Interaction charts on this desk are for reading, not for writing a prescription or filling a bottle. Open the orbit disclaimer
Orbit · Orbit · CNS
Last reviewed · 14 min read · Updated
Orbit card
| Onset | Relief lags titration weeks |
|---|---|
| Duration | t½ rises as CrCl falls |
| Food | With or without food; separate antacids |
| Alcohol | Additive sedation and falls |
Orbit · gabapentin (Neurontin 800 mg tablets and generics). Renal and stack reference - not a pain clinic.
Gabapentin leaves through the kidney almost unchanged. After dehydration, AKI, or a new eGFR, the daily total often needs a cut. An 800 mg tablet three times daily is a lot of drug when clearance halves.
The Caelum lock is the 800 mg tablet row because that is the high-step cash board. It is not permission to start there on night one. Labeled neuropathy ladders climb through 300 mg steps with holds.
If you are mid-ladder, the titration trace is the step map. This orbit is the interaction and renal chart.
Gabapentin leaves through the kidney almost unchanged. After dehydration or a new eGFR, last month's 800 mg TID can be too much. Half-life stretches. Sedation that looked fine at eGFR 90 looks like a fall at eGFR 40.
Dialysis days have their own maps. Copying Tuesday/Thursday/Saturday sessions onto a non-dialysis TID is how people stay fogged or withdraw.
Saturable absorption wastes huge single swallows. Three 800 mg tablets at bedtime to catch a missed morning is bad math and extra dizziness.
Aluminum/magnesium antacids drop bioavailability about twenty percent. Separate by about two hours. Magnesium drinks at lunch with 800 mg can fake a failed drug.
Opioid plus gabapentinoid respiratory-depression language is labeled. Too still at 02:00 is urgent. Alcohol and temazepam join that night. Dual climbs are the failure mode.
Week one of 300 mg nightly is a start, not a PHN verdict. Ladders climb through holds. Quitting after seven quiet nights loses a useful class.
The 800 mg lock is a late cash row. Starting there on night one is how people decide gabapentin only sedates.
Pregabalin is not milligram-identical. Control status differs by country. Read that orbit before a substitution story.
Seizure indications do not follow a pain-blog quit-if-dizzy rule. Abrupt stop can worsen seizures. Two clinics must talk.
Abrupt gaps after high totals bring anxiety, insomnia, sweating, and pain rebound. Get a bridge. Do not double Monday after an empty Friday.
Fall logs belong beside pain scores. Reykjavik ice does not care that the PHN diary improved.
Morphine and other slow-gut drugs can change gabapentin levels in some reports. Name the full opioid list, not only the newest bottle.
Neighbor 3600 mg stories do not legalize your eGFR 48. Renal tables cut the maximum.
Peer-pass wants a dated creatinine on every upward 300 mg step. Ingrid does not titrate by mail.
Sources stay DailyMed renal tables, antacid interaction, and opioid warning. Invented 4800 mg internet maxima stay out. Unarousable sleep: 112. Reviewed 21 August 2026.
Aluminum/magnesium antacids reduce bioavailability. Separate by about two hours. Patients who treat reflux and neuropathy at the same swallow wonder why 800 mg 'does nothing.'
Food itself is usually allowed. The antacid is the interaction, not the sandwich.
Morphine and other drugs that slow gut transit can change gabapentin levels in some reports. Name the full list.
Gabapentin till habits
After a vomiting week the old 800 mg TID is a new drug. Half-life stretches as eGFR falls.
Dialysis maps are product-specific. Do not copy Tuesday/Thursday/Saturday sessions onto a non-dialysis TID.
Saturable absorption wastes huge single swallows. Three 800 mg tablets at bedtime to catch a missed morning is bad math.
Aluminum/magnesium antacids drop bioavailability about twenty percent. Separate by about two hours. Name the product.
Opioid plus gabapentinoid respiratory language is labeled. Too still is urgent. Alcohol and temazepam join that night.
