Gabapentin

Introduction: Gabapentin is a medicine used to relieve the pain caused by nerve damage (neuropathic pain) due to various conditions like diabetes, shingles (herpes zoster infection), spinal cord injury, etc. It is also used to treat certain types of seizures (fits) in combination with other medicines.

How it works: Gabapentin is an antiepileptic medication that works by reducing the abnormal electrical activity in the brain, thus preventing seizures. It also blocks pain by interfering with pain signals travelling through the damaged nerves and the brain.

Important Information: This medicine may be taken with or without food, but it is important to take it at the same time each day. Your doctor will probably start at a low dose and increase it gradually. Do not stop taking Gabapentin suddenly as it may increase the frequency of seizure.

• Neuropathic Pain
• Adjunctive therapy in partial seizure and secondary generalized seizure

Adjunct anti-epileptic drugs

Anticonvulsant

Gabapentin is an anti-convulsant. It is a structural analog of gamma-amino-butyric-acid (GABA). All pharmacological actions following administration of Gabapentin are due to the activity of parent compound. Gabapentin binds with the alpha-2-delta subunit of voltage gated L-type Calcium channel, and inhibits branched chain amino acid transferase and probably inhibits neurotransmitter release of excitatory amino acid.

Gabapentin binds to the alpha-2-delta subunit of voltage-gated calcium channels, reducing the release of excitatory neurotransmitters, thereby controlling seizures and neuropathic pain.

Neuropathic Pain:

• Day 1: 300 mg single dose
• Day 2: 300 mg twice daily
• Day 3: 300 mg three times daily
• Titrate up as needed to 1800 mg/day (divided TID)

Epilepsy (12+ years):

• Effective dose: 900-1800 mg/day (3 divided doses)
• Starting dose: 300 mg three times daily

Children (3-12 years):

• Starting dose: 10-15 mg/kg/day (3 divided doses)

Renal Impairment: Dose reduction required.

* Use as directed by the registered physician

Oral capsule/tablet. Can be taken with or without food, but better to take at a fixed time. Swallow whole, do not chew or crush.

If you miss a dose, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common Side Effects:

• Fatigue
• Dizziness
• Ataxia
• Weight gain
• Peripheral edema
• Dry mouth
• Somnolence
• Nausea
• Vomiting
• Fever
• Nystagmus

Precautions:

• Take only as prescribed.
• Do not drive or operate machinery until you know how this medicine affects you.
• Dose reduction needed in renal impairment.
• Do not take antacids 2 hours before or after taking Gabapentin (reduces absorption).

Contraindications:

• Hypersensitivity to gabapentin
• Lactation

Drug Interactions:

• Morphine may increase plasma levels.
• Antacids reduce absorption.

Food Interactions:

• Alcohol may cause excessive drowsiness.

Use in Pregnancy: May be unsafe during pregnancy. Animal studies have shown harmful effects. Your doctor will weigh the benefits and risks.

Use in Lactation: Probably safe during breastfeeding. Baby should be monitored for excessive sleepiness and weight gain.

Pediatric Use: Dosage available for children 3-12 years.

Geriatric Use: Elderly patients are more likely to have decreased renal function - use with caution.

Renal Impairment: Use with caution in kidney disease. Dose adjustment may be needed based on CrCl.

Hepatic Impairment: Limited information available. Please consult your doctor.

Overdose: Overdose may cause drowsiness, dizziness, ataxia. Gastric lavage and supportive care.

Storage: Store below 25°C, away from light and moisture. Keep out of reach of children.

Gabapentin Capsule/Tablet