Gabapentin

How Does Gabapentin Work?

Despite its name suggesting a connection to GABA (gamma-aminobutyric acid), Gabapentin does not act on GABA receptors. Instead, it works by binding to the alpha-2-delta (α2δ) subunit of voltage-gated calcium channels on nerve cells. This is a regulatory component that controls how easily calcium enters neurons when they fire.

When Gabapentin binds to this subunit, it reduces calcium influx into overactive neurons. Less calcium means fewer neurotransmitters (like glutamate and substance P) get released — which means the abnormal firing that causes seizures and neuropathic pain is dampened. The α2δ subunit is particularly abundant in areas of the spinal cord and brain involved in pain signaling and seizure propagation, which is why Gabapentin is especially effective for these conditions.

Pregabalin (Lyrica) works through the same mechanism but has higher and more consistent bioavailability (~90% vs. ~60% for Gabapentin), which allows twice-daily instead of three-times-daily dosing. Gabapentin is renally eliminated unchanged and requires dose reduction in patients with kidney impairment.

How Hard Is It to Find Gabapentin in Stock?

As of early 2026, Gabapentin tablets and capsules are generally widely available at most pharmacies. There is no active FDA-declared shortage. The drug is produced by many generic manufacturers — including Amneal, Hikma, Lupin, Aurobindo, Teva, and others — providing robust supply redundancy. The oral solution (liquid form) experienced a documented shortage from May 2023 to July 2024, which has since been resolved.

That said, with over 73 million prescriptions filled annually, local pharmacy stock gaps do occur — particularly for less common strengths (100 mg, 400 mg capsules) and in states where Gabapentin is classified as Schedule V (Kentucky, West Virginia, Tennessee, Alabama, Utah, Virginia). Independent pharmacies may run out temporarily; large chains and mail-order pharmacies are generally more reliable.

To find which pharmacies near you have your specific Gabapentin dose in stock, use Medfinder — enter your medication, strength, and zip code to see real-time availability without making phone calls.

Who Can Prescribe Gabapentin?

Because Gabapentin is not a federal controlled substance, any licensed prescriber with prescribing authority can write a prescription for it in most states. In the six states where it is classified as Schedule V (KY, WV, TN, AL, UT, VA), prescribers must have DEA registration and follow state Schedule V rules — but Gabapentin remains accessible to all licensed prescribers in those states who hold DEA numbers.

Provider types who commonly prescribe Gabapentin include:

• Primary Care Physicians (PCPs) — most common source of Gabapentin prescriptions
• Neurologists — epilepsy and complex neuropathic pain management
• Psychiatrists — off-label use for anxiety, insomnia, alcohol use disorder
• Pain Management Specialists — chronic neuropathic pain, fibromyalgia
• Nurse Practitioners (NPs) and Physician Assistants (PAs) — full prescribing authority in most states
• Anesthesiologists and Oncologists — perioperative pain, cancer-related neuropathic pain

Gabapentin is widely available via telehealth in most states — because it is not federally scheduled, telehealth prescribers can issue prescriptions during standard online visits without an in-person exam requirement. In Schedule V states (KY, WV, TN, AL, UT, VA), state telehealth and controlled substance rules apply and may require an in-person evaluation for new prescriptions.

Is Gabapentin a Controlled Substance?

Gabapentin is not a federally scheduled controlled substance under the DEA Controlled Substances Act. Any licensed prescriber — including MDs, DOs, nurse practitioners (NPs), and physician assistants (PAs) — can prescribe it without DEA Schedule II/III/IV/V federal restrictions.

However, due to increasing reports of misuse (Gabapentin can induce euphoria at high doses and is sometimes diverted), several states have classified it as Schedule V at the state level: Kentucky, West Virginia, Tennessee, Alabama, Utah, and Virginia. In these states, prescribers must have DEA registration and pharmacies must track dispensing more carefully. Early refills may be restricted and PDMP checks may be required.

In all other states, Gabapentin can be prescribed without controlled substance requirements, refilled freely per prescriber judgment, and obtained via telehealth without an in-person visit requirement. Despite the abuse potential at high doses, Gabapentin is considered a non-scheduled drug with fewer prescribing restrictions than Schedule V federally.

Common Side Effects of Gabapentin

The most common side effects of Gabapentin, particularly during initial titration:

• Dizziness and drowsiness (most common — up to 20-30% of patients)
• Ataxia (lack of coordination, unsteady gait)
• Fatigue and malaise
• Peripheral edema (swelling of hands/feet/legs)
• Nausea and vomiting
• Blurred or double vision (dose-related)
• Weight gain (with long-term use)
• Memory and concentration difficulties

Serious side effects — seek immediate care:

• Respiratory depression (life-threatening, especially with opioids or CNS depressants)
• DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) — fever, rash, multi-organ involvement
• Suicidal thoughts or behavior (FDA class warning for all antiepileptic drugs)
• Anaphylaxis / severe allergic reactions
• Withdrawal syndrome with abrupt discontinuation (anxiety, insomnia, seizures)

Final Thoughts on Gabapentin

Gabapentin is one of the most versatile and widely used medications in modern medicine. With FDA-approved applications for epilepsy, postherpetic neuralgia, and restless legs syndrome — and a broad range of evidence-supported off-label uses — it fills an important role in treating conditions that often prove resistant to other therapies. Its relative affordability (as low as $2 with a coupon) makes it accessible to most patients.

Key safety reminders: never stop Gabapentin abruptly, avoid combining it with opioids or alcohol without medical supervision, and ensure dose adjustment if you have kidney disease. As with any CNS-active medication, monitoring for mood changes, suicidal ideation, and respiratory symptoms is important.

If you're having trouble finding Gabapentin at your local pharmacy, Medfinder makes it easy to check real-time pharmacy inventory near you, compare prices, and find your medication without calling pharmacies one by one. Use our free pharmacy lookup tool to locate your dose and get back to focusing on your health.