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.
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.
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.
Contact your healthcare provider immediately if you experience any of the following.
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.
You should take Gralise (gabapentin) with your evening meal every day. Food keeps the tablet in your stomach for a longer period of time. Staying in the stomach longer helps the medication get slowly released into your body through the night. It's possible that this can be helpful to stop your nerve pain symptoms from interrupting your sleep.
Studies show that people reported improvement in shingles-related nerve pain within a week of starting treatment with Gralise (gabapentin). But it can take several weeks of treatment to feel the maximum pain-relieving effects of the medication.
It takes about a day or so for most of Gralise (gabapentin) to leave your body after you take one dose. This time frame is estimated based on the half-life of gabapentin. It can stay in your system longer if you have kidney problems because your body uses the kidneys to help get rid of the medication. Talk with your healthcare team if you have any specific concerns related to how long Gralise (gabapentin) stays in your body.
The active ingredient in Gralise is gabapentin. It's the extended-release form of gabapentin. There are other forms of gabapentin available under the brand names Neurontin and Horizant. The three forms of gabapentin aren't interchangeable — one can't be easily replaced with another. The dosage for the forms of gabapentin isn't equal to each other and how often they're taken during the day is different. While all three forms of gabapentin can be used for nerve pain from shingles, some can treat other medical conditions such as restless legs syndrome or certain types of seizures. Gralise, though, is FDA-approved for shingles-related nerve pain only. Talk to your care team if you have questions on the differences between the gabapentin products.
No, don't take Gralise (gabapentin) with any other form of gabapentin, such as immediate-release gabapentin (Neurontin) or Horizant (gabapentin enacarbil). Taking more than one form of gabapentin at the same time puts you at risk for serious side effects like sleepiness, dizziness, and suicidal thoughts and behaviors.
It's possible, but not common. In clinical studies, only about 2% of people who took Gralise (gabapentin) reported weight gain. It's not clear how much weight these people gained while they took the medication. Talk to your care team about how to lower your risk for weight gain from Gralise (gabapentin). They can suggest ways to plan for balanced and nutritious meals with lean proteins, whole-grains, fruits, and vegetables. They can also help build an exercise routine that's appropriate for you. Talk with your prescriber if you have more questions about Gralise (gabapentin) and weight gain.
Gralise (gabapentin) isn't classified as a controlled substance by the federal government. But gabapentin has a potential to be misused because the medication can cause a "high" when it isn't taken properly and when it's taken at higher doses. Some states might consider gabapentin as a controlled substance or have put strict dispensing regulations on the medication. Keep in mind that state laws can change. So, it’s best to ask your prescriber or pharmacist whether Gralise (gabapentin) is a controlled substance in your state and how to safely take the medication.
No, Gralise (gabapentin) isn't a narcotic. The term "narcotic" refers to opioid medications, and Gralise (gabapentin) isn't an opioid.
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.
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.
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.
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 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).
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.
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 600mg | 90 tablets | $19.62 | $0.22 |
| 300mg | 30 tablets | $53.14 | $1.77 |
| 450mg | 30 tablets | $92.45 | $3.08 |
| 750mg | 30 tablets | $135.54 | $4.52 |
| 900mg | 30 tablets | $135.54 | $4.52 |
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.
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.
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.