Understanding Your Condition
What is postherpetic neuralgia?
Postherpetic neuralgia (or PHN) is a term used to describe the sharp, burning pain that some people experience after an outbreak of shingles (that's why it's often referred to as "after-shingles pain"). Some people may also experience sensitivity to light touch, itching, and numbness around the affected area of skin, but these symptoms are less common. In very rare cases, weakness or paralysis can occur.1 Many patients with after-shingles pain may have trouble sleeping.2

What causes PHN?
PHN occurs when nerves in your skin are damaged by an outbreak of shingles.
Shingles is a term used to describe the symptoms that come about when the virus that causes chicken pox—varicella zoster virus—becomes reactivated. The chicken pox virus, like all herpes viruses, never really goes away, it just hides dormant (inactive) in your body for long periods of time.3
A common place for the chicken pox virus to hide is in the nerves that innervate your skin. Even after years of dormancy the virus can suddenly reactivate, causing shingles (and not the symptoms of shingles).3
When the chicken pox virus reactivates, it travels along the nerves to the skin resulting in a rash, blisters, and pain known as shingles. In some people, the pain continues after the shingles rash has healed. This is called PHN and the pain results from nerve damage caused by the virus.4
Do not take GRALISE if you are allergic to gabapentin or any of the ingredients in GRALISE.
Indication and Usage
GRALISE is a prescription medicine used in adults, 18 years and older, to treat pain from damaged nerves (neuropathic pain) that follows healing of shingles (a painful rash that comes after a herpes zoster infection).

Important Safety Information
Do not take GRALISE if you are allergic to gabapentin or any of the ingredients in GRALISE.

Do not change your dose or stop taking GRALISE without talking with your healthcare provider. If you stop taking GRALISE suddenly, you may experience side effects. Talk with your healthcare provider about how to stop GRALISE slowly.

Like other antiepileptic drugs, gabapentin, the active ingredient in GRALISE, may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. However, it is not known if GRALISE is safe and effective in people with seizure problems (epilepsy). Therefore, GRALISE should not be used in place of other gabapentin products.

It is not known if GRALISE is safe and effective in children under 18 years of age with postherpetic pain.

Before taking GRALISE, tell your healthcare provider if you:
  • have or have had depression, mood problems or suicidal thoughts or behavior
  • have seizures
  • have kidney problems or get kidney dialysis
  • are pregnant or plan to become pregnant. Tell your healthcare provider right away if you become pregnant while taking GRALISE.
  • are breastfeeding or plan to breastfeed. GRALISE can pass into your breast milk.
Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins or herbal supplements. Taking GRALISE with certain other medicines can cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider.

Do not drink alcohol or take other medicines that make you sleepy or dizzy while taking GRALISE without first talking to your healthcare provider. Taking GRALISE with alcohol or medicines that cause sleepiness or dizziness may make your sleepiness or dizziness worse.

Do not operate heavy machines or do other dangerous activities until you know how GRALISE affects you. GRALISE can slow your thinking and motor skills.

The most common side effect of GRALISE is dizziness. Tell your healthcare provider about any side effect that bothers you or that does not go away. This is not the only possible side effect of GRALISE. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. You may also report negative side effects to Depomed at 1-866-458-6389.

References: 1. MayoClinic.com. Postherpetic neuralgia. http://www.mayoclinic.com/health/postherpetic-neuralgia/DS00277. Accessed May 22, 2012. 2. Drolet M, Brisson M, Schmader KE, et al. The impact of herpes zoster and postherpetic neuralgia on health-related quality of life: a prospective study. CMAJ. 2010;182(16):1731-1736. 3. Plotkin SA, Orenstein WA, Offit PA. Vaccines, 5th ed. Saunders, 2008. 4. Matlin HJ, Foley MW. Sensation and Perception, 5th ed. Allyn
& Bacon; June 26, 2009. 5. GRALISE [prescribing information]. Newark, CA: Depomed Inc.; December 2012. 6. Data on file. Depomed Inc.

Please see full Prescribing Information and Medication Guide.
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