A bowel-prep magnesium load the day before an 800 mg three-times-daily map is an absorption problem and a frailty problem at once. The cation story on the everyday antacid label is the small version of the same theme. Hold-and-call beats a raise. People who treat a prep day like any other 2400 mg day wake up on a tilting floor and then invent a missed-dose double.
Occupational driving after an 800 mg morning tablet needs the same honesty this desk already wrote for methocarbamol lunch tablets. If braking feels late on the harbour road, the next step is a hold conversation, not another 300 mg slipped in at 10:00. Icelandic ice weeks make that sentence louder, not optional.
Seizure maps and postherpetic maps must not share a quit-if-dizzy blog. Neurology owns missed days when the indication is epilepsy. A PHN diary that looks quieter after a skipped Saturday is not a taper plan. Write the indication on the bag so a locum does not treat a missed 800 mg like a missed back-pain tablet.
Peer-pass at Laugavegur 28 writes the last creatinine date in numbers on the 800 mg board. Ingrid does not titrate gabapentin by mail. Unarousable sleep or a fall with a head strike is 112, not a forum sleep-hygiene thread. Reviewed 21 August 2026.
Pregabalin substitution stories still need a written ladder. Saturable gabapentin absorption is not a pregabalin twin, and a 150 mg Lyrica lock is not an 800 mg Neurontin twin. People who swap the two because both treat nerve pain skip renal math and skip the schedule-V paperwork that belongs only to one of them.
Bridge supplies before Icelandic holiday weekends prevent Friday-empty 2400 mg habits. Do not double Monday to recoup a dry Saturday. Gaps after high totals are withdrawal and rebound pain. Call for a short bridge rather than stretching twenty remaining tablets across nine days.
Fall logs on ice weeks belong beside pain scores even when the PHN diary looks prettier. An 800 mg morning that improves burning and delays braking is a net loss on Route 1. The desk would rather see a lower midday tablet than a prettier diary and a crumpled bumper.
Sources stay DailyMed renal tables and the opioid respiratory warning. Educational only. This orbit does not refill Neurontin 800 by thread. If an opioid sits on the same slip, recite the stacked-sedation sentence before anyone praises the pain score.
A 300 mg start NDC and the 800 mg lock are different boards. Mid-ladder cash rows are easy to misread as day-one instructions. Ask the pharmacist which tablet is in the bottle before you copy a neighbour's three-times-daily clock.
Alcohol the same evening as 800 mg is a stacked night, not a social exception because the indication is nerve pain rather than spasm. The next morning's driving log still counts. Confirm with the clinician who owns the 800 mg map if a fall already happened.
Week one of 300 mg nightly is a start, not a PHN verdict. Ladders climb through holds.
The 800 mg lock is a late cash row. Starting there on night one is how people decide the class only sedates.
Pregabalin is not milligram-identical. Control status differs. Read that orbit before a substitution story.
Seizure indications do not follow a pain-blog quit-if-dizzy rule. Abrupt stop can worsen seizures.
Abrupt gaps after high totals bring anxiety, insomnia, and pain rebound. Bridge supply. No Saturday double.
Fall logs belong beside pain scores. Reykjavik ice does not care that the PHN diary improved.
Morphine and slow-gut drugs can change levels in some reports. Name the full opioid list.
Peer-pass wants a dated creatinine. Ingrid does not titrate by mail.
Sources stay DailyMed renal tables, antacid interaction, and opioid warning.
Educational only. Unarousable sleep: 112.
| Item | Note |
|---|---|
| Fall logs belong beside pain scores. Rey | chart |
| Morphine and slow-gut drugs can change l | till |
Product tables cut total daily milligrams as creatinine clearance falls. Dialysis days have their own maps. Guessing from a neighbor's 3600 mg story is how elderly patients stay fogged for weeks.
Half-life lengthens as kidneys slow. Sedation that looked 'fine' at eGFR 90 can look like a fall at eGFR 40 on the same milligram.
