Gabapentin – Uses, Doses, and Side Effects
Neurontin contains an active substance called Gabapentin and belongs to a group of drugs called antipyretics. It works by binding to the alpha-2-delta subunit of voltage-dependent calcium channels, which lead to a reduction in the concentration of excitatory neurotransmitters in the central nervous system region. Neurontin quickly passes into the cerebral cortex and prevents convulsions. The same mechanism of action is also responsible for the reduction of pain in patients suffering from peripheral neuropathy.
Unlike most antiepileptic drugs, Gabapentin does not bind to GABA-A and GABA-B receptors and does not interact with sodium channels. The drug is not metabolized in a significant percentage by the liver and is mainly excreted in the unchanged form via the kidneys. The elimination half-life elimination is 5-7 hours, which means that the Neurontin effects last for 10-14 hours.
Indications
Neurontin Gabapentin is indicated as an additional treatment of partial convulsions with or without secondary generalization in patients over 6 years of age. It also has evidence for a monotherapy use in patients older than 12 years. This medicine is also often used in the treatment of peripheral neuropathic pain in diabetic patients, as well as in adult patients suffering from postherpetic neuralgia.
Dosage
The recommended dosage for patients who need to buy Gabapentin online and are older than 12 years is given below:
- Day 1 – 300mg once a day
- Day 2 – 300mg two times a day
- Day 3 – 300mg three times a day
The dose after the third day may be increased by 300mg/day every 3-4 days until an appropriate therapeutic effect is achieved. The maximum dosage is 3600mg daily.
The treatment of epilepsy and peripheral neuropathy is usually long-term. Consult your doctor about the duration of your treatment.
The recommended dosage for children aged 6-12 years is shown below:
- Day 1 – 10mg/kg once a day
- Day 2 – 10mg/kg two times a day
- Day 3 – 10mg/kg three times a day
The maximum daily dose for children 6-12 years is 50mg/kg (divided into three doses).
The same doses are used in the treatment of epilepsy and peripheral neuropathic pain available on meds4sure. The dosage should be reduced in patients who have moderate or severe damage to the kidney function. It should also be reduced in patients who are over 65 years of age, as these patients may experience increased Neurontin’s blood levels and increased incidence of adverse effects, such as asthenia, drowsiness, and peripheral edema.
Gabapentin exists in the form of capsules, tablets and oral suspension (syrup). It can be administered regardless of meals because food does not have an effect on its absorption.
The interval between two doses of Neurontin must be less than 12 hours, otherwise, breakthrough convulsions may occur. Therefore, it is recommended that the drug is taken in three divided doses (every 8 hours).
The treatment with Neurontin should not be stopped abruptly because withdrawal symptoms may occur. It is recommended that the Gabapentin therapy is stopped gradually – by gradually reducing the dose for at least 7 days. For example, if you have used 300mg three times a day, then the dosage should be first reduced to 300mg twice a day for 3-4 days, and then – to 300mg once a day for 4-5 days. After that, you can completely discontinue the use of this medicine.
Precautions
DRESS (drug-induced rash with eosinophilia and systemic symptoms) is a dangerous, potentially life-threatening hypersensitivity reaction that has been reported in patients using Neurontin. If you notice symptoms, such as high temperature and swelling of lymph nodes, you should contact your doctor immediately.
The use of Gabapentin increases the risk of suicidal thoughts and ideas. If you’re experiencing suicidal thoughts, you should contact your doctor immediately. Neurontin-induced pancreatitis is also reported as an adverse effect. If this adverse effect occurs, treatment discontinuation should be considered. Although it has not been clinically proven, it is presumed that sudden withdrawal of Neurontin can lead to rebound convulsions that may go to status epilepticus. It is therefore important that you take the drug regularly and that you do not abruptly discontinue the treatment without consulting your doctor.
Post-marketing studies have shown that Neurontin Gabapentin can cause physical dependence. Therefore, it is recommended to carefully evaluate the patient’s anamnesis before starting the treatment, in order to determine if there is any risk of drug misuse.
Pregnancy and Breastfeeding
There is an increased risk of congenital malformations in newborns whose mothers took antiepileptics during pregnancy. Following malformations occur most often: cleft palate, cardiovascular malformations and neural tube defects. A multiple antiepileptic therapy may be associated with an increased risk of congenital malformations when compared to a monotherapy, and therefore it is recommended whenever possible. It is recommended that women planning pregnancy and females of reproductive age, review the current therapy with their doctor prior conceiving. Abrupt discontinuation of therapy must be avoided, as this can lead to breakthrough seizures and, consequently to the deterioration of the condition in the pregnant women and her child. Development delay of children whose mothers suffer from epilepsy have been rarely reported, but it is not possible to determine why the development delay of these children occurred (genetic factors, social factors, maternal epilepsy or antiepileptic therapy).
Side Effects
Neurontin may cause the following side effects:
• Pneumonia
• Urinary tract infections
• Otitis media
• Viral infections
• Leukopenia
• Thrombocytopenia
• Depression
• Anxiety
• Nervousness
• Hallucinations
• Emotional weakness
• Double vision
• Visual disturbances
• Palpitations
• Hypertension
• Widening of blood vessels
• Cough
• Difficulty breathing
• Hair loss
• Rhabdomyolysis
• Acute renal failure
• Decreased libido
• Anorgasmia
• Gynaecomastia
• Fever
• Asthenia
• Malaise
• Flu-like symptoms
• Angioedema
• Stevens-Johnson syndrome
• Vomiting
• Dental problems
• Liver damage
• Jaundice
• Dry mouth
• Dry throat
• Pain in the abdomen
• Diarrhea
• Pancreatitis
• Muscle pain
• Pain in the joints
• Gingivitis
• Bleeding of the gums
• Respiratory tract infections (bronchitis, pharyngitis and rhinitis)
Call your doctor right away if you notice any side effects.
by Helen Parker