Pregnant women who get shingles, the painful, blistering skin rash resulting from reactivation of the varicella zoster virus – chickenpox —  must make a difficult decision whether to treat the pain  with medication.

Neurontin (gabapentin) is an anticonvulsant and analgesic that can help ease shingles’ symptoms until the condition improves, which typically takes between two and four weeks.

While Neurontin, made by Pfizer, is one of the most widely prescribed drugs on the market, it is recommended that doctors only prescribe it to pregnant women when the benefit outweighs the risk. That’s because there is some indication that taking Neurontin while pregnant could lead to birth defects — a risk that some birth defect lawsuits claim Pfizer failed to adequately warn about.

Pregnancy Risks

Gabapentin is a pregnancy category C, meaning that animal studies have shown evidence of fetotoxicity involving delayed ossification in several bones of the skull, vertebrae, forelimbs and hindlimbs as well as hydroureter and hydronephrosis, according to drugs.com.

Animals given high doses of gabapentin showed bone and kidney problems. It is not known whether Neurontin passes into breast milk.

The drug first received FDA approval as an adjunct treatment for partial epileptic seizures in adults and children and in 2002 was cleared to treat post-herpetic neuralgia (PHN), or the nerve pain due to damage caused by shingles.

Understanding Shingles

Shingles is a reactivation of the chickenpox virus, which remains in the nerve cells of the body in those who have had it. If you’ve ever had chickenpox, you are at risk of developing shingles later in life as the virus is dormant in the body.

Since 1995 there has been a varicella (chickenpox) vaccine available, which has resulted in a drastic reduction of the virus, which spreads easily when an infected person sneezes, coughs or shares food or drinks.

People who have never had chickenpox can catch it from a person with shingles, though in order to get shingles the person must have previously had chickenpox.

Those at greatest risk for contracting shingles are people over age 50 and/or those who have a weakened immune system from another disease, such as leukemia, diabetes or HIV. Stress or trauma are also considered shingles risk factors as are medications like steroids or undergoing cancer treatment, something that is known to compromise the immune system.

The hallmark of a shingles rash is a band around or across one side of the body – most often the chest or stomach — forming a characteristic pattern because the virus works down the nerves that branch out from the spinal cord and encircle the body.

When the shingles pattern first appears it is in the form of a painful rash or blisters that will eventually scab over before the rash disappears. Skin usually returns to normal with the exception of scarring if it is a severe case. It is rare for someone to get shingles more than once.