Patients with birth defects
The patients with rare birth defects such as Lapp lactase deficiency, galactose intolerance, or decreased absorption of glucose-galactose are at an increased risk. The medicinal product of Gabapentin which contains lactose is not recommended in such patients.
Abuse and dependence
The patients with a history of drug abuse are at an increased risk while using this medicine. Such patients may experience symptoms of drug abuse, for example, drug-seeking behavior, developing tolerance or increasing the dose consumption. The patients with a history of drug abuse should be carefully evaluated and observed for the presence of such symptoms.
Slow and ineffective breathing
The patients with nervous system disorder, respiratory disorder, kidney dysfunction, using other CNS depressants and the elderly are at an increased risk while using this medicine. Such patients are at risk of slow and ineffective breathing. The dosage adjustment may be required in such patients.
Sleepiness and dizziness
The patients with nerve
pain due to untreated herpes viral infection are at an increased risk while using this medicine. Such patients are at risk of sleepiness,
dizziness,
confusion, loss of consciousness, and mental disorders. Such patients should take caution while using Gabapentin. The patients using Gabapentin with other sedative drugs must be carefully observed for CNS
depression such as sleepiness and sedation due to the possibility of an additive effect. The use of Gabapentin with morphine may require dosage adjustment.
Patients who drive or operate heavy machinery
The patients who use Gabapentin may suffer from sleepiness and
dizziness, this may affect the patient's ability to drive. The patients are advised not to drive vehicle and operate machinery while using this medicine.
Seizures
The patients with
epilepsy are at an increased risk while using this medicine. The sudden withdrawal of Gabapentin in such patients may precipitate a life-threatening
seizure disorder (called as status epilepticus). Some patients may also experience increased seizure frequency or occurrence of new types of seizures while using Gabapentin. Gabapentin should be used with caution in patients with absence seizures or mixed seizures.
Inflammation of the pancreas
The patients are at an increased risk of inflammation of the pancreas (acute
pancreatitis) while using this medicine. If the patient develops such condition, the discontinuation of Gabapentin should be considered.
Neuropsychiatric disorders
The children with
epilepsy of age 3-12 years are at an increased risk while using this medicine. The patients are at risk of developing central nervous system disorders such as aggressive behavior, hatred, emotional lability mainly behavioral problems, thought disorder, difficulty while focusing, restlessness, hyperactivity, and changes in school performance.
Suicidal thoughts and behavior
The patients treated with Gabapentin are at an increased risk while using this medicine. Such patients may experience an increase in suicidal thoughts or behavior, developing
depression, worsening of the depression, any abnormal fluctuations in behavior or mood. The doctor must consider the risk of suicidal thoughts or behavior to untreated illness before prescribing this medicine in such patients. The patients should be advised to remain alert and carefully monitored for the emergence of such symptoms. If such symptoms appear, contact the doctor immediately and take appropriate treatment.
Multi-organ allergic reaction
Drug reaction with
eosinophilia and systemic symptoms (DRESS)/multi-organ allergic reaction can be life-threatening or possibly fatal. This drug reaction may be accompanied by rash,
fever, increase in the number of a type of white blood cells or disease of lymph nodes. It may involve other organ systems, such as inflammation of the kidneys or liver, blood disorders, inflammation of the muscles, inflammation of heart membrane (
myocarditis), sometimes look like a viral infection. If such symptoms appear, examine the patient for the presence of multi-organ allergic reaction (known as DRESS) and if such drug reaction is confirmed Gabapentin should be discontinued immediately.