Table of ContentsView AllTable of ContentsCommon UsesArthritis BenefitsSide EffectsDosing InstructionsOther Options
Table of ContentsView All
View All
Table of Contents
Common Uses
Arthritis Benefits
Side Effects
Dosing Instructions
Other Options
While potentially useful for treating severe knee OA, there is no strong evidence that gabapentin can provide relief from autoimmune forms of arthritis, such asrheumatoid arthritisandpsoriatic arthritis.
The article describes how gabapentin is commonly used and how it may be prescribed to treat knee arthritis pain. It also explains how gabapentin is taken and possible side effects of treatment.
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Common Uses for Gabapentin
Gabapentin, sold under the brand name Neurontin, belongs to a class of drugs calledanticonvulsants. Gabapentin has two approved uses: the treatment ofpartial seizuresin people withepilepsyand the treatment ofneuropathic (nerve-related) pain.
An extended-release form of gabapentin, sold under the brand name Horizant, is licensed for the treatment ofrestless legs syndrome (RLS), a condition that causes the strong urge to move.
When used for nerve pain, gabapentin may be recommended if you have:
Gabapentin is also sometimes used off-label (meaning for uses other than what it is licensed for) to preventmigraines, although the evidence supporting such use is inconclusive.
How Gabapentin Helps Restless Leg Syndrome
Benefits of Gabapentin for Arthritis Pain
Gabapentin is used off-label for the treatment of severe knee osteoarthritis and typically when all other treatment options have failed to provide adequate relief.
Even so, the evidence remains mixed as to how effective the drug is when applied to OA pain.
What the Research Says
A 2019 study published inClinical Rheumatologyreported that 300 milligrams (mg) of gabapentin, when combined withCymbalta (duloxetine), reduced knee OA pain more effectively than Cymbalta combined withTylenol (acetaminophen).
The three-month study, which involved 150 adults with moderate to severe OA, concluded that gabapentin was an effective add-on treatment to Cymbalta, an antidepressant commonly used for the treatment of nerve pain. When used in this way, pain relief was felt within two to four weeks and leveled off thereafter.
Other studies are less supportive of treatment. A 2023 analysis from Brigham and Women’s Hospital in Boston. which evaluated the cost efficacy of gabapentin in treating OA, reported that gabapentin was only “modesty effective” and that the benefits of treatment largely outweighed the high rate of side effects.
There is also potential to misuse gabapentin for recreational or non-medication purposes which can lead to dependence on the drug. One research review found that people who misuse opioids, benzodiazepines, and alcohol have an increased risk of misusing gabapentin.
Does Gabapentin Help Rheumatoid Arthritis?Rheumatoid arthritis (RA) is an autoimmune disease that mainly targets the joints but also causes inflammation and injury throughout the body. There are few studies to date suggesting any benefit to treating RA with gabapentin. If anything, gabapentin is known to trigger flare-ups with certain types of autoimmune diseases, such asmyasthenia gravis.
Does Gabapentin Help Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is an autoimmune disease that mainly targets the joints but also causes inflammation and injury throughout the body. There are few studies to date suggesting any benefit to treating RA with gabapentin. If anything, gabapentin is known to trigger flare-ups with certain types of autoimmune diseases, such asmyasthenia gravis.
Gabapentin for Fibromyalgia
Gabapentin Side Effects
Some side effects will subside as your body adapts to treatment. Others may develop later due to long-term exposure to the drug.
Nervous system side effects like sleepiness, dizziness, fatigue, uncontrolled eye movement, and loss of muscle control affect 8% or more of users. Other side effects are far less common, affecting only 2% to 4% of users.
The risk of side effects is largely dose-dependent, meaning that larger doses or prolonged exposure increases their risk. Given that gabapentin is often prescribed on an ongoing basis, it is important to discuss the benefits and risks with your healthcare provider before starting treatment.
Stopping TreatmentNever stop gabapentin without speaking with your healthcare provider. Stopping abruptly can lead to withdrawal symptoms like anxiety, insomnia, nausea, pain, and sweating. If you are being treated for epilepsy, stopping suddenly can also trigger seizures.
Stopping Treatment
Never stop gabapentin without speaking with your healthcare provider. Stopping abruptly can lead to withdrawal symptoms like anxiety, insomnia, nausea, pain, and sweating. If you are being treated for epilepsy, stopping suddenly can also trigger seizures.
Gabapentin Interactions
Gabapentin has few drug interactions. Interactions can cause the concentration of gabapentin or the accompanying drug to rise or fall. Increases in concentration increase the risk of side effects, while decreases in concentration decrease the effectiveness of the drug.
Do not drink alcohol with gabapentin as it can also increase the risk of drowsiness, sleepiness, and loss of coordination.
Gabapentin and PregnancyAnimal studies have shown that gabapentin can cause birth defects, although it is unclear if the same can occur in humans. As such, advise your healthcare provider if you are pregnant or intend to get pregnant to weigh the benefits and risks of treatment.Breastfeeding should be avoided while taking gabapentin as the drug can be passed in breast milk. The effect of this on newborns is unknown.
