabalin
- Primidone
- Prochlorperazine
- Promazine
- Promethazine
- Propofol
- Quazepam
- Quetiapine
- Ramelteon
- Remifentanil
- Remimazolam
- Remoxipride
- Secobarbital
- Sertindole
- Sodium Oxybate
- Sufentanil
- Sulpiride
- Suvorexant
- Tapentadol
- Temazepam
- Thiethylperazine
- Thiopental
- Thiopropazate
- Thioridazine
- Tilidine
- Tizanidine
- Tolonium Chloride
- Topiramate
- Tramadol
- Triazolam
- Trifluoperazine
- Trifluperidol
- Triflupromazine
- Trimeprazine
- Zaleplon
- Zolpidem
- Zopiclone
- Zotepine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aluminum Carbonate, Basic
- Aluminum Hydroxide
- Aluminum Phosphate
- Dihydroxyaluminum Aminoacetate
- Dihydroxyaluminum Sodium Carbonate
- Ginkgo
- Magaldrate
- Magnesium Carbonate
- Magnesium Hydroxide
- Magnesium Oxide
- Magnesium Trisilicate
How much does Gralise (gabapentin) cost?
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What are alternatives to Gralise (gabapentin)?
There are a number of medications that your doctor can prescribe in place of Gralise (gabapentin). Compare a few possible alternatives below.
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Gralise (gabapentin) images
