Gabapentin

What is it?

Gabapentin (Neurontin®) is used in people with epilepsy, certain types of nerve pain, and migraine.

Is it safe to take gabapentin in pregnancy?

When deciding whether to use gabapentin during pregnancy it is important to weigh up the potential benefits to your health and wellbeing against any possible risks to you or your baby, some of which may depend on how many weeks pregnant you are. Use of gabapentin in pregnancy may sometimes be considered necessary to control epilepsy or neuropathic pain. Your doctor or specialist will help you make decisions about your treatment.

It is recommended that all women taking anti-epileptic medicines also take high dose folic acid (5mg/day) whilst trying to conceive and during the first trimester of pregnancy. High dose folic acid has to be prescribed by a doctor. For more information, please see the folic acid bump leaflet.

What if I have already taken gabapentin during pregnancy?

If you have taken or are taking any medicines it is always a good idea to let your doctor know that you are pregnant so that you can decide together whether you still need the medicines that you are on and, if so, to make sure that you are taking the lowest dose that works and only for as long as you need to.

If you have epilepsy it is very important that you do not suddenly stop taking gabapentin as this could be dangerous. Do not make any changes to your medication without first talking to your doctor.

Because of the normal bodily changes associated with a progressing pregnancy, the dose of gabapentin may need to be increased to ensure that symptoms remain well-controlled. Your doctor will offer ongoing monitoring to determine whether dose changes are required.

Can taking gabapentin in pregnancy cause birth defects in the baby?

A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.

Around 650 babies born to women who took gabapentin during pregnancy have been studied. These babies do not appear to be more likely to have a birth defect than babies born to women not taking gabapentin, and no link with any particular birth defect has been shown. However, more information needs to be collected from women taking gabapentin during pregnancy to confirm this result.

Can taking gabapentin in pregnancy cause miscarriage?

Likelihood of miscarriage has been studied in only around 300 pregnant women taking gabapentin. While no concerns have been raised, more research on this subject is required.

Can taking gabapentin in pregnancy cause stillbirth?

No link between taking gabapentin in pregnancy and stillbirth was identified in one study of 223 women. While this is reassuring, further studies are required to confirm this finding.

Can taking gabapentin in pregnancy cause preterm birth, or my baby to be small at birth (low birth weight)?

Studies of around 300 pregnant women provide mixed results about whether preterm birth and low infant birth weight are more common following gabapentin use. Women with epilepsy may be more likely to have induced early delivery which is itself linked to low birth weight. Larger studies are therefore required to determine if gabapentin has any specific effects on timing of delivery and birthweight, or if these findings are fully explained by the effects of the mother’s condition.

Can taking gabapentin in pregnancy cause other health problems in the child?

Withdrawal symptoms at birth (neonatal withdrawal)
Withdrawal symptoms are thought to occur when a newborn baby’s body has to adapt to no longer getting certain types of medicines through the placenta.

Gabapentin can be addictive and there are a number of case reports of neonatal withdrawal symptoms in newborn babies who were exposed to gabapentin in the womb. Close monitoring of your baby for a few days after birth may therefore be advised if you have taken gabapentin regularly in the weeks before delivery. Monitoring of your baby may be particularly important if you have taken gabapentin in combination with other anti-epileptic medicines or medicines that act on the brain.

Learning and behavioural problems
A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.

One study did not raise concern that gabapentin exposure in the womb is linked to developmental delay. Further studies, including those assessing learning and behaviour in older children, are ideally required to rule out any effects on brain development.

Will I or my baby need extra monitoring?

Most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects as part of their routine antenatal care. Taking gabapentin in pregnancy is not expected to cause problems that would require extra monitoring of your baby. However, women with epilepsy may be more closely monitored during pregnancy to ensure that they remain well throughout and that their baby is growing and developing as expected. 

If you have taken gabapentin around the time of delivery your baby may require extra monitoring after birth because of the risk of neonatal withdrawal.

Are there any risks to my baby if the father has taken gabapentin?

We would not expect any increased risk to your baby if the father took gabapentin before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org