How Long It Takes Gabapentin to Treat Nerve Pain

Medically reviewed by Alex Yampolsky, PharmD

Neurontin (gabapentin) is a prescription antiepileptic medication commonly used for neuropathic pain (pain due to nerve damage), along with other health conditions.

If you've been prescribed gabapentin for nerve pain, you may begin to feel pain relief within one to two weeks of starting it, depending on your dosage. However, for some people, it can take longer to see benefits.

Gabapentin is approved to treat seizures and postherpetic neuralgia, a type of nerve pain from shingles. It is thought to work by changing how nerves send messages to your brain. It is also used off-label to treat other neuropathic pain conditions.

This article discusses gabapentin and its uses, how long it takes to treat nerve pain, dosage recommendations, side effects, and more.

Taking antiepileptic drugs like gabapentin can increase the risk of suicidal thoughts or behavior. Contact your healthcare provider immediately if you notice emerging or worsening depression or unusual changes in mood or behavior after starting treatment.

If you have suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911

What Is Gabapentin and How Does It Work?

The United States (U.S.) Food and Drug Administration (FDA) approved gabapentin in 1993 initially as a new antiepileptic to treat seizures. Today, it is also used as a first-line treatment for postherpetic neuralgia.

It's also used off-label for conditions it is not FDA-approved for, such as fibromyalgia, alcohol use disorders, and neuropathic pain disorders, such as nerve pain associated with diabetes or spinal cord injury.

It is available only as a prescription. Dosage forms of gabapentin include capsules, tablets, and a solution.

Neurontin is the immediate-release (IR) formulation of gabapentin that is indicated to treat seizures and postherpetic neuralgia. Gabapentin is also marketed under extended-release (ER) forms:

• Horizant is indicated for postherpetic neuralgia and restless legs syndrome.

• Gralise is used only to treat nerve pain.

These formulations are not interchangeable. Always use only the brand your healthcare provider has prescribed, and double-check all refills to ensure you receive the correct one.

How It Works for Nerve Pain

Nerve pain results from damage or illnesses that impact the somatosensory system. Gabapentin is structurally similar to the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), a chemical in the brain.

However, the exact mechanism by which gabapentin works to alleviate nerve pain is not completely clear. It appears to prevent the heightened sensitivity to pain by regulating the release of neurotransmitters in the central nervous system.

How Long Does Gabapentin Take to Work for Nerve Pain?

After taking a dose, IR gabapentin starts to work in the body within two to three hours. However, the full effects of gabapentin can take one to two weeks to become noticeable, and some people may need to wait longer to experience significant pain reduction. It may depend on your dose and individual response to the medication.

It is important to be patient and continue taking it as prescribed. To see if gabapentin works for you, your healthcare provider may prescribe it for four to six weeks or have you take the maximum tolerated dose for at least two weeks.

Nerve pain can be recurring and persistent, sometimes lasting three months or longer. Many people stay on gabapentin for long-term management of their nerve pain and take it daily. Talk to your healthcare provider if you don't have pain relief within a couple of weeks after starting treatment.

Long-Term Use of Gabapentin

Neuropathic pain is challenging to treat effectively. Many people will not benefit from just one intervention alone, so a combination of strategies is often recommended.

Since nerve pain can be long-lasting and recurring, extended treatment may be required in some cases.

Although gabapentin has not been studied for periods longer than six months, healthcare providers may prescribe it for extended durations as long as the medication continues to be effective and no serious side effects occur.

How Much Gabapentin Do I Take for Nerve Pain?

Generally, the recommended dosage of IR gabapentin is:

• One 300-milligram dose on the first day

• Two 300-milligram doses on the second day

• Three 300-milligram doses on the third day

If needed, your healthcare provider may increase your dose to a maximum of 1800 milligrams per day. In clinical trials, doses up to 3600 milligrams per day have also been used.

Do not change your dosage without talking to your healthcare provider. Taking too much gabapentin can be dangerous or cause serious side effects.

To stay safe while taking gabapentin, remember the following:

• If you have impaired kidney function, taking a lower dose or spacing out the dosing time is essential to prevent unwanted side effects.

• Taking gabapentin with opioids (e.g., morphine, hydrocodone) can cause respiratory depression and sedation, and lead to fatal outcomes. Tell your healthcare provider if you are also taking opioids.

• Do not stop taking gabapentin without first talking to your healthcare provider. Stopping suddenly can cause serious problems. Your healthcare provider will gradually decrease your dosage to ensure a safe transition.

• Wait at least two hours after taking an antacid containing magnesium and aluminum hydroxide before taking gabapentin to prevent interactions.

If you forget to take a dose of gabapentin, do not panic. Take it on the same day unless it is too close to the time of your next dose. If it is too close to the next dose, skip the missed dose. Resume the regular dosing schedule the following day. Do not take extra to make up for the missed dose. Call your healthcare provider or pharmacist if you have questions.

Signs of an overdose of gabapentin may include:

• Double vision

• Tremors

• Slurred speech

• Drowsiness

• Altered mental state

• Diarrhea

If you accidentally take too much, call your healthcare provider or local Poison Control Center (1-800-222-1222).

If someone collapses or isn't breathing after taking gabapentin, call 911 immediately.

Side Effects of Gabapentin

The most common side effects of gabapentin include:

• Dizziness

• Drowsiness

• Peripheral edema (swelling in the legs, ankles, feet, arms, or hands)

It is recommended to avoid any activities that require alertness, such as driving or operating heavy machinery while experiencing side effects like dizziness or drowsiness.

Other side effects may include:

• Dry mouth

• Nausea

• Tremor

• Viral infection and fever

• Lack of coordination

• Difficulty speaking

• Difficulty with coordination

• Unusual eye movements

Call a healthcare provider immediately if you have any of these symptoms, especially if they are new or worsening:

• Suicidal thoughts or actions

• Unusual changes in behavior or mood

• Serious or life-threatening allergic reactions

• Serious breathing problems

These are not all the possible side effects of gabapentin. Contact your healthcare provider or pharmacist for more information.

Summary

If you are experiencing nerve pain, gabapentin may be a suitable medication. However, it may take some time to determine if it is effective for you. The medication can take a few weeks to reach its full potential. For some people, it may take even longer.

Generally, it is recommended to take gabapentin for at least four to six weeks or at the highest tolerated dose for at least two weeks. However, nerve pain can be a long-term issue, lasting for three or more months. If gabapentin provides relief, your healthcare provider may have you continue taking it daily.

Frequently Asked Questions

What happens when you stop taking gabapentin abruptly?

Do not stop taking gabapentin without consulting with your healthcare provider. Stopping suddenly can cause withdrawal symptoms, including anxiety, insomnia, nausea, pain, sweating, and sometimes agitation, disorientation, and confusion. Contact your healthcare provider, who can supervise a gradual reduction.

Is gabapentin safe to take long-term?

Common conditions, such as post-herpetic neuralgia and painful diabetic neuropathy, are classified as chronic neuropathic pain and are associated with pain lasting longer than three months. Pharmaceutical therapies used to treat neuropathic pain include gabapentin, among others. Many people stay on gabapentin long-term and take it every day.

What time of day should I take gabapentin?

Your healthcare provider may suggest starting gabapentin once a day, depending on what you're using it for. However, it's best to take it at night, as one of the most frequent side effects of gabapentin is drowsiness.

Most people will end up taking gabapentin three times daily. However, to ensure a consistent level of gabapentin throughout the day, it's recommended to take the medication at even intervals, approximately every eight hours. This will help optimize its effectiveness.