The drug

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One of the most commonly prescribed drugs in human medicine, gabapentin also is used abundantly in veterinary practice.

Starting Saturday, veterinarians in North Carolina are required to report when they dispense the drug gabapentin in quantities greater than a 48-hour supply.

A March 1, 2025, reporting date for veterinarians was established in a law passed in 2023 as part of an effort to reduce harmful interactions of gabapentin and opioids in people. Pharmacies were required to report on gabapentin starting in 2024.

If dispensed in a compounded preparation in dosages of 100 mg or less, gabapentin need not be reported.

The anti-seizure and neuropathic pain medication is used in both human and veterinary medicine. Common applications for gabapentin in veterinary practice include short-term use — such as to ease an anxious cat for a trip to the clinic — or long-term treatment of chronic pain caused by conditions such as arthritis or intervertebral disk disease (IVDD), a degeneration of spinal disks in dogs.

Dr. Meghan Ellis, a veterinarian in Sanford, North Carolina, said she mostly prescribes gabapentin for pain or sedation, usually a bottle of 100 capsules at a time in 100 mg or 300 mg dosages. "Unfortunately, I do have a lot of pets who have chronic neurologic pain," she said. "IVDD is pretty common, especially among large breed dogs."

Ellis' practices are in step with larger trends. In a 2021 survey of 529 veterinarians in Canada and the United States, 69% of respondents reported prescribing gabapentin daily or weekly, according to results published in Veterinary Anaesthesia and Analgesia. In a 2017 quick poll by the Veterinary Information Network, an online community for the profession, 81% of 2,064 respondents said they prescribed gabapentin in some way for acute pain management. When the same poll question was asked in 2024, the number had risen to 93% of 2,779 respondents.

North Carolina joins a handful of other states, such as Connecticut and Indiana, that require veterinarians to report gabapentin to the state's prescription drug monitoring program, owing to the potential health risks of using gabapentin in conjunction with opioids.

Though overdose potential is low for gabapentin on its own, a 2019 study in Clinical Toxicology reports that misuse of gabapentin has increased in recent years. Authors of a literature review published in 2020 in the Journal of Infection and Public Health found that prescription drug monitoring programs can be useful in reducing misuse.

Gabapentin was approved by the FDA in 1993 under the brand name Neurontin. It was sold by Warner-Lambert, which was later acquired by Pfizer. It's been available as a generic drug since 2004. Gabapentin is approved for use in people to treat seizures and manage nerve pain caused by shingles. The medication is labeled for use only in humans, but it is common and lawful for human medications to be used in veterinary patients.

However, drug companies are not allowed to market their products for so-called off-label or extralabel uses. In 2004, Pfizer pleaded guilty to civil and criminal charges related to promoting gabapentin for uses that are not on the label, such as bipolar disorder and migraine headaches.

Pfizer was fined, but gabapentin use continued to balloon: Prescriptions for gabapentin for human patients nearly doubled between 2009 and 2016, according to a study in the Journal of Managed Care and Specialty Pharmacy. In 2019, it was the seventh most prescribed drug in the country, the U.S. Centers for Disease Control and Prevention reported.

"It's become a we-don't-know-what-else-to-do drug," Dr. Michael Steinman, a physician and co-director of the U.S. Deprescribing Research Network, was quoted as saying in a 2024 New York Times article headlined "The Painkiller Used For Just About Anything." (The article is behind a paywall.)

Some veterinary professionals believe that gabapentin is prescribed too readily in veterinary medicine, too. A message board discussion on VIN titled Is gabapentin being overused? drew more than 150 posts and stimulated vigorous conversation in 2022.

Solid evidence one way or another is hard to come by, as there are few published studies on gabapentin use and prescription-writing rates in veterinary practice.

Information on the drug's efficacy in veterinary patients is likewise limited, according to Dr. Lydia Love, a veterinary specialist in anesthesia and analgesia who practices in North Carolina.

She said veterinarians gravitate toward gabapentin for pain of any type because it is inexpensive, reasonably safe and is not a controlled substance at the federal level nor the state level in most states.

"The disadvantage of prescribing gabapentin for analgesia mostly revolves around the fact that there's very little evidence in veterinary medicine for this use," Love told VIN News in an interview by email.

"Gabapentin is not a substitute for opioids, or NSAIDs, for that matter," she said, referring to nonsteroidal anti-inflammatory medications. "It is likely more effective in specific chronic neuropathic pain states, but there's so much still to learn about those conditions that treatment — and actual diagnoses — are not always straightforward."

Love predicts that the rule change in North Carolina will cause some veterinarians to shift gabapentin dispensing to outside pharmacies.

Dr. Shannon Bass, president of the North Carolina Veterinary Medical Association (NCVMA), recommends exactly that. "I'm advising veterinarians, if you don't want to mess with the reporting, then don't," she said.

Ellis is in accord. Submitting reporting paperwork several times per week would require setting aside time for the veterinarian or a staff member, "which I'm not going to do," Ellis said. "Nobody's got time for that."

Bass said the NCVMA has been sending information to its members to try to answer questions about the rule change. One veterinarian told her that sending prescriptions to an outside pharmacy means losing the income associated with filling the prescription in-clinic.

The counterpoint, Bass said, is that retaining those prescriptions entails the labor cost of having a clinic employee handle the reporting.

To ease the transition, she recommends veterinarians have conversations as soon as possible with clients whose pets are on gabapentin and to make sure all clinic staff are aware of the change in procedure.