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Gabapentin Side effects

The most common side effects of gabapentin in adult patients include dizziness, fatigue, drowsiness, weight gain, and peripheral edema (swelling of extremities).[40] Gabapentin may also produce sexual dysfunctionin some patients, symptoms of which may include loss of libido, inability to reach orgasm, and erectile dysfunction. Gabapentin should be used carefully in patients with renal impairment due to possible accumulation and toxicity. What side effects can Gabapentin cause?

Neurontin can be used to treat Fibromyalgia, Migraine, sleep and restless legs syndrome

Studies have also found the drug to have a substantial analgesic effects on diabetic neuropathy, postherpetic neuralgia, migraine, and other neuropathic pain conditions, as well as beneficial effect on sleep and restless legs syndrome. On the basis of these findings, the researchers suspected that gabapentin might also ease fibromyalgia pain. 

For treating the chronic pain and other symptoms of fibromyalgia, the anticonvulsant gabapentin (Neurontin) proved safe and effective, researchers here reported.

In a 12-week randomized, double-blind clinical trial, patients taking gabapentin displayed significantly less pain, better sleep, and less fatigue than placebo controls, Lesley M. Arnold, M.D., of the University of Cincinnati, and colleagues reported in the April issue ofArthritis and Rheumatism.

However, the drug had no effect on acute pain points or depression, the researchers reported.

Although gabapentin, which was used off-label for fibromyalgia, has little, if any, effect on acute pain, it has shown a robust effect on pain caused by a heightened response to stimuli related to inflammation or nerve injury in animal models of chronic pain syndromes, Dr. Arnold said.

Studies have also found the drug to have a substantial analgesic effects on diabetic neuropathy, postherpetic neuralgia, migraine, and other neuropathic pain conditions, as well as beneficial effect on sleep and restless legs syndrome. On the basis of these findings, the researchers suspected that gabapentin might also ease fibromyalgia pain.

The study, supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, included 150 mainly white fibromyalgia patients (90% women). Of these, 75 took gabapentin at dosages of 1,200 to 2,400 mg daily for 12 weeks, while there were 75 placebo controls.

The study was conducted at three outpatient research centers in the U.S., from September 2003 to January 2006.

The mean pain severity scores, measured by the Brief Pain Inventory (BPI), decreased in both groups but more so among the gabapentin patients (P = 0.015). The estimated difference between groups at week 12 was – 0.92 (95% confidence interval -1.75, -0.71).

Of the gabapentin-treated patients, 51% achieved a response at the endpoint compared with 31% of the placebo patients (P=0.014).

gabapentin overviewGabapentin compared with placebo also significantly improved the BPI average pain interference score, as well as a series of other scores. These included the Fibromyalgia Impact Questionnaire total score, the Clinical Global Impression of Severity Improvement, the Patient Global Impression of Improvement, the Medical Outcomes Study (MOS), the Sleep Problems Index, and the MOS Short Form 36 vitality score.

However, the drug had no effect on acute pressure-point pain or depression (the Montgomery Asberg Depression Rating Scale), the researchers reported.

Overall, the drug was well-tolerated. Of the 150 patients, 19 dropped out due to adverse events, with no significant difference between the treatment groups.

The gabapentin patients reported dizziness, sedation, lightheadedness, and weight gain significantly more often that did the placebo-treated patients. Notably, the researchers said, there was no significant difference in weight change in the two groups as measured in the clinic, although edema may have explained some of the patients’ perceptions. Most treatment adverse events, they reported, were mild to moderate in severity.

The pathophysiology of fibromyagia is unknown, but evidence suggests that it is associated with aberrant central nervous system pain processing, the researchers said.

The drug appears to be effective in reducing abnormal hypersensitivity induced by inflammatory responses or nerve injury. Yet unlike many other pain syndromes, there is no physical evidence of inflammation or CNS damage.

One possible explanation, Dr. Arnold said, is that gabapentin’s effects involve binding to a specific subunit of voltage-gated calcium channels on neurons. This binding, she said, reduces calcium flow into the nerve cell, which reduces the release of some signaling molecules involved in pain processing.

In discussing the study’s limitations, the researchers said that because the study was short, the results may not generalize to longer treatment periods, and long-term efficacy should be studied in future clinical trials.

