|
Gabapentin
Gabapentin (Neurontin)
Gabapentin
(
gab-ah-
PEN-tin)
Pregnancy Category: C
Neurontin
(Rx)
Classification:
Anticonvulsant
See Also:
See also
Anticonvulsants
[.
]
Action/Kinetics:
Anticonvulsant mechanism is not known. Food has no effect on the rate and extent of absorption; however, as the dose increases, the bioavailability decreases.
t
1/2: 5-7 hr. Excreted unchanged through the urine.
Uses:
In adults as an adjunct in the treatment of partial seizures with and without secondary generalization.
Investigational: Control pain in diabetic neuropathy and shingles.
Special Concerns:
Use during lactation only if benefits outweigh risks. Plasma clearance is reduced in geriatric clients and in those with impaired renal function. Safety and efficacy have not been determined in children less than 12 years of age.
Side Effects:
Side effects listed are those with an incidence of 0.1% or greater.
CNS: Most commonly: somnolence, ataxia, dizziness, and fatigue. Also, nystagmus, tremor, nervousness, dysarthria, amnesia, depression, abnormal thinking, twitching, abnormal coordination, headache,
convulsions (including the possibility of precipitation of status epilepticus) confusion, insomnia, emotional lability, vertigo, hyperkinesia, paresthesia, decreased/increased/absent reflexes, anxiety, hostility, CNS tumors, syncope, abnormal dreaming, aphasia, hypesthesia,
intracranial hemorrhage hypotonia, dysesthesia, paresis, dystonia, hemiplegia, facial paralysis, stupor, cerebellar dysfunction, positive Babinski sign, decreased position sense, subdural hematoma, apathy, hallucinations, decreased or loss of libido, agitation depersonalization, euphoria, ``doped-up'' sensation,
suicidal tendencies psychoses.
GI: Most commonly: N&V.; Also, dyspepsia, dry mouth and throat, constipation, dental abnormalities, increased appetite, abdominal pain, diarrhea, anorexia, flatulence, gingivitis, glossitis, gum hemorrhage, thirst, stomatitis, taste loss, unusual taste, increased salivation, gastroenteritis, hemorrhoids, bloody stools, fecal incontinence, hepatomegaly.
CV: Hypertension, vasodilation, hypotension, angina pectoris, peripheral vascular disorder, palpitation, tachycardia, migraine, murmur.
Musculoskeletal: Myalgia, fracture, tendinitis, arthritis, joint stiffness or swelling, positive Romberg test.
Respiratory: Rhinitis, pharyngitis, coughing, pneumonia, epistaxis, dyspnea, apnea.
Dermatologic: Pruritus, abrasion, rash, acne, alopecia, eczema, dry skin, increased sweating, urticaria, hirsutism, seborrhea, cyst, herpes simplex.
Body as a whole: Weight increase, back pain, peripheral edema, asthenia, facial edema, allergy, weight decrease, chills.
GU: Hematuria, dysuria, frequent urination, cystitis, urinary retention, urinary incontinence, vaginal hemorrhage, amenorrhea, dysmenorrhea, menorrhagia, breast cancer, inability to climax, abnormal ejaculation, impotence.
Hematologic: Leukopenia, decreased WBCs, purpura, anemia, thrombocytopenia, lymphadenopathy.
Ophthalmologic: Diplopia, amblyopia, abnormal vision, cataract, conjunctivitis, dry eyes, eye pain, visual field defect, photophobia, bilateral or unilateral ptosis, eye hemorrhage, hordeolum, eye twitching.
Otic: Hearing loss, earache, tinnitus, inner ear infection, otitis, ear fullness.
Laboratory Test Alterations:
False + reading with Ames N-Multistix SG dipstick test for urinary protein.
Overdose Management:
Symptoms: Double vision, slurred speech, drowsiness, lethargy, diarrhea.
Treatment: Hemodialysis.
Drug Interactions:
-
Antacids /
 Bioavailability of gabapentin
-
Cimetidine /
Renal excretion of gabapentin
How Supplied:
Capsule: 100 mg, 300 mg, 400 mg;
Tablet
Dosage
?Capsules
Anticonvulsant.
Adults: Dose range of 900-1,800 mg/day in three divided doses. Titration to an effective dose can begin on day 1 with 300 mg followed by 300 mg b.i.d. on day 2 and 300 mg t.i.d. on day 3. If necessary, the dose may be increased to 300-400 mg t.i.d., up to 1,800 mg/day. In clients with a C
CR of 30-60 mL/min, the dose is 300 mg b.i.d.; if the C
CR is 15-30 mL/min, the dose is 300 mg/day; if the C
CR is less than 15 mL/min, the dose is 300 mg every other day. |
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