Gabapentin

(Date: July 2019. Version: 3)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

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

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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