{"id":631298,"date":"2025-02-06T19:46:52","date_gmt":"2025-02-07T00:46:52","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=631298"},"modified":"2025-02-06T19:46:52","modified_gmt":"2025-02-07T00:46:52","slug":"is-gabapentin-bad-for-your-liver","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/is-gabapentin-bad-for-your-liver\/","title":{"rendered":"Is gabapentin bad for your liver?"},"content":{"rendered":"

Epilepsy<\/span> and <\/span>nerve pain<\/span> can throw a serious wrench into your life\u2014which is why <\/span>gabapentin<\/span><\/a> is essential for many people. <\/span>Gabapentin<\/span> is an <\/span>anticonvulsant<\/span> medication that calms <\/span>nervous system<\/span> activity, helping prevent or decrease symptoms. While <\/span>gabapentin<\/span> has various <\/span>side effects<\/span> and precautions, it typically doesn\u2019t affect the liver, although there are rare cases when it might. We\u2019ve got everything you need to know below.\u00a0<\/span><\/p>\n

Is <\/span>gabapentin<\/span> hard on the liver?\u00a0<\/span><\/h2>\n

Nearly half of all <\/span>liver failure<\/span> cases are caused by <\/span>drug-induced liver injury<\/span>, according to 2014 research in <\/span>Clinical <\/span><\/i>Liver Disease<\/span><\/i>. <\/span><\/i>So it\u2019s natural to be concerned about it. However, most people taking <\/span>gabapentin<\/span> can put their minds at ease since it rarely harms the liver.<\/span><\/p>\n

Gabapentin<\/span> is considered an analogue for the neurotransmitter <\/span>gamma-aminobutyric acid<\/span> (<\/span>GABA<\/span>), which blocks certain signals to the brain, slowing down the <\/span>nervous system<\/span>. Even though the liver contains <\/span>GABA<\/span>\u2014and <\/span>GABA<\/span> has some positive <\/span>hepatic<\/span> effects\u2014<\/span>gabapentin<\/span> rarely reaches it.<\/span><\/p>\n

That\u2019s why \u201c<\/span>gabapentin<\/span> is not known to have any effect on the liver, and if it were to, it would be rare and completely unexpected,\u201d psychiatrist Dr. Cooper Stone, MD. \u201cThe reason for this is that <\/span>gabapentin<\/span> is not metabolized by the liver like most drugs, instead it is simply cleared from the body unmetabolized by the body’s kidneys.\u201d<\/span><\/p>\n

That said, there have been some <\/span>case reports<\/span> that showed <\/span>gabapentin-induced<\/span> liver issues. One 2018 study published in <\/span>Cureus, <\/span><\/i>for example, found liver injury in a 67-year-old <\/span>gabapentin<\/span> patient who had no other known cause for it. But this uncommon <\/span>side effect<\/span> isn\u2019t just confined to older adults\u2014a 2022 study from <\/span>The American Journal of <\/span><\/i>Gastroenterology<\/span><\/i> reported <\/span>gabapentin-induced<\/span> hepatotoxicity<\/span> in a 41-year-old as well. These cases are the exception, not the rule, but it\u2019s still important to know it\u2019s possible.<\/span><\/p>\n

Typically, doctors use a blood test to evaluate liver health and potential injury, and these tests measure <\/span>enzymes<\/span>, a byproduct of red blood cells called <\/span>bilirubin<\/span>, and a type of white blood cell called eosinophils. <\/span>Gabapentin use<\/span> isn\u2019t known to affect <\/span>enzyme<\/span> or <\/span>bilirubin<\/span> levels, but it may rarely cause an <\/span>allergic reaction<\/span> characterized by elevated eosinophil levels. This is a condition called <\/span>eosinophilia<\/span>, which may cause liver damage. In certain cases, <\/span>drug reactions<\/span> with <\/span>eosinophilia<\/span> and systemic symptoms (DRESS) can even be life-threatening\u2014both those cases are rare.\u00a0<\/span><\/p>\n

Can you take <\/span>gabapentin<\/span> if you have <\/span>liver disease<\/span>?<\/span><\/h2>\n

Yet there\u2019s still a small chance that liver issues can affect <\/span>gabapentin<\/span>\u2019s effects. \u201cPeriodically those with <\/span>liver disease<\/span> may experience an acute worsening of their liver, which, for some, can result in an accumulation of toxic chemicals in the body. This accumulation may then lead to changes in one\u2019s cognition, cause confusion, and other such unwanted effects, all of which can be worsened when combined with <\/span>gabapentin<\/span>,\u201d <\/span>Dr. Stone<\/span><\/a> says.<\/span><\/p>\n

However, he continues, \u201cThis effect is not exclusive to <\/span>gabapentin<\/span> and can be seen with other medications such as muscle relaxers, benzodiazepines, <\/span>opioids<\/span>, etc. It is important to note just because one may have <\/span>liver disease<\/span> does not mean they cannot necessarily be on these or other medications.\u201d<\/span><\/p>\n

It\u2019s a somewhat different story for people with <\/span>kidney disease<\/span>, though. <\/span>Gabapentin<\/span> doesn\u2019t directly damage the kidneys, but because the body excretes it through the kidneys, reduced renal function might make it harder to clear. That\u2019s why doctor\u2019s will often adjust the <\/span>dose of gabapentin<\/span> or consider alternatives for people with significant kidney dysfunction.<\/span><\/p>\n

Regardless of liver and kidney health, <\/span>gabapentin<\/span> may cause certain <\/span>side effects<\/span><\/a>. According to the <\/span>clinical trials<\/span> outlined on<\/span> Neurontin<\/span>\u2019s label<\/span><\/a>, the most <\/span>common side effects of gabapentin<\/span> for people with <\/span>postherpetic neuralgia<\/span> are dizziness, <\/span>drowsiness<\/span>, and peripheral edema. For adults with <\/span>epilepsy<\/span>, the most common are <\/span>drowsiness<\/span>, dizziness, ataxia, fatigue, and uncontrolled eye movements. And for children with <\/span>epilepsy<\/span>, the most common are viral infection, fever, nausea\/vomiting, <\/span>drowsiness<\/span>, and hostility.<\/span><\/p>\n

Safe <\/span>gabapentin<\/span> dosages for people with <\/span>liver disease<\/span><\/h2>\n

As we mentioned above, <\/span>gabapentin<\/span> is generally safe for people who have <\/span>liver disease<\/span>, so <\/span>prescribers<\/span> often use the standard dose.<\/span> According to the NIH<\/span><\/a>, those <\/span>gabapentin<\/span> doses <\/span><\/a>are:<\/span><\/p>\n

Since the liver doesn\u2019t metabolize <\/span>gabapentin<\/span>, it\u2019s typically safe for people who have cirrhosis or other <\/span>liver diseases<\/span>. In fact, a<\/span> study from the <\/span>Journal of <\/span><\/i>Gastroenterology<\/span><\/i> & Hepatology<\/span><\/i><\/a> concluded that cirrhotic patients might tolerate <\/span>gabapentin<\/span> better than other analgesics for post-surgical pain.<\/span><\/p>\n