Also, because the study was relatively small, they said it may have lacked the power to detect potentially relevant differences between the groups. Finally, they wrote that the results may not apply to patients with some comorbid psychiatric disorders, such as bipolar disorder, or to patients with other painful musculoskeletal disorders.

“In this, the first randomized, placebo-controlled study to evaluate gabapentin in the treatment of fibromyalgia, the results demonstrated that gabapentin, taken for up to 12 weeks, is effective and safe in the treatment of pain and other symptoms associated with fibromyalgia,” Dr. Arnold concluded.

Gabapentin may be useful in the treatment of comorbid anxiety in bipolar patients, (however not the bipolar state itself). Gabapentin may be effective in acquired pendular nystagmus and infantile nystagmus, (but not periodic alternating nystagmus). It is effective in hot flashes. It may be effective in reducing pain and spasticity in multiple sclerosis. Gabapentin may reduce symptoms of alcohol withdrawal (but it does not prevent the associated seizures). Use for smoking cessation has had mixed results. Gabapentin is effective in alleviating itching in renal failure (uremic pruritus)  and itching of other etiologies. It is well-established in the treatment of restless leg syndrome. (A prodrug form, gabapentin enacarbil, is also effective.)  Gabapentin is effective in insomnia.

Uses

Gabapentin is used with other medications to prevent and control seizures. It is also used to relieve nerve pain following shingles (a painful rash due to herpes zosterinfection) in adults. Gabapentin is known as an anticonvulsant or antiepileptic drug.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by yourhealth care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Gabapentin may also be used to treat other nerve pain conditions (such as diabetic neuropathy, peripheral neuropathy, trigeminal neuralgia) and restless legs syndrome.

How to use gabapentin

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking gabapentin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor. Dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight.

If you are taking the tablets and your doctor directs you to split the tablet in half, take the other half-tablet at your next scheduled dose. Discard half tablets if not used within several days of splitting them. If you are taking the capsules, swallow them whole with plenty of water.

It is very important to follow your doctor’s dosing instructions exactly. During the first few days of treatment, your doctor may gradually increase your dose so your body can adjust to the medication. To minimize side effects, take the very first dose at bed time.

Take this medication regularly to get the most benefit from it. This drug works best when the amount of medicine in your body is kept at a constant level. Therefore, take gabapentin at evenly spaced intervals at the same time(s) each day. If you are taking this medication 3 times a day to control seizures, do not let more than 12 hours pass between doses because your seizures may increase.

Do not take this medication more often or increase your dose without consulting your doctor. Your condition will not improve any faster and the risk of serious side effects may increase.

Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.

Antacids containing aluminum or magnesium may interfere with the absorption of this medication. Therefore, if you are also taking an antacid, it is best to take gabapentin at least 2 hours after taking the antacid.

Different forms of gabapentin (such as immediate-release, sustained-release, enacarbil sustained-release) are absorbed in the body differently. Do not switch from one form to the other without consulting your doctor.

Tell your doctor if your condition does not improve or if it worsens.

Gabapentin can not be used for a long time. You must exercise or take balanced nutrition to relieve your pain. Please try nu skin products by joining nu skin distributor network.

 

What is the Side Effects of Gabapentin ?

Drowsiness, dizziness, loss of coordination, tiredness, blurred/double vision, unusual eye movements, or shaking (tremor) may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: swelling of the hands/ankles/feet, signs of infection (such as fever, cough, persistentsore throat).

A small number of people who take anticonvulsants for any condition (such as seizures, bipolar disorder, pain) may experience depression, suicidalthoughts/attempts, or other mental/mood problems. Tell your doctor right away if you or your family/caregiver notice any unusual/sudden changes in your mood, thoughts, or behavior including signs of depression, suicidal thoughts/attempts, thoughts about harming yourself.

