Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet, see section 4.

What is in this leaflet:

1. What gabapentin is and what it is used for
2. What you need to know before you take gabapentin
3. How to take gabapentin
4. Possible side effects
5. How to store gabapentin
6. Contents of the pack and other information

Do not take Gabapentin

• if you are allergic to gabapentin or to any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Talk to your doctor or pharmacist before taking gabapentin if you:

• suffer from kidney problems your doctor may prescribe a different dosing schedule.
• are on haemodialysis (to remove waste products because of kidney failure), tell your doctor if you develop muscle pain and/ or weakness.
• develop signs such as persistent stomach pain, feeling sick and being sick contact your doctor immediately as these may be symptoms of acute pancreatitis (an inflamed pancreas).
• have nervous system disorders, respiratory disorders, or you are more than 65 years old, your doctor may prescribe you a different dosing regimen.

Cases of abuse and dependence have been reported for gabapentin. Talk to your doctor if you have a history of abuse or dependence.

A small number of people being treated with anti-epileptics such as gabapentin have had thoughts of harming or killing themselves.

If at any time you have these thoughts, contact your doctor immediately.

Important information about potentially serious reactions

A small number of people taking gabapentin get an allergic reaction or potentially serious skin reaction, which may develop into more serious problems if they are not treated. You need to know the symptoms to look out for while you are taking gabapentin.

Read the description of these symptoms in section 4 of this leaflet under ‘Tell your doctor straight away’.

Muscle weakness, tenderness or pain and particularly, if at the same time, you feel unwell or have a high temperature, may be caused by an abnormal muscle breakdown which can be life-threatening and lead to kidney problems. You may also experience discoloration of your urine, and a change in blood test results (notably blood creatine phosphokinase increased). If you experience any of these signs or symptoms, please contact your doctor immediately.

Other medicines and Gabapentin

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. In particular, tell your doctor or pharmacist if you are taking, or have recently taken, any medicines for convulsions, sleeping disorders, depression, anxiety, or any other neurological or psychiatric problems.

Medicines containing opioids such as morphine

If you are taking any medicines containing opioids (such as morphine), tell your doctor or pharmacist as opioids may increase the effect of gabapentin. In addition, the combination of gabapentin with opioids may cause symptoms like sleepiness, sedation, a decrease in breathing or death.

Antacids for indigestion

If gabapentin and antacids containing aluminium and magnesium are taken at the same time, the absorption of gabapentin from the stomach may be reduced. It is therefore recommended that gabapentin is taken at the earliest two hours after taking an antacid.

Gabapentin is not expected to interact with other drugs against epilepsy or your oral contraceptive pill.

Gabapentin may interfere with some laboratory tests, if you require a urine test tell your doctor or hospital what you are taking.

Gabapentin with food

Gabapentin can be taken with or without food.

Pregnancy, breast-feeding and fertility

• If you are pregnant or think you may be pregnant, you must tell your doctor straight away and discuss possible risks the medicine you are taking might pose to your unborn baby
• If you are planning to become pregnant you should discuss your treatment with your doctor as early as possible before you become pregnant
• You should not stop your treatment without discussing this with your doctor.

Pregnancy

Gabapentin should not be taken during pregnancy, unless you are told otherwise by your doctor. Effective contraception must be used by women of child-bearing potential.

There have been very few studies specifically looking at the use of gabapentin in pregnant women. More research is needed to better understand the safety of use of gabapentin during pregnancy and whether it is associated with an increased risk of harm to the unborn child.

Some medicines used to treat epilepsy have reported an increased risk of harm to the developing baby, particularly when more than one seizure medication is taken at the same time. This means that where possible, your doctor should consider using one epilepsy medicine to control your epilepsy.

Breast-feeding

Gabapentin is passed on through human milk. Because the effect on the baby is unknown, it is not recommended to breast-feed while using gabapentin.

Fertility

There is no effect on fertility in animal studies.

Driving and using machines

Gabapentin may produce dizziness, drowsiness and tiredness. You should not drive, operate complex machinery or take part in other potentially hazardous activities, until you know whether this medicine affects your ability to perform these activities.

Gabapentin Capsules contains lactose.