Gabapentin and Pregnancy
Animal studies have shown that gabapentin can cause birth defects, although it is unclear if the same can occur in humans. As such, advise your healthcare provider if you are pregnant or intend to get pregnant to weigh the benefits and risks of treatment.Breastfeeding should be avoided while taking gabapentin as the drug can be passed in breast milk. The effect of this on newborns is unknown.
Animal studies have shown that gabapentin can cause birth defects, although it is unclear if the same can occur in humans. As such, advise your healthcare provider if you are pregnant or intend to get pregnant to weigh the benefits and risks of treatment.
Breastfeeding should be avoided while taking gabapentin as the drug can be passed in breast milk. The effect of this on newborns is unknown.
Gabapentin Dosage
When used for pain, gabapentin is prescribed at a lower “loading dose” and gradually increased to the optimal “therapeutic dose.” This helps ease you into treatment with minimal side effects.
This is typically done as follows:
The dose can be increased if needed up to 1,800 mg per day (600 mg three times a day) to achieve the desired effect.
How Long Does It Take Gabapentin to Work?It can take two to four weeks before you experience the full benefits of gabapentin.Until then, you need to keep taking the drug consistently to reach the therapeutic concentration in your bloodstream.You can continue to take Gabapentin for as long as it helps your pain if you are not having any side effects.
How Long Does It Take Gabapentin to Work?
It can take two to four weeks before you experience the full benefits of gabapentin.Until then, you need to keep taking the drug consistently to reach the therapeutic concentration in your bloodstream.You can continue to take Gabapentin for as long as it helps your pain if you are not having any side effects.
It can take two to four weeks before you experience the full benefits of gabapentin.Until then, you need to keep taking the drug consistently to reach the therapeutic concentration in your bloodstream.
You can continue to take Gabapentin for as long as it helps your pain if you are not having any side effects.
Other Arthritis Treatment Options
The treatment for osteoarthritis arthritis focuses on relieving pain, swelling, and stiffness while improving joint function. You will likely need to take different medicines or a combination of treatments before you find the solution that works best for you.
Among the options:
Summary
Gabapentin is an anticonvulsant drug approved for the treatment of partial seizures and neuropathic pain. It is sometimes used off-label to treat severe knee osteoarthritis (OA), although the evidence supporting this use is mixed.
If intended for the treatment of OA, speak with your healthcare provider about the benefits and risks of gabapentin to make an informed choice.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pfizer.Neurontin (gabapentin) capsules, for oral use.MedlinePlus.Gabapentin.Peckham AM, Evoy KE, Ochs L, Covvey JR.Gabapentin for off-label use: evidence-based or cause for concern?Subst Abuse. 2018;12:1178221818801311. doi:10.1177/1178221818801311Enteshari-Moghaddam A, Azami A, Isazadehfar K, Mohebbi H, Habibzadeh A, Jahanpanah P.Efficacy of duloxetine and gabapentin in pain reduction in patients with knee osteoarthritis.Clin Rheumatol. 2019;38(10):2873-2880. doi:10.1007/s10067-019-04573-7Du Z, Chen H, Cai Y, Zhou Z.Pharmacological use of gamma-aminobutyric acid derivatives in osteoarthritis pain management: A systematic review.BMC Rheumatol.2022;6:28. doi:10.1186/s41927-022-00257-zBenson GP, Rogers AC, Leifer VP, at al.Does gabapentin provide benefit for patients with knee OA? A benefit-harm and cost-effectiveness analysis.Osteoarthritis Cartilage. 2023 Feb; 31(2): 279–290. doi:10.1016/j.joca.2022.07.013Smith RV, Havens JR, Walsh SL.Gabapentin misuse, abuse and diversion: a systematic review.Addiction. 2016;111(7):1160-1174. doi:10.1111/add.13324Quintero QC.Review about gabapentin misuse, interactions, contraindications and side effects.J Exp Pharmacol.2017;9:13–21. doi:10.2147/JEP.S124391National Health Service Trust (UK).Gabapentin.van Rensburg R, Reuter H.An overview of analgesics: NSAIDs, paracetamol, and topical analgesics Part 1.South African Family Practice. 2019;61(sup1):S4-S10. doi:10.1080/20786190.2019.1610228