Get medical help right away if you have any serious side effects, including: unusual fever, swollen glands, yellowing skin/eyes, unusual tiredness, dark urine, change in the amount of urine, chest pain.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • back pain
  • constipation
  • coughing
  • dizziness
  • drowsiness
  • dry mouth
  • erectile difficulties (problems getting or maintaining an erection sufficient for sexual intercourse)
  • fatigue
  • headache
  • heartburn
  • increased appetite
  • itchy skin
  • muscle pain
  • nervousness
  • runny nose
  • sore throat
  • swelling of feet or ankles
  • tremors (shaking)
  • twitching
  • weight gain

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:

  • abnormal heartbeat or heart palpitations
  • abnormal thoughts
  • involuntary eye movements, double vision, or other vision changes
  • poor coordination
  • problems with your teeth or gums
  • shortness of breath
  • speech problems such as slurred speech; abnormal rhythm, speed, or tone (such as sounding hoarse or “nasal”) of speech; limited mouth or tongue movements; or drooling
  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
  • signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
  • symptoms of liver problems (e.g., abdominal pain, persistent vomiting, feeling unwell, fever, itching, yellowing of the skin and eyes, dark urine)

Stop taking the medication and seek immediate medical attention ifany of the following occur:

  • hallucinations
  • signs of a serious allergic reaction (e.g., swelling of face or throat, hives, or difficulty breathing)

Some people may experience side effects other than those listed.Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any precautions or warnings for taking Gabapentin?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol: Avoid alcohol while taking gabapentin, as gabapentin may cause alcohol intolerance that leads to an unpleasant reaction after drinking alcohol, such as flushing, redness of the face after drinking alcohol, nausea, palpitations, or headache.

Diabetes: Gabapentin may affect blood sugar levels. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/reduced alertness: If you have uncontrolled epilepsy, do not drive or handle potentially dangerous machinery. Gabapentin may cause drowsiness, dizziness, or problems with coordination. Avoid any activity requiring mental alertness or physical coordination until you determine that gabapentin does not affect you in this way.

Kidney function: Gabapentin is not removed from the body as quickly in people with reduced kidney function as compared with those who have regular kidney function. Your doctor may reduce your dose as needed.

Stopping the medication: As with other medications used to control seizures, stopping gabapentin suddenly could increase the risk of seizures. Do not stop gabapentin suddenly. Ask your doctor how to safely and gradually stop the medication.

Suicidal or agitated behaviour: People taking this medication may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking gabapentin, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

What is Gabapentin ?

Gabapentin is an anti-epileptic medication, also called an anticonvulsant. It affects chemicals and nerves in the body that are involved in the cause of seizures and some types of pain.

Gabapentin is used in adults to treat nerve pain caused by herpes virus or shingles (herpes zoster).

The Horizant brand of gabapentin is also used to treat restless legs syndrome (RLS).

The Neurontin brand of gabapentin is also used to treat seizures in adults and children who are at least 3 years old.

Use only the brand and form of gabapentin that your doctor has prescribed. Check your medicine each time you get a refill at the pharmacy, to make sure you have received the correct form of this medication.

DIN (Drug Identification Number)
02084260 Neurontin 100 mg capsule
02084279 Neurontin 300 mg capsule
02084287 Neurontin 400 mg capsule
02239717 Neurontin 600 mg tablet
02239718 Neurontin 800 mg tablet

Gabapentin, marketed under the brand name Neurontin among others, is a medication used to treat epilepsy, neuropathic pain, hot flashes, and restless leg syndrome.

In epilepsy it may be used for those with partial seizures. It is recommended as one of a number of first line medications for the treatment of neuropathic pain in diabetic neuropathy, post-herpetic neuralgia, and central neuropathic pain. For neuropathic pain about 14% of people have a meaningful benefit.

Common side effects include sleepiness and dizziness. Serious side effects may include an increased risk of suicide, aggressive behaviour, and drug reaction with eosinophilia and systemic symptoms. It is unclear if it is safe during pregnancy or breastfeeding.

Lower doses should be used in people with kidney problems. Gabapentin affects the inhibitory neurotransmitter γ-aminobutyric acid (GABA) but how it works is otherwise unclear.

Gabapentin was first approved for use in 1993.  The wholesale price is about 1.35 USD per day.  In the United States it has been available as a generic medicationsince 2004. As of 2015 the cost for a typical month of medication in the United States is 100 to 200 USD.

During the 1990s Parke-Davis, a sub-company of Pfizer, used a number of techniques to encourage physicians in the United States to use gabapentin for unapproved uses.

What form(s) does this medication come in?

Capsules

100 mg
Each hard gelatin Coni-Snap capsule, with white opaque body and cap printed with “PD” on one side and “Neurontin/100 mg” on the other, contains gabapentin 100 mg. Nonmedicinal ingredients: cornstarch, lactose, and talc; capsule shell: FD&C Blue No. 2, gelatin, red iron oxide, silicon dioxide, sodium lauryl sulfate, titanium dioxide, and yellow iron oxide.

