Would you describe your vulvar pain as mostly “shooting or stabbing”? Do you have some suspicions, or did you maybe get a diagnosis from your doctor, that your vulvodynia might stem from a damaged nerve? If you answered yes to at least two of these questions then anticonvulsants might be an effective solution for you.

Anticonvulsants are one of the fundamental medical solutions prescribed for vulvodynia treatment. The two most popular are Gabapentin and Pregabalin (Lyrica).

#1: What is Gabapentin?

Gabapentin is a prescription anticonvulsant drug available under the brand name Neurontin, amongst others.

#2: How Does Gabapentin Work?

Gabapentin like other anticonvulsants works in the brain and nervous system. It stabilizes the electrical activity in the brain which calms the excessive rapid firing of neurons during convulsions, which prevents seizures.

It also affects the way nerves send messages to the brain.

#3: Gabapentin for Vulvodynia

Along with treating seizure disorder, Gabapentin is used also for neuropathic pain. Thanks to its nerve calming qualities, it is effective in treating burning, stabbing or shooting vulvar pain caused by damaged or over-sensitized nerves.

However, the exact way in which Gabapentin works for vulvodynia is not fully understood.

#4: Gabapentin Dosage

Gabapentin is available in capsules, oral solutions, tablets, and topical cream.

Gabapentin for vulvodynia is usually administered in the form of a tablet taken orally and a cream applied to the vulvar area.

Oral use

Orally, Gabapentin is usually started with low doses increased gradually, to help prevent side effects.

The starting dosage is usually between 100 to 300 mg administered at bedtime or three times per day. It is increased by 100 to 300 mg until a maximum daily dosage of 3600 mg (1200 mg by mouth three times a day) is reached.

Oral Gabapentin Study

A large retrospective review of 152 women with generalized vulvodynia, showed that 64% had a least an 80% resolution of their pain while using Gabapentin.

152
Women
64
Participants improved
80
Resolution of pain

Topical use

Topically, Gabapentin is recommended for generalized and localized vulvodynia. A cream is available in the compounded form of 2, 4 and 6% concentration. Lower strengths are better tolerated.

Doctors advise applying a small amount of cream, approximately 0.5 ml (the size of a small pea) two to three times per day to the vestibule area. To increase the benefits of the cream they suggest to do it with repeated touch or massage, which may help desensitize the vestibule. However, this particular way of application might increase the chance of irritation or contact dermatitis.

Topical Gabapentin Study

A relatively recent study showed that applying Gabapentin cream to the vestibular area for a period of eight weeks decreased pain by over 50% in 80% of the participating women.

8
Weeks
50
Decrease in pain
80
Participants improved

#5: Best Practices for Gabapentin Uses

1

General Side Effects

Start from a low dose and slowly increase the amount to temper adverse side effects.
2

Stomach Upset

Take the meds with a full glass of water or with food to reduce upset stomach.
3

Withdrawal symptoms

Take doses the same time each day. Don't go more than 12 hours between doses. Don’t just stop taking the medications suddenly as this can cause withdrawal symptoms.
4

Missed dose

If you miss a dose, take it as soon as possible. Skip the missed dose if it’s almost time (few hours before) for your next dose. Never double up your dose (to make up for a missed one, for example). Please remember that your medication may not work as well or may stop working altogether.

#6: Gabapentin Side Effects

A topical version of Gabapentin for vulvodynia produces fewer side-effects because of its lower systematic absorption, which means your body absorbs less of it through the bloodstream.

The most common side effects of Gabapentin include:

  • Dizziness
  • Sleepiness, drowsiness, tiredness
  • Fatigue
  • Visual changes (including double vision)
  • Tremors
  • Digestive problems (indigestion, nausea, diarrhea, constipation, vomiting)
  • Nervousness
  • Muscle ache
  • Dry mouth or sore throat
  • Memory loss
  • Headaches
  • Runny nose
  • Weight gain
  • Swelling of hands or feet
  • Clumsiness and unsteadiness
  • Difficulties speaking
  • Abnormal eye movements
  • Itchy eyes

Less common, but very serious side effects of Gabapentin include:

  • Suicidal thoughts or behavior
  • Violent behavior, aggressiveness
  • Depression
  • Anxiety
  • Panic attacks
  • Mania
  • Seizures
  • Allergic reactions:
    • Severe rashes
    • Swelling of the face, lips, tongue, lymph nodes
    • Difficulty breathing or swallowing
    • Abnormal bleeding
    • Yellowing of the skin or eyes
    • Fevers

#7: Gabapentin Interactions

IMPORTANT: Let your healthcare professional know if you are taking any other prescription and non-prescription medications, illegal, recreational, herbal, nutritional and dietary drugs.Some truly unpleasant side effects can be intensified.