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pfizer.Neurontin (gabapentin) capsules, for oral use.MedlinePlus.Gabapentin.Peckham AM, Evoy KE, Ochs L, Covvey JR.Gabapentin for off-label use: evidence-based or cause for concern?Subst Abuse. 2018;12:1178221818801311. doi:10.1177/1178221818801311Enteshari-Moghaddam A, Azami A, Isazadehfar K, Mohebbi H, Habibzadeh A, Jahanpanah P.Efficacy of duloxetine and gabapentin in pain reduction in patients with knee osteoarthritis.Clin Rheumatol. 2019;38(10):2873-2880. doi:10.1007/s10067-019-04573-7Du Z, Chen H, Cai Y, Zhou Z.Pharmacological use of gamma-aminobutyric acid derivatives in osteoarthritis pain management: A systematic review.BMC Rheumatol.2022;6:28. doi:10.1186/s41927-022-00257-zBenson GP, Rogers AC, Leifer VP, at al.Does gabapentin provide benefit for patients with knee OA? A benefit-harm and cost-effectiveness analysis.Osteoarthritis Cartilage. 2023 Feb; 31(2): 279–290. doi:10.1016/j.joca.2022.07.013Smith RV, Havens JR, Walsh SL.Gabapentin misuse, abuse and diversion: a systematic review.Addiction. 2016;111(7):1160-1174. doi:10.1111/add.13324Quintero QC.Review about gabapentin misuse, interactions, contraindications and side effects.J Exp Pharmacol.2017;9:13–21. doi:10.2147/JEP.S124391National Health Service Trust (UK).Gabapentin.van Rensburg R, Reuter H.An overview of analgesics: NSAIDs, paracetamol, and topical analgesics Part 1.South African Family Practice. 2019;61(sup1):S4-S10. doi:10.1080/20786190.2019.1610228
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Pfizer.Neurontin (gabapentin) capsules, for oral use.MedlinePlus.Gabapentin.Peckham AM, Evoy KE, Ochs L, Covvey JR.Gabapentin for off-label use: evidence-based or cause for concern?Subst Abuse. 2018;12:1178221818801311. doi:10.1177/1178221818801311Enteshari-Moghaddam A, Azami A, Isazadehfar K, Mohebbi H, Habibzadeh A, Jahanpanah P.Efficacy of duloxetine and gabapentin in pain reduction in patients with knee osteoarthritis.Clin Rheumatol. 2019;38(10):2873-2880. doi:10.1007/s10067-019-04573-7Du Z, Chen H, Cai Y, Zhou Z.Pharmacological use of gamma-aminobutyric acid derivatives in osteoarthritis pain management: A systematic review.BMC Rheumatol.2022;6:28. doi:10.1186/s41927-022-00257-zBenson GP, Rogers AC, Leifer VP, at al.Does gabapentin provide benefit for patients with knee OA? A benefit-harm and cost-effectiveness analysis.Osteoarthritis Cartilage. 2023 Feb; 31(2): 279–290. doi:10.1016/j.joca.2022.07.013Smith RV, Havens JR, Walsh SL.Gabapentin misuse, abuse and diversion: a systematic review.Addiction. 2016;111(7):1160-1174. doi:10.1111/add.13324Quintero QC.Review about gabapentin misuse, interactions, contraindications and side effects.J Exp Pharmacol.2017;9:13–21. doi:10.2147/JEP.S124391National Health Service Trust (UK).Gabapentin.van Rensburg R, Reuter H.An overview of analgesics: NSAIDs, paracetamol, and topical analgesics Part 1.South African Family Practice. 2019;61(sup1):S4-S10. doi:10.1080/20786190.2019.1610228
Pfizer.Neurontin (gabapentin) capsules, for oral use.
MedlinePlus.Gabapentin.
Peckham AM, Evoy KE, Ochs L, Covvey JR.Gabapentin for off-label use: evidence-based or cause for concern?Subst Abuse. 2018;12:1178221818801311. doi:10.1177/1178221818801311
Enteshari-Moghaddam A, Azami A, Isazadehfar K, Mohebbi H, Habibzadeh A, Jahanpanah P.Efficacy of duloxetine and gabapentin in pain reduction in patients with knee osteoarthritis.Clin Rheumatol. 2019;38(10):2873-2880. doi:10.1007/s10067-019-04573-7
Du Z, Chen H, Cai Y, Zhou Z.Pharmacological use of gamma-aminobutyric acid derivatives in osteoarthritis pain management: A systematic review.BMC Rheumatol.2022;6:28. doi:10.1186/s41927-022-00257-z
Benson GP, Rogers AC, Leifer VP, at al.Does gabapentin provide benefit for patients with knee OA? A benefit-harm and cost-effectiveness analysis.Osteoarthritis Cartilage. 2023 Feb; 31(2): 279–290. doi:10.1016/j.joca.2022.07.013
Smith RV, Havens JR, Walsh SL.Gabapentin misuse, abuse and diversion: a systematic review.Addiction. 2016;111(7):1160-1174. doi:10.1111/add.13324
Quintero QC.Review about gabapentin misuse, interactions, contraindications and side effects.J Exp Pharmacol.2017;9:13–21. doi:10.2147/JEP.S124391
National Health Service Trust (UK).Gabapentin.
van Rensburg R, Reuter H.An overview of analgesics: NSAIDs, paracetamol, and topical analgesics Part 1.South African Family Practice. 2019;61(sup1):S4-S10. doi:10.1080/20786190.2019.1610228
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