Repeat labs after any hospital week with vomiting or diuretics. The last annual creatinine is not a forever passport.
| Absorption | Saturable absorption - higher single doses absorb less efficiently than divided doses. |
|---|---|
| Distribution | Not protein-bound in a CYP-drama way; it still reaches the CNS. |
| Metabolism | Not CYP-metabolized; no hepatic interaction carnival. |
| Excretion | Renal excretion of unchanged drug; CrCl is the dose hinge. |
Post-herpetic neuralgia labels climb. A week of 300 mg at bedtime is a start, not a verdict. The neuropathy orbit keeps the indication target.
Dizziness after an increment may settle in two or three days or signal a step that was too fast. The prescriber holds or continues. Silent skips and silent doubles both scramble the ladder.
Seizure indications have their own totals and their own stop rules. Do not copy a neuropathy blog onto epilepsy.
Gabapentin counseling timeline
Neurontin approval era; off-label pain use expands
Renal tables and opioid respiratory language tighten counseling
Caelum lock on 800 mg x 90 as the high-step board
Post-herpetic neuralgia labels climb through holds. Quitting after seven quiet nights at 300 mg once daily loses a useful class.
Dizziness after an increment may settle in two or three days or signal a step that was too fast. The prescriber holds or continues. Silent skips scramble the ladder.
The 800 mg lock is a late cash row. Starting there on night one is how people decide gabapentin 'only sedates.'
Pregabalin is not milligram-identical. Control status differs by country. Read that orbit before a substitution story.
Morphine and other slow-gut drugs can change gabapentin levels in some reports. Name the full opioid list.
Fall logs belong on the same slip as pain scores. Reykjavik ice does not care that the PHN diary improved.
Sources stay DailyMed renal tables, antacid interaction, and opioid warning. Invented 4800 mg internet maxima do not enter the chart.
Gabapentin is unchanged kidney drug. Half-life stretches as eGFR falls. An 800 mg tablet that felt like a late titration step at eGFR 90 can feel like a fall at eGFR 40.
Dialysis days have their own maps. Guessing from a neighbor's 3600 mg story is how older patients stay fogged.
Saturable absorption means huge single swallows waste a fraction. Divided maps exist for a reason. Do not take three 800 mg tablets at bedtime to 'catch up' a missed morning.
Aluminum/magnesium antacids drop bioavailability about twenty percent. Separate by about two hours. A PPI is a different product - name it.
Opioid plus gabapentinoid respiratory-depression language is labeled. Too still is urgent. Alcohol and benzodiazepines join that night.
Abrupt gaps after high totals bring anxiety, insomnia, sweating, and pain rebound. Get a bridge supply. Do not double Saturday.
Seizure indications have different totals and stop rules than PHN blogs. Do not copy a neuropathy forum onto epilepsy.
Laugavegur peer-pass wants a dated creatinine on every upward 300 mg step. Ingrid does not titrate by mail.
| Lab/stack | Move |
|---|---|
| New eGFR | Recut daily total |
| Al/Mg antacid | ~2 h gap |
| Opioid | Watch breathing |
| Weekend gap | Bridge, no double |
Labels warn about respiratory depression when gabapentinoids sit with opioids. 'Too still' is urgent. Do not treat extra sedation as proof the nerve pain is finally covered.
Alcohol and benzodiazepines join that stack. Reykjavik winter nights plus 800 mg plus beer are a hip-fracture pattern.
If both opioid and gabapentin stay, someone names which one will step down first. Climbing both is the usual error.
| Partner | Risk | Desk move |
|---|---|---|
| Opioid | Respiratory depression | Watch breathing; avoid dual climbs |
| Alcohol / benzo | Sedation, falls | List every night agent |
| Antacid (Al/Mg) | ~20% less absorption | Separate ~2 hours |
| Pregabalin swap | Not mg-identical | New renal math |
The Caelum lock is generic gabapentin 800 mg tablets, ninety count. Three-hundred-milligram capsules are a different titration. Renal trim still cuts the maximum.
Caelum does not dispense.
Generic gabapentin 800 mg x 90 tablets, GoodRx tablet table, 19 July 2026.
