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Snook

Change to Gabapentin Formula Causing Anxiety/Panic Attacks

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Snook   

I thought I'd share this just in case anyone else has their dogs on gabapentin, although it's probably also relevant for anyone else who might see an unexplained increase in their dog's anxiety after refilling a prescription. Justice has been taking 800mg tablets of gabapentin at half a tablet twice a day. When I got his latest box of gabapentin tablets, the packaging had changed slightly and the tablets were no longer hard with a break line in them, but softer and thinner with no break line.

 

I didn't think much about the difference but suddenly clicked that the change in appearance might mean the formula itself had changed, after Justice had been taking them for 11 days and had unexplained shaking and panic attacks every day for a week and a half. I had some old 100mg gabapentin capsules in the cupboard from when we were working out the correct dosage for him, so I swapped him to them yesterday morning (four capsules twice a day to get the same dosage) to see if my theory was correct, and the shaking and panic attacks stopped. I rang the chemist this morning and got them to look in to it and they confirmed that the ingredients in the 800mg tablets have changed since the previous box. He's getting swapped over to 400mg capsules in the same brand that I've had him on since yesterday instead but I wanted to alert people, in case anyone experiences something similar with their dogs and can't work out what's going on.

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Oh :( Glad you figured it out, Snook. My dear old Mum was always greeted with raised eyebrows when she had her scripts filled "not the generic ones please..or a different brand, even if they're cheaper ".."they don't agree with me "

BUT- she knew very well, that sometimes they were NOT the same :(

I hope you can continue to source the trusted brand now. 

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Deeds   

Thanks for letting us know about that Snook.  Many people supplement anti seizure drugs with gabapentin for their dogs.  The new formula could actually trigger seizure activity in dogs with epilepsy rather than subdue them.

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Dogsfevr   

That’s a big dose increase aswell though .

 

My 40 kg dog who has bad arthritis gets a low dose 

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Snook   
3 hours ago, Deeds said:

Thanks for letting us know about that Snook.  Many people supplement anti seizure drugs with gabapentin for their dogs.  The new formula could actually trigger seizure activity in dogs with epilepsy rather than subdue them.

Yeah, when I was reading up on it and trying to find out if there had been any changes, I saw that it's used for seizures and withdrawal can trigger seizures. Hopefully whatever changes they've made don't affect any other dogs. 

 

2 hours ago, Dogsfevr said:

That’s a big dose increase aswell though .

 

My 40 kg dog who has bad arthritis gets a low dose 

His dose hasn't changed. He's been on half an 800mg tablet (so 400mg) twice a day for at least a couple of years. He was prescribed it by a vet behaviourist as part of managing severe anxiety and was initially dosed in 100mg increments until we found the dose that kept him on an even keel and stopped him from having panic attacks over minor noises, like someone wheeling a bin past the unit, or a neighbouring unit closing a cupboard door too loudly, or my phone beeping with an incoming message etc. 

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22 hours ago, persephone said:

.... Mum was always greeted with raised eyebrows when she had her scripts filled "not the generic ones please..or a different brand, even if they're cheaper ".."they don't agree with me "

BUT- she knew very well, that sometimes they were NOT the same ....

 

My doctor said the same, but used many more very angry words.  Always ticked the 'no substitue' box, and said the generic supports Big Pharm, and damages the original company who have no come-back against it.  Refusing to accept generic is an active vote for the scientists and research companies who made the original, and who don't get fat and rich off some-one else's work whilst contributing to nothing except shareholder profits.

 

And that's aside from the other issue of "not the same" - even if its just sugar coating over the same active ingredient and/or strength content per dose. 

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Snook   
25 minutes ago, PossumCorner said:

 

My doctor said the same, but used many more very angry words.  Always ticked the 'no substitue' box, and said the generic supports Big Pharm, and damages the original company who have no come-back against it.  Refusing to accept generic is an active vote for the scientists and research companies who made the original, and who don't get fat and rich off some-one else's work whilst contributing to nothing except shareholder profits.

 

And that's aside from the other issue of "not the same" - even if its just sugar coating over the same active ingredient and/or strength content per dose. 

They're good points. My aunty said today that there's a medication she can't tolerate the generic version of and she only gets the original brand. A number of people in the group for patients of Justice's vet behaviourist have also noticed changes to the packaging and pills for different dosages of gabapentin but thankfully, none of their dogs have had the same reaction as Justice. One person did say that they'd recently started their dog on 300mg tablets, as it was easier to administer than 3 x 100mg capsules, and had felt like the tablets weren't as effective as the capsules. They hadn't tried the old version of the tablets. 

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Snook   
1 hour ago, Papillon Kisses said:

I think we might be having this problem. Malcolm is losing his freaking mind. Waiting to hear back from VB. 

I'm so sorry to hear that. We work so incredibly hard to get our special needs dogs in to a good place and it's devastating seeing them go backwards. I hope you get a quick response and it can be sorted out easily. Please let me know how you get on and if there's anything I can do. 

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So by way of explanation, when he was on anxiety doses of gabapentin he was more anxious. The lower dose they use for pain treats his pain, without the side effect of increased anxiety, and pain better treated = lower anxiety also.

 

Since the formulation change he is barking non stop in the evening/night, can’t stop fidgeting, his compulsive fixation and attacking of lights/shadows has returned with a vengeance (it hasn’t been this bad in a looooong time), as has aggression directed towards my husband. He will literally not stop barking unless we’re both on the lounge with him on my lap, he’s eating, or I’m standing holding him at the other end of the room. He’s also licking his legs and moaning more again.
 

VB thinks if it’s gaba formulation related, he could be worse because the dose is effectively low and he’s therefore in more pain, or worse because the dose is being absorbed more efficiently and therefore giving him more side effects.

 

The suggestion was to try halving the dose, but will that address his pain/mobility issues. In the meantime we’ve decided to go back to the hideously expensive vet formulation to get a clearer picture.
 

We’ve discovered in the meantime that meloxicam is significantly reducing his anxiety and not just treating pain. It has never done that before, but the net result is that it’s tempering whatever it is that we’re seeing. He literally asks for his meloxicam and will demand it if not listened to!

 

PS. I have two friends with dogs on pregabalin who had the problems after switching brands and their BV is looking into it, with other patients also seeming affected.

Edited by Papillon Kisses

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Snook   

The poor little man. I'm so sorry that both you and he have been dealing with such a significant increase in anxiety. I'm glad the meloxicam is helping with pain and anxiety. With the Gabapentin, is it worth trying his usual dose but with the capsules instead? Putting Justice on to the capsules stopped the increased anxiety that was being caused by the reformulated tablets. 

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1 minute ago, Snook said:

The poor little man. I'm so sorry that both you and he have been dealing with such a significant increase in anxiety. I'm glad the meloxicam is helping with pain and anxiety. With the Gabapentin, is it worth trying his usual dose but with the capsules instead? Putting Justice on to the capsules stopped the increased anxiety that was being caused by the reformulated tablets. 


Haha the majority of his medication including gaba is compounded because he’s teeny tiny. :laugh: Our pharmacist is probably compounding a tablet that’s different to what BOVA uses.

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Snook   
6 minutes ago, Papillon Kisses said:


Haha the majority of his medication including gaba is compounded because he’s teeny tiny. :laugh: Our pharmacist is probably compounding a tablet that’s different to what BOVA uses.

Ohhh... If it's being compounded could you talk to the pharmacist about returning to the old formula they were using? I don't even know if that's possible or whether the materials they make it from have changed? 

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