300 mg
Each hard gelatin Coni-Snap capsule, with yellow opaque body and cap printed with “PD” on one side and “Neurontin/300 mg” on the other, contains gabapentin 300 mg. Nonmedicinal ingredients: cornstarch, lactose, and talc; capsule shell: FD&C Blue No. 2, gelatin, red iron oxide, silicon dioxide, sodium lauryl sulfate, titanium dioxide, and yellow iron oxide.

400 mg
Each hard gelatin Coni-Snap capsule, with orange opaque body and cap printed with “PD” on one side and “Neurontin/400 mg” on the other, contains gabapentin 400 mg. Nonmedicinal ingredients: cornstarch, lactose, and talc; capsule shell: FD&C Blue No. 2, gelatin, red iron oxide, silicon dioxide, sodium lauryl sulfate, titanium dioxide, and yellow iron oxide.

Tablets

600 mg
Each white, elliptical, film-coated tablet with “Neurontin 600” printed on one side contains gabapentin 600 mg. Nonmedicinal ingredients:ammonium hydroxide, black iron oxide, candelilla wax, copolyvidone, cornstarch, hydroxypropyl cellulose, magnesium stearate, poloxamer 407 NF, and talc.

800 mg
Each white, elliptical, film-coated tablet with “Neurontin 800” printed on one side contains gabapentin 800 mg. Nonmedicinal ingredients: candelilla wax, copolyvidone, cornstarch, hydroypropylcellulose, hypromellose, magnesium stearate, poloxamer 407 NF, red iron oxide, yellow iron oxide, and talc.

 

Gabapentin Mechanism Of Action

The precise mechanisms by which gabapentin produces its analgesic and antiepileptic actions are unknown.

Gabapentin is structurally related to theneurotransmitter gamma-aminobutyric acid (GABA) but has no effect on GABA binding, uptake, or degradation. In vitro studies have shown that gabapentin binds with high-affinity to the α2δ subunit of voltage-activated calcium channels; however, the relationship of this binding to the therapeutic effects of gabapentin is unknown.

Treatment effects of gabapentin for primary insomnia

OBJECTIVES:

The prevalence of insomnia is very high in our society. Although pharmacological treatment of insomnia is available, most hypnotics have been shown to alter sleep architecture and have many adverse effects. Gabapentin was originally designed for antiepileptic therapy; however, some studies reported that its use increases slow-wave sleep in healthy volunteers or patients. Our goal was to evaluate the benefits of gabapentin in the treatment of primary insomnia in patients.

METHODS:

Eighteen patients with primary insomnia participated in the study. They received gabapentin treatment for at least 4 weeks. All patients received polysomnography, a biochemical blood test, and neuropsychological tests before and after the treatment period. All measures were analyzed with Student t test to examine the treatment effects of gabapentin, except that the measures of heart rate variability were analyzed with analysis of variance.

RESULTS:

Polysomnographic study revealed increased sleep efficiency and slow-wave sleep, decreased wake after sleep onset, and spontaneous arousal index after gabapentin treatment. The biochemical blood test revealed decreased prolactin levels in the morning after treatment. Electroencephalographic power spectral analysis showed increased delta-2 and theta power in sleep stage 1 and decreased sigma activity power in sleep stages N2 and N3 after gabapentin treatment. Heart rate variability analyses also showed a significant increase in normalized high frequency percentage in sleep stages N2 and N3 and low frequency-high frequency ratio in sleep stage N2 after treatment. In addition, neuropsychological tests revealed the elevation of visual motor processing speed after gabapentin treatment.

 

CONCLUSIONS:

Gabapentin enhances slow-wave sleep in patients with primary insomnia. It also improves sleep quality by elevating sleep efficiency and decreasing spontaneous arousal. The results suggest that gabapentin may be beneficial in the treatment of primary insomnia.

Author information

Department of Neurology and Sleep Center, Chung Shan Medical University and University Hospital, Tai-Chung, Taiwan.

