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Neurontin®
 

Pregnancy and Neurontin

The FDA lists gabapentin in Pregnancy Category C. Studies in animals have shown some harm to the fetus. There have not been enough well-controlled studies in women. Caution is advised, but the benefits of the medication may outweigh the potential risks.

The risk of defects generally is higher for women who take more than one AED and for women with a family history of birth defects. Whether this applies to Neurontin is not yet known.

Advise women who are capable of becoming pregnant to take at least 400 mcg (0.4 mg) of folic acid (folate) daily to help prevent neural tube defects. Women at high risk, such as those with a history of a neural tube defect in a previous pregnancy, should take 4000 mcg (4 mg) daily, beginning before they become pregnant. The effectiveness of prophylactic folic acid use in preventing defects related to Neurontin has not been proven, however, so diagnostic ultrasonography at the 18th to 20th week is recommended, especially if pregnancy termination is an option.

About 20% to 35% of women have seizures more often during pregnancy because of changes in hormones or changes in how their seizure medicine is metabolized. This does not appear to be an issue with Neurontin.

Breast-feeding by mothers taking gabapentin is likely to be safe for healthy, full-term newborns. A small amount of the medication will appear in the milk; one estimate is that the baby may receive up to about 1 mg/kg per day in the milk. The effect of this amount on an infant is unknown.