Gabapentin

Gabapentin is a medication which is used to treat epilepsy (specifically partial seizures), neuropathic pain, hot flashes, and restless legs syndrome. It is recommended as one of a number of first-line medications for the treatment of neuropathic pain caused by diabetic neuropathy, postherpetic neuralgia, and central neuropathic pain.

Molecular Structure

Gabapentin

Class of Drug

Anticonvulsant.

Mechanism of Action

Unknown.

Indications / Dosage / Route

Routes of Administration: Oral only.

Condition: Adjunct for treating partial and secondary generalized seizures that do not respond to other drugs

Dose: Adults, children >12 years: Initial: 300 mg t.i.d. Main­tenance: 900-1800 mg/d, 3 divided doses. Maximum: 3600 mg/d.

Adjustment of Dosage

Kidney disease: Creatinine clearance 30-60 mL/min: 300 mg b.i.d.; creatinine clearance 15-30 mL/min: 300 mg/d; creatinine clearance 15 mL/min: 300 mg q.o.d.

Liver disease: None.

Elderly: Use with caution because of age-related decrease in renal function.

Pediatric: Safety and effectiveness have not been established in children <12 years.

Food and Drug Interactions

Food: No restrictions.

Pregnancy: Category C.

Lactation: No data available. Best to avoid.

Contraindications: Hypersensitivity to gabapentin

Warnings / Precautions

> Use with caution in patient with renal insufficiency, elderly.

> Do not withdraw gabapentin suddenly because there is a risk of precipitating seizures. Withdraw over a period of about 1 week.

Clinically Important Drug Interactions

> Drugs that decrease effect/toxicity of gabapentin: antacids.

> Drug that increases effect/toxicity of gabapentin: cimetidine.

Adverse Reactions

> Common: dizziness (15%), ataxia (12%), fatigue, somnolence.

> Serious: depression, leukopenia, bronchospasm, nystagmus, diplopia, pancreatitis, thyroid abnormalities, personality changes, poor coordination.

Parameters to Monitor

> CBC with differential and platelets, serum BUN and creatinine.

> CNS side effects.

Advice to Patient

> Take first dose h.s.

> Do not take gabapentin within 2 hours of an antacid.

> Notify dentist or treating physician prior to surgery if taking this medication.

> Cany identification card at all times describing disease, treatment regimen, name, address, and telephone number of treating physician.

> Avoid alcohol.

> Avoid driving and other activities requiring mental alertness or that are potentially dangerous until response to drug is known.

Further Useful Info

> Gabapentin is used as an adjunct in the treatment of partial and secondary generalized seizures in adults.

> Off-label indications include treatment of chronic pain syndromes.

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