Gabapentin capsules contain lactose (a type of sugar). If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

If you take gabapentin to treat epilepsy the recommended dose is

Adults and adolescents

Take the number of capsules as instructed by your doctor. Your doctor will usually build up your dose gradually.

The starting dose will generally be between 300mg and 900mg each day.

Thereafter, the dose may be increased progressively up to a maximum of 3600mg each day. Your doctor will tell you to take the dose in 3 divided doses, i.e. once in the morning, once in the afternoon and once in the evening.

Children aged 6 years and above

The dose to be given to your child will be decided by your doctor as it is calculated against your child’s weight. The treatment is started with a low initial dose which is gradually increased over a period of approximately 3 days.

The usual dose to control epilepsy is 25-35mg/kg/day.

It is usually given in 3 divided doses, by taking the capsule(s) each day, usually once in the morning, once in the afternoon and once in the evening.

Gabapentin is not recommended for use in children below 6 years of age.

If you take gabapentin to relieve peripheral neuropathic pain the recommended dose is

Adults

Take the number of capsules as instructed by your doctor. Your doctor will usually build up your dose gradually.

The starting dose will generally be between 300mg and 900mg each day.

Thereafter, the dose may be increased progressively up to a maximum of 3600mg each day. Your doctor will tell you to take the dose in 3 divided doses, i.e. once in the morning, once in the afternoon and once in the evening.

If you have kidney problems or are receiving haemodialysis

Your doctor may prescribe a different dosing schedule and/or dose if you have problems with your kidneys or are undergoing haemodialysis.

If you are an elderly patient (over 65 years old), you should take gabapentin as indicated unless you have problems with your kidneys. Your doctor may prescribe a different dosing schedule and/or dose if you have problems with your kidneys.

If you have the impression that the effect of gabapentin is too strong or too weak, talk to your doctor or pharmacist as soon as possible.

Method of administration

Gabapentin is for oral use. Always swallow the capsules with plenty of water.

Continue taking gabapentin until your doctor tells you to stop. You should not stop taking this medicine without medical advice.

If you take more gabapentin than you should

Higher than recommended doses may result in an increase in side effects including loss of consciousness, dizziness, double vision, slurred speech, drowsiness and diarrhoea . Call your doctor or go to the nearest hospital emergency unit immediately if you take more gabapentin than your doctor prescribed. Take along any capsules that you have not taken, together with the container and the label so that the hospital can easily tell what medicine you have taken.

If you forget to take gabapentin

If you forget to take a dose, take it as soon as you remember unless it is time for your next dose. Do not take a double dose to make up for a forgotten dose.

If you stop taking gabapentin

Do not stop taking gabapentin unless your doctor tells you to. If your treatment is stopped, it should be done gradually over a minimum of 1 week. If you stop taking gabapentin suddenly or before your doctor tells you, there is an increased risk of seizures.

Stop taking this medicine and see a doctor straight away if you experience any of the following symptoms as they can be serious:

• severe skin reactions that require immediate attention, swelling of the lips and face, skin rash and redness, and/or hair loss (these may be symptoms of a serious allergic reaction).
• persistent stomach pain, feeling sick and being sick. These may be symptoms of acute pancreatitis (an inflamed pancreas).
• breathing problems, if severe you may need emergency and intensive care to continue breathing normally
• serious or life-threatening allergic reactions that may affect your skin (a skin rash) or other parts of your body such as your liver or blood cells . You may or may not have a skin rash when you get this type of reaction. You may need to be hospitalized;
  contact your doctor immediately if you have the following:
  • skin rashes
  • hives
  • fever
  • swollen glands that do not go away
  • swelling of your lip and tongue
  • yellowing of your skin or of the whites of the eyes
  • unusual bruising or bleeding
  • severe fatigue or weakness
  • unexpected muscle pain
  • frequent infections

These symptoms may be the first signs of a serious reaction. A doctor should examine you to decide if you should continue taking gabapentin.

If you are on haemodialysis, tell your doctor if you develop muscle pain and/or weakness.

