Neurontin

Monotherapy in the treatment of partial seizures w/ & w/o secondary generalization in adult & childn ≥12 yr. Adjunctive therapy in the treatment of partial seizures w/ & w/o secondary generalization in adult & childn ≥3 yr. Neuropathic pain in adult ≥18 yr.

Epilepsy Adult & childn >12 yr Dose range: 900-3,600 mg daily. Initially 300 mg tid on day 1 or titrate the dose as 300 mg once daily on day 1, increasing to 300 mg bid on day 2, then 300 mg tid on day 3. Thereafter, increase dose in 3 equally divided doses up to max 3,600 mg daily. Max time between tid doses: 12 hr to prevent breakthrough convulsions. Childn 3-12 yr Initially 10-15 mg/kg daily in 3 equally divided doses, & the effective dose reached by upward titration over a period of approx 3 days. Max time interval between doses: 12 hr. Effective dose: Childn ≥5 yr 25-35 mg/kg daily in 3 equally divided doses, 3-<5 yr 40 mg/kg daily in 3 equally divided doses. Neuropathic pain Adult Initially 900 mg daily in 3 equally divided doses, increased if necessary up to max 3,600 mg daily. Titrate the dose as 300 mg once daily on day 1, increasing to 300 mg bid on day 2, then 300 mg tid on day 3. Neuropathic pain or epilepsy Patient w/ renal impairment CrCl ≥80 mL/min 900-3,600 mg daily, 50-79 mL/min 600-1,800 mg daily, 30-49 mL/min 300-900 mg daily, 15-29 mL/min 150-600 mg daily (administer 150 mg as 300 mg every other day), <15 mL/min 150-300 mg daily (administer 150 mg as 300 mg every other day). Administer total daily dose as tid regimen. Patient undergoing hemodialysis who has never received gabapentin 300-400 mg loading dose, then 200-300 mg following each 4 hr of hemodialysis.

May be taken with or without food.

Hypersensitivity.

Reports of systemic hypersensitivity reactions eg, DRESS in patients taking antiepileptic drugs. Early manifestations of hypersensitivity eg, fever or lymphadenopathy may be present even though rash is not evident. Discontinue if patient experiences signs or symptoms of anaphylaxis. May precipitate status epilepticus w/ abrupt w/drawal. W/drawal symptoms have been observed after discontinuation of short- & long-term treatment. Not considered effective in the treatment of absence seizures. Associated w/ dizziness & somnolence which could increase occurrence of accidental injury (fall). Post-marketing reports of confusion, loss of consciousness & mental impairment. Should not allow >12 hr between gabapentin doses to prevent breakthrough convulsions. Cases of abuse & dependence; evaluate patients for history of drug abuse &/or psychiatric disorders. Concomitant use w/ opioids & other CNS depressants; carefully observe for signs of CNS depression (eg, somnolence, sedation & resp depression). False +ve readings w/ Ames N-Multistix SG dipstick test. May impair ability to drive or operate machinery. Use in the 1st trimester of pregnancy may cause major birth defects in the unborn child. Should not be used during pregnancy unless the benefit to the mother clearly outweighs the potential risk to the fetus. Women of childbearing potential must use effective contraception during treatment. Exercise caution when administered to nursing mother. Safety & effectiveness have not been established for childn <18 yr (neuropathic pain); <12 yr (monotherapy in epilepsy); <3 yr (adjunctive therapy in epilepsy).

Abdominal pain, back pain, headache; constipation, diarrhea, dyspepsia, dry mouth, nausea, vomiting; peripheral edema, increased wt; amnesia, ataxia, confusion, dizziness, somnolence, abnormal thinking, tremor; pharyngitis; rash; amblyopia. Epilepsy (adjunctive therapy): Fatigue, fever, viral infection; vasodilation; dental abnormalities, increased appetite, dry throat; leukopenia, decreased WBC; fracture, myalgia; abnormal coordination, depression, dysarthria, emotional lability, insomnia, nervousness, nystagmus, twitching; coughing, rhinitis; abrasion, acne, pruritus; diplopia; impotence. Asthenia, malaise, facial edema; HTN; flatulence, anorexia, gingivitis; purpura; arthralgia; vertigo; hyperkinesia; increased/decreased or absent reflexes; paresthesia; anxiety; hostility; pneumonia; UTI; abnormal vision. Childn (3-12 yr): Viral infection, fever, increased wt, fatigue; nausea, vomiting; somnolence, hostility, emotional lability; dizziness; hyperkinesia; bronchitis; resp infection. Neuropathic pain: Accidental injury, asthenia, flu syndrome, infection, pain; flatulence; abnormal gait, hypesthesia, vertigo; dyspnea.

Reports of resp depression, sedation, & death w/ CNS depressants including opioids. Increased mean AUC w/ morphine. Reduced bioavailability w/ antacids containing Al & Mg.

Anticonvulsants / Drugs for Neuropathic Pain

N02BF01 - gabapentin ; Belongs to the class of gabapentinoids. Used to relieve pain and other conditions.

Rx