MY neighbor who is one of my many about brain dead friends has benign skin cancer, high blood pressure, high cholestrol and IS an alcoholic. His boss sends him home insisting he is drunk a lot of times. He insists it is the medications. I tell him it is the beer he drinks all day on top of the medications. He takes B1, a cholestrol medicine, and 30 mg gabapentin. He says the doctor gave him the gabapentin for the high blood pressure. He quit taking that in the morning because he said that was what was making him weak and 'looking drunk' So he goes doubling it up at night to make up for not taking it before work. I told him that if that is for high blood pressure and he isn't taking it in the A.M. and then doubling up at night he is making his blood pressure go crazy. Now he tells me he had a seizure yesterday. I asked him is he still taking the gabapentin doubled at night. He said he is. I told him that I thought I got him to understand that he can't take it that way and he needs to not double up at night. Knowing him he will forget and still do that. My question is what all can I tell him to get him to realize how bad it is to double it at night and not take it in the A.M.
Although I doubt I can convince him to take it in the A.M. I at least want to get him to realize he can't double it up at night.

Thanks

You tell him that his blood pressure will bottom out and that his heart may not be able to recover from that.

While the blood pressure bottoms out, the heart has to work harder to recover from that. If he continues to double at night, he may not have a chance to ever take it in the morning.

He really needs to stop drinking, this could lower his BP alone.

Thanks I wish I could find a way to get it to sink into his head. And he is a burnt out alcoholic. I know it is useless to think he will stop drinking. Told him he has his blood pressure on a roller coaster ride doing that.

Kk hold on, I'm looking in my text... You say he said he had a seizure?

Yeah he had two in the summer and one yesterday.

Okay, this is strange, but Gabapentin is an Anticonvulsant, has nothing to do with High Blood Pressure. It is being used investigationally for tremors in MS, neuropathic pain, bipolar disorder, migraine prophylaxis and diabetic neuropathy.

I don't even see where it is available in 30mg doses. My text lists capsules in 100 mg and up to 800 mg.

Now, for the side effects, it does list dizziness, fatigue, anxiety, and unsteady gait, so he very well could be looking drunk at work.

Now, I also see the Interactions that are listed and Alcohol will most definitely increase the effects of the drug and the drug will increase the effects of the alcohol.

I kind of figured, thanks. I will have to check his bottle he might have meant 300 mg. I don't know why he isn't on a high blood pressure pill cause that seems to be more the problem than the seizures. He says they are high blood pressure pills but he can't even remember anything to get it right. The seizures seem more like a symptom especially since they are few and far between.

Yeah, there is a 300 mg capsule, so that is probably what he is on. But Mosby's says this is definitely a med for seizure disorder not HTN. But for seizure disorder it is recommended that he even take a higher dosage in three divided doses per day. Hmmmmm

Gabapenten might also be prescribed for the skin cancer to reduce pain and to help with seizures. I've taken 3600 mg/day. At higher than that level, I'll spin and loose balance. Off label use, so I won't get into that.