Nurse Teaching on Side Effects of Gabapentin

Patient/caregiver was educated on side effects of gabapentin as follows:

  1. General allergic reactions: Gabapentin use can result in general allergic reactions, such as, skin rashes, hives, and itching. Some patients can present with symptoms of severe allergic and anaphylactic response, such as, swelling of face, lips, throat, and tongue, with consequent difficulty breathing. Seek emergency medical help for such findings, especially with difficulty breathing, for any appropriate measures to be considered.
  2. Genitourinary Side Effects: Gabapentin use, especially in individuals with compromised renal function, can sometimes result in progression of renal damage. Individuals can present with compromised renal function, reduced urine formation, and increased retention of fluid, with edema and weight gain due to fluid retention. Individuals can also present with severe nausea and vomiting and altered levels of consciousness, secondary to reduced excretion in urine and increased accumulation of waste metabolites in the body.
  3. Gastrointestinal Side Effects: Gabapentin use can result in common general constitutional symptoms such as, nausea and vomiting. Gabapentin use can also result in compromised appetite occasionally. Taking gabapentin after having a meal or a snack can help avoid having unpleasant gastrointestinal symptoms with the medication. Gabapentin can also induce extreme dry mouth and constipation. Sucking on a sugar free hard candy can help with symptomatic relief of dry mouth. Proper hydration measures and compliance with daily fluid intake recommendations can help with relief from constipation. If you experience any further bothersome constipation, report it to your physician for a recommendation on laxative/stool softener use. Observing compliance with fiber intake recommendations in the diet can also help with preventing episodes of constipation with the medication.
  4. Musculoskeletal Side Effects: Gabapentin use can result in poor motor coordination and unsteadiness, with increased fall risk and accidents.  Confusion and dizziness with gabapentin use, can add to the motor incoordination, thus enhancing the fall risk significantly. Gabapentin use can also result in abnormal contractions of muscles controlling the movement of the eyes, resulting in random and unusual eye movements and consequent vision changes.
  5. Central nervous system Side Effects: Gabapentin use can result in depression of the central nervous system and lead to episodes of confusion, hallucinations, dizziness, and light-headedness. Starting the medication at a low dose, watching for the response, and gradually changing the dose, to help optimum control of your symptoms, can contribute to controlling/reducing the risk for drowsiness and dizziness due to the medication Individuals taking this medication can also present compromised memory and forgetfulness. Individuals taking gabapentin can develop anterograde amnesia, which is a compromised ability to form new memories after the intake of medication. Gabapentin use, especially in individuals with history of anxiety and bipolar disorder, carries risk of deterioration of mood disorders and worsening of clinical symptoms of mood disorders. Individuals can present with complaints such as, feeling low, anxiety, panic attacks, trouble sleeping, gross appetite changes, impulsiveness, agitation, aggression, and suicidal thoughts. Discontinuing abruptly on medication intake or significant reduction of medication dose, after prolonged use, can result in exacerbation of anxiety, relapse and rebound of the panic episodes, precipitation of seizure episodes, exacerbation of nerve pain, muscle spasms, unpleasant withdrawal symptoms of insomnia and behavior changes. Discontinuing the medication should be gradual, using tapering doses, and only as recommended by your physician.

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