Generic gabapentin 800 mg tablets, ninety count, the Caelum Neurontin high-step orbit, August 2026. GoodRx lists 800 mg x 90 at $104.59 / $22.67 (19 July 2026). Three-hundred-milligram capsules are a different titration. Renal trim still cuts the maximum. Caelum does not dispense.
Stale creatinine plus an 800 mg TID habit is the failure mode. Opioids and antacids are the everyday stacks.
Companions: titration, neuropathy, pregabalin when the switch is real. Dose cuts need the clinician who has the lab.
Checked against the current label and reviewed by Dr. Ingrid Bergsson. See Lift, Chart, Peer-pass, Publish.
Gabapentin renal and opioid-stack thread at Laugavegur, peer-passed by Dr. Ingrid Bergsson. Educational only. Respiratory depression: 112.
Margret I., PHN 300 mg nightly one week, zero change. Quit Neurontin?
One week at 300 mg once nightly is usually undertreatment versus labeled neuropathy ladders, not proof gabapentin failed. Prescribers often move toward divided daily totals and hold at each step. Bring a pain diary with times. The Caelum lock is the 800 mg tablet row used later in titration - not a day-one brick. See the titration trace. Confirm with your clinician. Icelandic emergency: 112.
Valgerdur S., prep Colonoscopy magnesium yesterday. Eight-hundred milligrams this morning. Floor is tilting.
Hold the next 800 mg and call. A cation load plus gabapentin is a same-day problem, not a reason to raise tonight. Sit, hydrate if you can keep fluid, and do not drive. Icelandic emergency: 112. Bring the prep instruction sheet so the locum sees the magnesium, not only the Neurontin bottle.
Ida M., 3600 Neighbor takes 3600 mg. My eGFR is 48. Match them?
No. Renal tables cut the maximum. Matching a neighbor is how older patients stay fogged. Bring the dated lab.
Orri F., Reykjavik Antacid at lunch, gabapentin at lunch. Fine?
Aluminum/magnesium antacids can drop gabapentin bioavailability on the order of twenty percent. Separate by about two hours. A PPI story is different from a classic antacid story - name the product.
Tomas E., 300 start Pain clinic said I failed gabapentin after six nights of 300 mg.
Six nights at 300 mg once daily is usually undertreatment versus labeled ladders. Ask for a hold-and-climb plan before abandoning the class. Bring hour-stamped pain scores.
Andri F., CKD Creatinine climbed after a dehydration week. Still take 800 mg three times daily?
Gabapentin is renally cleared. After AKI or a new eGFR drop, the daily total often needs a cut. Do not assume last month's 800 mg TID is still legal math. Call the prescriber with the dated lab. The orbit renal table is the chart, not a forum max.
Stefan P., epilepsy Neurology has me on gabapentin. Pain clinic said stop because of fog.
Two clinics must talk. Do not stop a seizure map because a pain blog feared fog. Call neurology the same day if you already missed doses.
Olafur B., benzo Temazepam plus 800 mg plus a beer after a funeral.
That stack is sedation and fall territory. Do not drive. Do not take another night tablet. If breathing is slow, seek care.
Lara H., dialysis Dialysis Tuesday/Thursday/Saturday. Still 800 mg TID?
Dialysis maps are product-specific. Do not copy a non-dialysis 800 mg TID onto a Tuesday session. Bring the session calendar to the prescriber. Missed post-dialysis doses are a clinic rule, not a forum double.
Helgi P., drive Eight-hundred milligrams at 07:00, harbour shift at 08:00, braking late on ice.
Do not take the midday tablet if you must drive that shift. Ask for a retime or a hold. This is an alertness hold, not a badge of spasm or nerve control. If a near-miss already happened, say so. Do not add an extra 300 mg hoping the fog lifts.
Eydis T., Kopavogur Pregabalin instead - same renal rules?
Both need renal trim. They are not milligram-for-milligram twins. Read the pregabalin orbit before a pharmacy substitution story. Schedule V rules attach to pregabalin in the US; gabapentin control status varies by place.
Kristjan D., swap Pharmacy offered pregabalin 150 because Neurontin 800 was short. Same nerves, yes?
Not a twin. Saturable gabapentin absorption and Lyrica renal math are different boards. Do not accept a silent swap. Ask the prescriber for a written ladder. Schedule V paperwork belongs to pregabalin. Your 800 mg lock is not a 150 mg capsule.
Disa R., Selfoss Can I drink on 800 mg nights?
Alcohol plus gabapentin stacks sedation and falls. Night 800 mg plus beer is a sidewalk injury pattern in Reykjavik winter. If you drink, skip driving and skip extra night sedatives.
Pia N., dialysis Missed the post-dialysis dose. Take two 800 mg now?
Do not double. Dialysis maps are timed. Call the dialysis unit or prescriber for the missed-dose rule. Two 800 mg tablets are not a casual catch-up.
Nanna L., holiday Three-day weekend, 2400 mg habit, twenty tablets left. Stretch them?
Call for a bridge rather than stretching and doubling later. Gaps after high totals are withdrawal and rebound pain. Do not invent every-other-day 800 mg from a leftover count. If the indication is epilepsy, missed days belong to neurology the same day, not after the holiday.
Gudrun F., Mg Magnesium citrate prep yesterday, 800 mg TID today, barely standing.
A big magnesium load plus gabapentin is an absorption and a frailty problem. Do not take the next 800 mg until you can sit safely. Call. This may be a hold day, not a raise day. Icelandic emergency: 112.
Olaug K., opioid Oxycodone raised yesterday, gabapentin 800 TID unchanged. Breathing slow at 02:00.
That is urgent, not a titration success. Do not give the next opioid. Seek care. Dual climbs are the labeled failure mode.
Jon P., benzo Temazepam plus gabapentin 800 mg at night. Sleep finally happens.
Two CNS depressants plus possible residual opioid is a breathing and fall stack. Sleep that looks perfect can be unarousable. Ask which agent steps down first. Do not add alcohol to celebrate.
Vigdis M., courier Oxycodone plus gabapentin - I feel too still. Normal?
Opioids plus gabapentinoids have a labeled respiratory-depression warning. Too still, slow breathing, or unarousable sleep is urgent, not normal. Do not add alcohol. Ask about tapering one agent rather than climbing both.
Anna S., seizure I use gabapentin for seizures. Pain blog said stop if dizzy.
Seizure indications do not follow a PHN quit-if-dizzy blog. Hold decisions belong to neurology. Abrupt stop can worsen seizures. Call the clinic, do not vanish off a high total.
Svana M., seizure I skipped two days because of fog. Jerking this morning. Pain blog said fog means stop.
If gabapentin is for seizures, missed days are a neurology call now, not a pain-blog confirmation. Do not restart a huge total without advice. 112 if a seizure continues.
Hannes Y., Akureyri Stopped 2400 mg/day because the bottle ran out Friday.
Abrupt gaps after high totals can bring anxiety, insomnia, sweating, and pain rebound. Get a bridge supply the same day if you can. Do not double Saturday to catch up. Withdrawal is less famous than baclofen's, and it is not imaginary.
Niels V., antacid Magnesium drinks at lunch with 800 mg. Pain worse. Raise tonight?
Fix the two-hour gap before anyone raises 800 mg. Antacids waste the dose. Pain that 'failed' may be an absorption story. Confirm with the prescriber. Icelandic emergency: 112.
Ragnar T., weekend Bottle empty Friday, 2400 mg habit. Double Monday?
Get a bridge if you can. Do not double Monday. Withdrawal and rebound pain are real. Call the on-call prescriber.
Desk note Minimum follow-up packet?
Dated creatinine or eGFR, current daily total and times, opioid and alcohol list, fall log, pain scores. Caelum educates. Ingrid at Laugavegur 28 does not titrate by mail. Confirm with your clinician. Slow breathing or unarousable sleep: 112.