Off-Label Prescription
Prescription Medicine

Gabapentin for Hot Flashes

An off-label gabapentin prescription that may reduce hot flashes. Pregabalin is a related gabapentinoid but is not recommended for hot flashes.

Last verified:

Gabapentin for Hot Flashes (Prescription Medicine)
Method at a Glance
Efficacy

45 out of 100 people reduction in hot flash frequency .

Typical use outcome rate.

DurationDaily pill (ongoing)
Cost$4–$30
/monthly
Used forHot flash & night sweat relief
PrescriptionRequired
Available Products

1 product in this category

Specific branded items that use this method. Compare manufacturer details, active ingredients, and regulatory status.

Off-Label
GA
Oral Capsule

Gabapentin

A low-cost generic gabapentinoid prescribed off-label to reduce menopause hot-flash frequency.

Gabapentin for Hot Flashes
The details

What the evidence says

How well it works, what to watch for, who should avoid it, and the studies behind it.

How well it works
45%reduction in hot flash frequency

Around 45% reduction in hot flash frequency.

How was this measured?▾

Guttuso 2003 RCT (n=59): 45% reduction in hot flash frequency at 12 weeks vs 29% placebo. NAMS 2023 Level I recommendation applies to gabapentin for hot flashes; pregabalin is not recommended (Level III).

Source studyObstet Gynecol 2003 (Guttuso 2003, PMID 12576259)
Why we rate it this wayNAMS 2023 Nonhormone Therapy Position Statement
Cost & insurance
$4–$30/monthly

Generic gabapentin is inexpensive; insurance usually covers

Insurance CoverageUsually
Duration & reversibility
Lasts forDaily pill (ongoing)
Reversibility
Reversible
The science
Clinical classGabapentinoid
How it works in the body

Gabapentin binds to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, which may calm overactive temperature regulation and reduce hot flash frequency. Pregabalin binds the same target but NAMS 2023 does not recommend it for hot flashes.

Regulatory status
StatusOff-Label Prescription
Used forHot flash & night sweat relief
PrescriptionRequired
Side effects
  • Drowsiness
  • Dizziness
  • Fatigue
  • Headache
  • Weight gain
  • Peripheral edema
Who shouldn't use this
  • •Hypersensitivity to gabapentin or any ingredient(An allergy or sensitivity to the medicine, device, or one of its ingredients)
  • •Severe renal impairment (requires dose adjustment)(Reduced kidney function or kidney disease)
Clinical Guidelines
NAMS

2023 Position Statement - Level I recommendation for gabapentin for hot flashes; pregabalin is not recommended

View Guideline
The full picture

What to know about Gabapentin for Hot Flashes

How it works

Gabapentin is a prescription drug approved for seizures and nerve pain. It is also used off-label for menopause hot flashes. It binds to calcium channels in the central nervous system, which may calm the overactive temperature regulation that triggers hot flashes. Pregabalin is a related gabapentinoid, but NAMS 2023 does not recommend it for hot flashes.

How well it works

A 2003 randomized controlled trial by Guttuso et al. found that gabapentin reduced hot flash frequency by 45% at 12 weeks, compared to 29% with placebo. The Menopause Society (NAMS 2023) lists gabapentin as a Level I recommendation for hot flashes. Pregabalin, a related gabapentinoid, is not recommended. Gabapentin is often taken at bedtime because drowsiness is a common side effect, which can also help with sleep.

Side effects and cautions

Gabapentin is not FDA-approved for hot flashes, so this use is off-label. Common side effects include drowsiness, dizziness, and fatigue. People with kidney disease need dose adjustments. If you have a history of substance use disorder, talk to your clinician before starting gabapentin, because it can be misused and dependence is possible (Smith 2016 systematic review).

Where to get it

Generic gabapentin is inexpensive and usually covered by insurance. You need a prescription, which you can get through telehealth or your primary care provider.