Gabapentin

Information for patients and healthcare professionals

Dr Rahul Seewal

2013 Dr Rahul Seewal. All rights reserved

Gabapentin (Neurontin ) Indication Gabapentin is available in form of capsules, tablets or an oral solution. In clinical studies, it is effective in treatment of Post herpetic Neuralgia and epilepsy. Dose Schedule The usual dose is between 300 and 600 mg taken 3 to 4 times a day. It is advisable to start on a small dose and allow your body to get used to the medicine and gradually increase the dose every 3 - 4 days by 300 mg.

Day of treatment
1 4 8 12

Morning Dose 150 - 300mg 300mg 300mg 600mg

Afternoon Dose 300mg 300mg 600mg 600mg

Bedtime dose 300mg 600mg 600mg 600mg

The table for dose adjustment is for guidance only. The dose increment can be done over a longer period of time or more gradually. Please contact us if you have any doubts or are experiencing side effects. Potential side effects Drowsiness Weight gain Behaviour changes like thought disorders, hostility (specially in children) Mood swings Suicide ideation - PLEASE STOP TREATMENT!!! DRESS syndrome - fever, skin rash, enlargement of glands (lymph nodes) Dizziness Swelling in hands and feet To be avoided during pregnancy and lactation. Medical Stuff Gabapentin is structurally related to GABA (an inhibitory neurotransmitter in nervous system) but does not appear to act through GABA receptors. The exact mechanism of action in neuropathic pain is not known. As the oral dose increases, bioavailability decreases ( 60% at 900mg / day, 27% at 4800mg/day). It is not bound to proteins and does not go first pass metabolism or have active metabolites. It is renally excreted, requires dose adjustment according to creatinine clearance and is cleared from circulation during haemodialysis. Precautions

Co - administration with Naproxen increases the absorption of Gabapentin by 12 - 15 %. Morphine increases the absorption by up to 40%. Its safety in pregnancy has not been studied. It is likely to be teratogenic. It is excreted in breast milk. Carcinogenic effect There is a statistical (not clinically significant) increase in the incidence of pancreatic acinar cell carcinoma in male rats. This did not affect survival, as the tumour is neither locally invasive nor metastatic.