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Gabapentin | Neurontin is used with other medications to prevent and control seizures. It is also used to relieve nerve pain following shingles in adults. Gabapentin is known as an anticonvulsant or antiepileptic drug.

Therapeutic Class

Adjunct anti-epileptic drugs

Pharmacology

Gabapentin/Neurontin 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.

Dosage

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).

Epilepsy:

Patients over 12 years of age: the effective dose of Gabapentin/Neurontin 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.

Administration

Gabapentin can be taken orally with or without food.

Interaction

Antacids may reduce the bioavailability of Gabapentin by up to 20 %. Cimetidine may alter its renal excretion. Gabapentin does not interact with other anti-epileptic drug or with oral contraceptive preparations.

Contraindications

Gabapentin/Neurontin is contraindicated in patients who have known hypersensitivity to the drug.

Side Effects

Drowsiness, dizziness, loss of coordination, tiredness, blurred/double vision, unusual eye movements, or shaking (tremor) may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: swelling of the hands/ankles/feet.

A small number of people who take anti-convulsants for any condition (such as seizures, bipolar disorder, pain) may experience depression, suicidal thoughts/attempts, or other mental/mood problems.

Tell your doctor right away if you or your family/caregiver notice any unusual/sudden changes in your mood, thoughts, or behavior including signs of depression, suicidal thoughts/attempts, thoughts about harming yourself.

Get medical help right away if you have any very serious side effects, including slow/shallow breathing.

Pregnancy & Lactation

Pregnancy category C. it should be used during pregnancy only if potential benefits justifies the potential risk to the fetus. Gabapentin/Neurontin may be secreted through the breast milk. So, it should be used during lactation only if potential benefits justify the potential risk to the baby.

Precautions & Warnings

Before taking gabapentin, tell your doctor or pharmacist if you are allergic to it; or to gabapentin enacarbil; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, mental/mood problems (such as depression, thoughts of suicide), use/abuse of drugs/alcohol, breathing problems (such as COPD).

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially swelling of the hands/ankles/feet, slow/shallow breathing, dizziness, or loss of coordination. Dizziness and loss of coordination can increase the risk of falling.

Children may be more sensitive to the side effects of this drug, especially mental/mood/behavior changes (such as hostility, problems concentrating, restlessness).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

Gabapentin passes into breast milk. Consult your doctor before breast-feeding.

Use in Special Populations

In case of renal impaired patients Gabapentin doses must be reduced.

Storage Conditions

Store below 25°C temperature. Protect from light and moisture. Keep all the medicines out of the reach of the children.