NEURONTIN may cause serious or life-threatening allergic reactions

Gabapentin may affect your skin or other parts of your body such as your liver or blood cells. This may cause you to be hospitalized or to stop NEURONTIN. You may or may not have a rash with an allergic reaction caused by NEURONTIN. Call a healthcare provider right away if you have any of the following symptoms:

  • skin rash
  • hives
  • difficulty breathing
  • fever
  • swollen glands that do not go away
  • swelling of your face, lips, throat, or 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 healthcare provider should examine you to decide if you should continue taking NEURONTIN.

Gabapentin is the best medications to treat Fibromyalgia

The symptoms of fibromyalgia include pain and tenderness throughout the body that is often associated with other conditions that reduce a person’s ability to function and affects her quality of life. People with fibromyalgia often have difficulty sleeping, feel tired during the day, and experience irritability and depression, all of which can affect their life at work and at home.

Between 1 percent to 5 percent of adults in the U.S. have fibromyalgia, with women much more likely to develop it than men—about 80 to 90 percent of fibromyalgia sufferers are women. It can strike children and teens, but it’s more common in older adults, with most cases occurring between the ages of 40 and 70.

Because there is not a single, specific cause of fibromyalgia and the symptoms can vary from patient to patient, choosing an effective treatment can be challenging. Experts say the best, overall strategy includes medications and nondrug therapies, such as exercise, counseling, and stress relief.

The medications used to treat fibromyalgia includeantidepressants (amitriptyline, nortriptyline, fluoxetine, paroxetine, duloxetine, milnacipran), a few anti-seizure medications (gabapentin, pregabalin), and a muscle relaxant (cyclobenzaprine). But studies show that the benefits of these medications are generally small. There is no clear evidence that one drug is better than another, and all of them probably lose their benefit over time.

gabapentin800mgtabEach drug differs in the risks it poses to you. All antidepressants should be used with caution in those with a history of suicide attempt or who are at risk of suicide, especially in people 25 years old or younger. Amitriptyline, cyclobenzaprine, gabapentin, and pregabalin all cause increased sedation and should be used with caution in the elderly.

The medications differ substantially in price, so cost might be an important factor in determining which one you choose. The monthly cost for these drugs ranges from as little as $6 to more than $500. Taking into account the evidence of their effectiveness and safety as well as their price, we have chosen three Consumer Reports Best Buy Drugs as initial options to consider if you and your doctor have decided that a medication is appropriate for your fibromyalgia symptoms:

  • Generic amitriptyline
  • Generic gabapentin
  • Generic paroxetine-IR (immediate release)

All of these medications have been on the market for 15 years or more and have been widely used. They are all available as inexpensive generics and are at least as effective and safe as the other fibromyalgia medications.

Although side effects of sedation, dry mouth, and dizziness are common, serious side effects are rare.

Gabapentin and pregabalin are classified as antiseizure medications, but they are also used to help relieve pain in people with fibromyalgia. Both medications alter the brain chemistry. Pregabalin decreases levels of chemicals in the brain called neurotransmitters that build up because of the constant firing of the nerves in the spinal cord and the brain. It also increases other neurotransmitters that help suppress the constant firing of the nerves, which helps relieve pain. It’s unclear which neurotransmitters are affected by gabapentin or pregabalin.

Both drugs improve pain, sleep, fatigue, and the quality of life in people with fibromyalgia to about the same degree as amitriptyline. In clinical trials, 70 percent of people with fibromyalgia who took gabapentin for 12 weeks said they felt better compared with 40 percent of those who took a placebo. In addition, 51 percent of those who took gabapentin experienced a reduction of one-third in their pain compared with those who took a placebo.

In another trial, between 40 percent and 80 percent of people who took pregabalin said their pain was reduced by nearly a third, compared with 28 percent to 38 percent of those who took a placebo. For doses of 300 mg to 600 mg per day of pregabalin, 20 percent to 24 percent of patients said their pain was reduced by half compared with 12 percent of patients taking placebo.

One of the most common side effects of pregabalin and gabapentin is sedation. This is why they are often given at higher doses at night, which seems to help with sleep. Other side effects can include confusion, blurred vision, dizziness, liver and kidney impairment, and problems with concentration. In particular, they should be used with caution in elderly people due to side effects of confusion, dizziness, and sedation. Both drugs can also cause swelling, so people with heart failure should not take them. Gabapentin has been shown to increase the risk of suicide in depressed people and should be avoided in those at increased risk of suicide attempt.

from: http://www.buyinggabapentin.com/category/fibromyalgia/