Gabapentin may interact with:

  • Pain relievers with Naproxen such as Aleve, Naprosyn
  • Acid drugs containing magnesium or aluminum hydroxide such as Tagamet, Mylanta, and Maalox
    • They may reduce the absorption of Gabapentin from the gut. To avoid this, an antacid should be taken two hours before or after Gabapentin
  • Opiate pain medication like Vicodin or morphine
    • They can worsen dizziness, drowsiness and breathing difficulties. Morphine can also increase the absorption of Gabapentin
  • Tranquilizers including Alprazolam (Xanax)
  • Antihistamine medicine such as Zyrtec
  • Alcohol
    • They might increase dizziness and drowsiness, and cause difficulty concentrating
  • Medication for obesity such as Orlistat (Xenical, Alli)
    • They may affect the absorption of Gabapentin from the gut which can make it less effective
  • Herbal remedies such as St. John’s Wort (Hypericum perforatum).
    • They may affect the level of anticonvulsants in the blood and can increase the risk of seizures
  • Antidepressants such as Tricyclic Antidepressants, MAOI and SSRI.
    • They can oppose the effects of Gabapentin
  • Medicine for malaria like Mefloquine
    • They can also oppose the effects of Gabapentin

#8: Gabapentin Contraindications and Warnings

1. If you are pregnant (or planning to get pregnant):

There haven’t been enough studies to show how the drug affects the fetus, however, Gabapentin research in animals has shown an adverse effect to the fetus when the mother takes the drug. Therefore this medication should only be used when the potential benefits justify the potential risks.

Also, for more information, please check NAAED Pregnancy Registry. This registry tracks the effects of anticonvulsants on pregnancy.

2. If you are breastfeeding, please be aware that:

Gabapentin can pass into breast milk and cause serious side effects in a breastfed child. You may need to decide whether to find an alternative to this drug, stop breastfeeding or cease the medication.

Please talk to your doctor about the possible risks to you and your baby, in order to weigh these risks against the benefits of using Gabapentin.

3. If you have kidneys problems:

Your body processes Gabapentin slower than at the average rate and it might not be able to clear the drug effectively from your system. This can dangerously increase the drug levels in your body, intensifying adverse effects.

4. If you have allergies:

This medication may contain inactive ingredients, which can cause allergic reactions including drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. This syndrome can be life-threatening. Pay attention for allergic symptoms like rashes, fevers or swollen lymph nodes.

#9: Gabapentin Discontinuation

Gabapentin can produce withdrawal symptoms if you suddenly stop taking it or miss several doses of it.

In case of stopping the drug, you can minimize these adverse symptoms by tapering down your dosage.

Withdrawal symptoms might include:

  • Anxiety
  • Confusion
  • Rapid heart rate
  • Sweating
  • Sleeping problems
  • Pain
  • Nausea

Conclusion

In this post, you can find general information about Gabapentin for vulvodynia:

  • What Gabapentin is and how it works for chronic vulvar pain
  • Initial guidelines regarding topical and oral dosage
  • What types of side effects you might experience, including withdrawal symptoms
  • Possible interactions, contraindications, and warnings

Please don’t feel discouraged if you feel little to no relief while taking Gabapentin or if your pain will come back after the discontinuation of the medication.

Please keep in mind that Gabapentin like other types of traditional medications might not treat nor heal the underlying root cause of your vulvar pain. Rather than temporarily eliminating and curing evidence of the illness or masking the symptoms. Gabapentin also doesn’t heal your body.

Please remember that Gabapentin is definitely not the only solution available for vulvodynia. There are still other medical and natural remedies that you can explore.

Did you find this post helpful? What other types of information would you like me to share with you?

Have you ever taken Gabapentin? Did Gabapentin help your symptoms?

Share with me all of your thoughts, experiences, and questions in the comments below! You can also ask me anything directly on FB.

Disclaimer

My goal is to provide you with the most relevant and current information that is factually correct, comprehensive and up-to-date.

However, the drug information provided herein is subject to changes and is not intended to cover all possible:

  • Uses
  • Dosage indications and best practices for usage
  • Side effects
  • Drug interactions
  • Contraindications and warnings
  • Drug withdrawal symptoms

Additionally, each person is different and may respond differently to the drug.

Please also bear in mind, that this article should not be used as a substitute for the knowledge and expertise of a doctor or other licensed healthcare professionals. Please before taking any medication, consult it with your health provider, who knows your medical history.

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