From the FDA Drug Label
Overdosage A lethal dose of gabapentin was not identified in mice and rats receiving single oral doses as high as 8000 mg/kg. Signs of acute toxicity in animals included ataxia, labored breathing, ptosis, sedation, hypoactivity, or excitation. Acute oral overdoses of gabapentin up to 49 grams have been reported In these cases, double vision, slurred speech, drowsiness, lethargy, and diarrhea were observed. All patients recovered with supportive care. Coma, resolving with dialysis, has been reported in patients with chronic renal failure who were treated with gabapentin. Gabapentin can be removed by hemodialysis Although hemodialysis has not been performed in the few overdose cases reported, it may be indicated by the patient’s clinical state or in patients with significant renal impairment. If overexposure occurs, call your poison control center at 1-800-222-1222
Gabapentin overdose symptoms may include:
- Double vision
- Slurred speech
- Drowsiness
- Lethargy
- Diarrhea
- Coma (in patients with chronic renal failure) Treatment for overdose may involve supportive care and possibly hemodialysis in severe cases or in patients with significant renal impairment 1.
From the Research
Gabapentin overdose is a medical emergency that requires immediate attention, and treatment should focus on supportive care, including airway management and monitoring of vital signs, as evidenced by recent studies 2. Gabapentin overdose can cause symptoms such as drowsiness, confusion, slurred speech, dizziness, double vision, and in severe cases, coma or respiratory depression.
- The risk of respiratory events is increased when gabapentin is used concurrently with opioids, as shown in a propensity-matched cohort study 2.
- Treatment typically involves supportive care in a hospital setting, including airway management, monitoring vital signs, and possibly activated charcoal if the ingestion was recent.
- Hemodialysis may be used in severe cases to remove the drug from the bloodstream, although this is rarely necessary.
- Recovery usually occurs within 24-48 hours with appropriate medical care, though the timeline depends on the amount ingested and individual factors like kidney function, as gabapentin is primarily eliminated through the kidneys.
- It is essential to exercise caution when prescribing gabapentin to patients who are also using opioids, due to the potential increased risk of respiratory events, as highlighted in a recent study 2.
- The management of gabapentin overdose should prioritize minimizing the risk of respiratory depression and other complications, and healthcare providers should be aware of the potential risks and take steps to mitigate them, as discussed in a literature review 3.