Gabapentin is indicated for-
- Neuropathic Pain.
- Adjunctive therapy in partial seizure and secondary generalized seizure.
Adjunct anti-epileptic drugs
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 & probably inhibits neurotransmitter release of excitatory amino acid.
Neuropathic Pain: The treatment may be initiated as a single 300 mg dose on Day-1, than 300 mg twice on Day-2 and 300 mg thrice on Day-3. The dose can be subsequently be titrated up as needed for pain relief to a daily dose of 1800 mg (divided TID).
- Patients over 12 years of age: the effective dose of Gabapentin is 900 to 1800 mg/day given in three divided doses. The starting dose is 300 mg three times a day.
- Paediatric patients age 3-12 year: the starting dose should range from 10-15 mg/kg/day in 3 divided doses, and the effective dose reached by upward titration over a period of approximately three days.
Gabapentin can be taken orally with or without food.
Antacids may reduce the bioavailability of Gabapentin by up to 20 %. Cimetidine may alter its reanal excretion. Gabapentin does not interact with other anti-epileptic drug or with oral contraceptive preparations.
Gabapentin is contraindicated in patients who have known hypersensitivity to the drug.
Fatigue, Dizziness, ataxia, weight gain, peripheral edema, dry mouth and somnolence may occur.
Pregnancy & Lactation
Pregnancy category C. it should be used during pregnancy only if potential benefits justifies the potential risk to the fetus. Gabapentin may be secreted through the breast milk. So it should be used during lactation only if potential benefits justifies the potential risk to the baby.
Precautions & Warnings
Patients should be instructed to take Gabapentin only as prescribed. While using Gabapentin patients should be instructed either not to drive a car or to operate other complex machinery until they have gained sufficient experiences about Gabapentin whether or not it affects their mental and/or motor performance adversely.
Use in Special Populations
In case of renal impaired patients Gabapentin doses must be reduced.
Store below 25°C temperature. Protect from light and moisture. Keep all the medicines out of the reach of the children.
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