Is Gabapentin Bad for Your Liver and Kidneys?
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 |
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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
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The following Gralise (gabapentin) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- Rash, fever, and swollen lymph nodes
- Thoughts of suicide or self-harm, worsening mood, feelings of depression
- Trouble breathing
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Dizziness
- Drowsiness
- Headache
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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.
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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 30 tablets of 300mg of of Gralise (gabapentin) is $39.01 with a free GoodRx coupon. This is 87.84% off the average retail price of $320.75. 
Tablet
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 300mg of | 30 tablets | $39.01 | $1.30 |
| 600mg of | 90 tablets | $20.50 | $0.23 |
| 450mg of | 30 tablets | $85.77 | $2.86 |
| 750mg of | 30 tablets | $135.25 | $4.51 |
| 900mg of | 30 tablets | $120.92 | $4.03 |
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.
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How much does Gralise (gabapentin) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
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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