Gabapentin

Indications
Oral
Epilepsy
Adult: Initially, 300 mg on the 1st day, 300 mg bid on the 2nd day and 300 mg tid on the 3rd day. Thereafter, may increase dose until effective antiepileptic control is achieved. Usual maintenance range: 0.9-3.6 g daily; daily dose to be taken in 3 equally divided doses and max dosing interval: 12 hr. Max: 4.8 g daily.
Child: 6-12 yr: Initially, 10 mg/kg on the 1st day, 20 mg/kg on the 2nd day and 25-35 mg/kg on the 3rd day. Maintenance: 1200 mg daily (37-50 kg); 900 mg daily (26-36 kg). Total daily dose to be taken in 3 equally divided doses.
Renal impairment: Total daily doses to be taken as 3 divided doses. Haemodialysis: Loading dose: 300-400 mg followed by 200-300 mg after each 4 hr of haemodialysis.
CrCl (ml/min)Dosage Recommendation
50-79600-1200 mg daily.
30-49300-600 mg daily.
15-29300 mg on alternate days to 300 mg daily.
<15300 mg on alternate days.

Oral
Neuropathic pain
Adult: Titrate to a max of 1.8 g daily in 3 divided doses.
Renal impairment: Total daily doses to be taken as 3 divided doses. Haemodialysis: Loading dose: 300-400 mg followed by 200-300 mg after each 4 hr of haemodialysis.
CrCl (ml/min)Dosage Recommendation
50-79600-1200 mg daily.
30-49300-600 mg daily.
15-29300 mg on alternate days to 300 mg daily.
<15300 mg on alternate days.


Special Populations: Renal impairment: CrCl: 50-79 mL/min: 600-1200 mg daily; 30-49 mL/min: 300-600 mg daily; 15-29 mL/min: 150 mg daily (or 300 mg every other day) to 300 mg daily; <15 mL/min: 150 mg daily (or 300 mg every other day). To be given in 3 divided doses. Recommended loading dose for patients undergoing haemodialysis who have never received gabapentin: 300-400 mg, followed by 200-300 mg after each 4 hr of haemodialysis.
Contraindications
Hypersensitivity. Lactation.
Warnings / Precautions
Discontinuation or transfer from other antiepileptics, history of psychotic illness; renal impairment; pregnancy. Gradual withdrawal over at least 7 days to prevent an increase in seizure frequency.
Adverse Reactions
Somnolence, dizziness, ataxia, weakness, paraesthesia, fatigue, headache; nystagmus, diplopia; nausea, vomiting, wt gain, dyspepsia; rhinitis; tremor; leucopenia; altered LFTs; Stevens-Johnson syndrome.
Drug Interactions
Cimetidine may reduce gabapentin clearance. Absorption reduced with antacids.
See Below for More gabapentin Drug Interactions
Lab Interactions
False-positive readings with some urinary protein tests.
Mechanism of Actions
Gabapentin is structurally related to the neurotransmitter GABA but is neither a GABA agonist nor antagonist. Gabapentin-binding sites have been identified throughout the brain tissues e.g. neocortex and hippocampus. However, the exact mechanism of action is still unknown.
Absorption: 50-60% absorbed (oral); peak plasma concentrations after 2 hr.
Distribution: Widely distributed; enters breast milk. Protein-binding: Minimal.
Metabolism: Poor.
Excretion: Urine and faeces; 5-7 hr (elimination half-life).
Administration
May be taken with or without food.
Storage Conditions
Oral: Store at 20-25°C. Oral solution: Refrigerate at 2-8°C.
ATC Classification
N03AX12 - gabapentin ; Belongs to the class of other antiepileptics.
Storage
Oral: Store at 20-25°C. Oral solution: Refrigerate at 2-8°C.
Available As
  • Gabapentin 10 mg
  • Gabapentin 100 mg
  • Gabapentin 200 mg
  • Gabapentin 250 mg
  • Gabapentin 300 mg
  • Gabapentin 400 mg
  • Gabapentin 450 mg
  • Gabapentin 600 mg
  • Gabapentin 800 mg
  • Gabapentin 900 mg
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