Other side effects include:

Very common (may affect more than 1 in 10 people):

• Viral infection
• Feeling drowsy, dizzy, lack of coordination
• Feeling tired, fever

Common (may affect up to 1 in 10 people):

• Pneumonia, respiratory infections, urinary tract infections, inflammation of the ear or other infections
• Low white blood cell counts
• Anorexia, increase in appetite
• Anger towards others, confusion, mood changes, depression, anxiety, nervousness, strange or unusual thoughts
• Convulsions, jerky movements, difficulty speaking, loss of memory, tremor, difficulty sleeping, headache, sensitive skin, decreased sensation (numbness), difficulty with coordination, unusual eye movements, increased, decreased or absent reflexes
• Blurred vision, double vision
• Vertigo
• High blood pressure, flushing or dilation of blood vessels
• Difficulty breathing, bronchitis, sore throat, cough, dry nose
• Vomiting (being sick), nausea (feeling sick), problems with teeth, inflamed gums, diarrhoea, stomach pain, indigestion, constipation, dry mouth or throat, flatulence
• Facial swelling, bruises, rash, itch, acne
• Joint pain, muscle pain, back pain, twitching
• Difficulties with erections (impotence),
• Swelling in the legs and arms, difficulty in walking, weakness, pain, feeling unwell, flu-like symptoms
• Increase in weight
• Accidental injury, fractures, abrasions

Uncommon (may affect up to 1 in 100 people):

• Decreased movement
• Falls
• Mental impairment
• Racing heartbeat
• Swelling that may involve the face, body and limbs
• Abnormal blood test results suggesting problems with the liver
• Increase in blood glucose levels (most often observed in patients with diabetes)
• Agitation (a state of chronic restlessness and unintentional and purposeless motions)
• Difficulty swallowing

Rare (may affect up to 1 in 1,000 people):

• Loss of consciousness
• Decrease in blood glucose levels (most often observed in patients with diabetes)
• Trouble breathing, shallow breathing (respiratory depression)

Not known (cannot be estimated from available data):

• A group of side effects that could include swollen lymph nodes (isolated small raised lumps under skin), fever, rash, and inflammation of liver occurring together
• Decreased platelets (blood clotting cells)
• Hallucinations
• Problems with abnormal movements such as writhing, jerking movements and stiffness
• Ringing in the ears
• Acute kidney failure, incontinence (leakage of urine which you cannot control)
• Yellowing of the skin and eyes (jaundice), inflammation of the liver
• Anaphylaxis (serious, potentially life threatening allergic reaction including difficulty breathing, swelling of the lips, throat, and tongue, and hypotension requiring emergency treatment)
• Increased breast tissue, breast enlargement
• Adverse events following the sudden stopping of gabapentin (anxiety, difficulty in sleeping, feeling sick, pain, sweating), chest pain
• Breakdown of muscle fibers (rhabdomyolysis)
• Low blood sodium level (hyponatraemia)
• Change in blood test results (creatine phosphokinase increased)
• Problems with sexual function including inability to achieve a sexual climax, delayed ejaculation

Additionally in clinical studies in children, aggressive behaviour and jerky movements were reported commonly.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

You can also report side effects directly via the Yellow Car Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store By reporting side effects, you can help provide more information on the safety of this medicine.

What Gabapentin Capsules contain:

The active substance is gabapentin. Each capsule contains either: 100mg, 300mg or 400mg of gabapentin.

The other ingredients are:

Gabapentin 100mg Capsules: lactose monohydrate, maize starch, talc, titanium oxide (E171) and gelatin.

Gabapentin 300mg Capsules: lactose monohydrate, maize starch, talc, titanium oxide (E171), yellow iron dioxide (E172) and gelatin.

Gabapentin 400mg Capsules: lactose monohydrate, maize starch, talc, titanium dioxide (E171), yellow iron dioxide (E172), red iron oxide (E172) and gelatin.

The printing ink used on the capsule contains: shellac (E104), titanium (E171) and FD&C Blue 1/Brilliant blue FCF Lake (E133).

What Gabapentin Capsules looks like and contents of the pack:

The 100mg Capsules are white, hard capsules marked S154 on one side.

The 300mg Capsules are yellow, hard capsules marked S155 on one side.

The 400mg Capsules are orange-yellow, hard capsules marked S156 on one side.

Pack size: 100 capsules.

Marketing Authorisation Holder is

The Manufacturer is: