Gabapentin vs. Baclofen

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

What's the Difference Between Gabapentin and Baclofen?

What Are Gabapentin and Baclofen?

Gabapentin is an anti-seizure (anticonvulsant) drug that is used for preventing seizures and for treating post-herpetic neuralgia, the pain that follows an episode of shingles. Other off-label uses for gabapentin include anxiety, alcohol withdrawal, cocaine withdrawal, hiccups, restless leg syndrome, hyperhidrosis, headaches, diabetic neuropathy, hot flashes, and fibromyalgia.

Baclofen is a skeletal muscle relaxer. It is believed that baclofen acts like the neurotransmitter gamma-aminobutyric acid (GABA) and blocks the activity of nerves within the part of the brain that controls the contraction and relaxation of skeletal muscle. Baclofen is used for treating skeletal muscle spasms, muscle clonus, rigidity, and pain caused by disorders such as multiple sclerosis. It is also injected into the spinal cord for management of severe spasticity.

Quick GuideChronic Pain Syndrome: Treatment and Management for CPS

Chronic Pain Syndrome: Treatment and Management for CPS

What Are the Side Effects of Gabapentin and Baclofen?

Gabapentin

The most common side effects of gabapentin are:

Other adverse effects and serious side effects associated with gabapentin include:

Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.

Baclofen

Common side effects of baclofen are:

Abrupt discontinuation of oral baclofen may cause seizures and hallucinations. Abrupt discontinuation of intrathecal baclofen may result in:

  • high fever,
  • rebound spasticity,
  • muscle rigidity, and
  • rhabdomyolysis (muscle breakdown) that can progress to failure of several organs, including the kidney, and even death.

What Is the Dosage of Gabapentin vs. Baclofen?

Gabapentin

Gabapentin is available as:

  • Capsules: 100, 300, and 400 mg.
  • Tablets: 100, 300, 400, 600, and 800 mg.
  • Solution: 250 mg/5 ml

Dosage for postherpetic neuralgia and seizures.

  • The recommended dose for postherpetic neuralgia is 1800 mg daily in 3 divided doses (Neurontin) or 1800 mg once daily (Gralise). Gralise is not interchangeable with other gabapentin products.
  • Seizures are treated with 900-1800 mg/daily in 3 divided doses (Neurontin). Withdrawal of treatment should occur slowly over a week.

Gabapentin may be taken with or without food.

Baclofen

The usual starting dose of oral baclofen for treating spasticity in adults is 5 mg given three times daily. Based on the response, the dose can be increased by 5 mg every three days to a maximum of 80 mg/day in divided doses.

What Drugs Interact with Gabapentin and Baclofen?

Gabapentin

Antacids reduce the concentration of gabapentin in blood. Therefore, gabapentin should be administered 2 hours or more after taking antacids.

Morphine significantly increases blood concentrations of gabapentin and may increase central nervous system-related adverse events associated with gabapentin.

Baclofen

Use of baclofen with other drugs that also depress the function of nerves may lead to additional reduction in brain function.

In addition to the risk of depressing brain function, the use of baclofen and tricyclic antidepressants (for example, amitriptyline [Elavil, Endep], doxepin [Sinequan, Adapin]) together may cause muscle weakness.

Use of baclofen and monoamine oxidase inhibitors (for example, phenelzine [Nardil], tranylcypromine or [Parnate]) can result in greater depression of brain function as well as low blood pressure.

Because baclofen can increase blood sugar, doses of antidiabetic drugs may need to be adjusted when baclofen is begun.

Are Gabapentin and Baclofen Safe to Take While Pregnant or Breastfeeding?

Gabapentin

Doctors do not know the safety of gabapentin during pregnancy. Gabapentin is secreted in human breast milk; therefore, if you are pregnant you should only use this medication if the benefits outweigh the unknown risk to the fetus.

Baclofen

The use of baclofen by pregnant women has not been evaluated. Baclofen can be detected in the breast milk of mothers taking oral baclofen. No information is available on the presence of baclofen in the breast milk of mothers receiving baclofen intrathecally.

Summary

Gabapentin and baclofen are used off-label to treat nerve pain (neuralgia). Gabapentin is also an anti-seizure medication and treats nerve pain from shingles. Baclofen is a muscle relaxant used to treat pain caused by disorders such as multiple sclerosis. It is also injected into the spinal cord for management of severe spasticity.

Treatment & Diagnosis

Medications & Supplements

Subscribe to MedicineNet's General Health Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Medically Reviewed on 3/22/2018
References
REFERENCE:

FDA Prescribing Information

Health Solutions From Our Sponsors