Is Gabapentin (Neurontin) safe during pregnancy?
What the FDA-approved label for Gabapentin (Neurontin) actually states in its Pregnancy Risk Summary — not a secondhand verdict. The decision is one to make with your prescriber.
What the label’s pregnancy summary says
The label states there are no adequate data on the developmental risks of gabapentin in pregnant women. Animal studies (mice, rats, rabbits) showed developmental toxicity — increased fetal skeletal/visceral abnormalities and increased embryofetal mortality — at doses similar to or lower than clinical doses, though the clinical significance is unknown. Because gabapentin is an antiepileptic drug, the label directs pregnant patients to enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry (1-888-233-2334). It does not declare the drug safe or unsafe in pregnancy; discuss use with your prescriber.
Frequently asked questions
Is Gabapentin safe to take during pregnancy?
The honest answer is uncertainty: the label does not have enough pregnancy data to call Gabapentin safe or unsafe (summary above). That is a "decide with your prescriber" situation, weighing your condition against the unknown, not a green or red light. The one universal rule: do not start or stop a medication in pregnancy without medical advice — an untreated condition can carry its own risk to a pregnancy.
What does the FDA label say about Gabapentin in pregnancy?
The summary above is transcribed from the label's Pregnancy Risk Summary (§8.1). Since 2015 FDA labels replaced the old A/B/C/D/X letter categories with a narrative that describes what human and animal data actually show, which is what you are reading here — not a single letter grade.
Is Gabapentin safe while breastfeeding?
That is a separate question the label answers in a different section (§8.2, Lactation), and it does not always match the pregnancy verdict. This page covers pregnancy only. For breastfeeding, ask your prescriber or pharmacist, or check the NIH LactMed database, which summarizes the drug-in-breast-milk evidence.
The questions people actually ask about gabapentin in pregnancy
Answered by MotherToBaby, the fact sheets written by the Organization of Teratology Information Specialists and published through the NIH. Quoted in full — we do not condense them.
I take gabapentin. Can it make it harder for me to get pregnant?
It is not known if gabapentin can make it harder to get pregnant. Sexual dysfunction (including loss of desire to have sex and loss of ability to have an orgasm) has been reported among people who take gabapentin.
Does taking gabapentin increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if gabapentin can increase the chance of miscarriage in humans. Animal studies reported an increased chance for miscarriage.
Does taking gabapentin increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Small, controlled studies on gabapentin have not suggested an increased chance of birth defects. There is also no known pattern of birth defects associated with the use of gabapentin in pregnancy.
One study looked at the pregnancy outcomes of women who received prescriptions for gabapentin. When looking at the outcomes of all the study participants, gabapentin exposure during early pregnancy does not appear to increase the chance of birth defects above the background risk. When the authors only looked at the data from participants who filled at least two prescriptions for gabapentin in the first trimester, an increased chance of heart defects was seen. Studies based on prescriptions cannot tell if a person took the medication, so it is hard to know if the outcomes are related to the medication being studied or other factors.
Gabapentin might lower levels of folic acid in people who take this medication. Some professional organizations recommend that women on this type of medication take a higher dose of folic acid, while other groups do not. Talk with your healthcare provider about how much folic acid is right for you. Please see our MotherToBaby fact sheet and baby blog on folic acid/folate at https://mothertobaby.org/fact-sheets/folic-acid/ and https://mothertobaby.org/baby-blog/folic-acid-is-more-really-better/ .
Does taking gabapentin in pregnancy increase the chance of other pregnancy-related problems?
Pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) have been reported in some studies looking at the use of gabapentin during pregnancy. However, is hard to know if these problems are from the gabapentin, from the underlying health condition(s) being treated, or other factors.
I need to take gabapentin throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?
Studies have not been done to see if gabapentin use alone can cause withdrawal in a newborn. One study found that when gabapentin is combined with opioids late in pregnancy, withdrawal can occur. It is not known how often withdrawal occurs in babies exposed to this combination. It is important that your healthcare providers know you are taking gabapentin so that if symptoms occur your baby can get the care that is best for them. The baby can be monitored for symptoms such as unusual eye, tongue, and/or muscle movements, restlessness of the arms and legs, and arching of the back after birth.
Does taking gabapentin in pregnancy affect future behavior or learning for the child?
One study that looked at 378 children exposed to gabapentin during pregnancy did not find an increased chance of conditions that affect how the brain works (neurodevelopmental disorders), conditions that cause problems with social and communication skills (pervasive developmental disorders), intellectual disability, or communication-related disorders.
If a man takes gabapentin, could it affect fertility or increase the chance of birth defects?
Sexual dysfunction, such as loss of desire to have sex and loss of ability to have an erection, ejaculate, and/or have an orgasm, has been reported in people using gabapentin. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/ .
Quoted from MotherToBaby Fact Sheets — Gabapentin, published January 2024. MotherToBaby states its fact sheets should not take the place of medical care and advice from your healthcare providers.
Breastfeeding is a separate question — what LactMed says about gabapentin
More guides for Gabapentin
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The pregnancy information is transcribed from the drug’s FDA-approved label (§8.1) and mirrors what the label states — “insufficient data” is never rounded up to “safe.” This is general reference information, not medical advice. Whether to take any medication in pregnancy is a decision for you and your prescriber; do not start or stop a drug on your own, because an untreated condition can also carry risk.