Introduction
Gabantin is a medicine used to relieve the pain caused by nerve damage (neuropathic pain) due to various conditions like diabetes, shingles (herpes zoster infection), spinal cord injury, etc. It is also used to treat certain types of seizures (fits) in combination with other medicines.
Gabantin belongs to the anti-epileptic group of medicines. You may take it with or without food, but it is important to take this medicine at the same time each day to get the most benefit. The exact dose and duration of treatment will depend on your condition and how you respond to it. Your doctor will probably start this medicine at a low dose and increase it gradually. It may take a few weeks for the medicine to work properly. Follow your doctor's instructions and continue taking it regularly until your doctor advises you to stop. Do not miss any dose, otherwise, your condition may worsen.
Most people taking Gabantin do not experience any side effects. The most common ones are feeling sleepy, dizzy, or tired (fatigue). These are usually mild and go away by themselves as your body gets used to the medicine. Most side effects are not serious and do not need medical attention. Talk to your doctor if any of the side effects persist or worry you.
You should avoid drinking alcohol along with this medicine as it may lead to excessive sleepiness and dizziness. Let your doctor know right away if you develop any unusual mood changes like anxiety, agitation, depression, or thoughts about harming yourself.
Before taking Gabantin, you should tell your doctor if you have any kidney-related problems or if you are more than 65 years old. Your doctor may prescribe a different dose in such people. Women who are pregnant, breastfeeding or planning to become pregnant should also consult their doctor before using this medicine.
Uses of Gabantin
- Neuropathic pain
- Epilepsy/Seizures
Side effects of Gabantin
Common
- Dizziness
- Fatigue
- Fever
- Impaired coordination
- Nausea
- Nystagmus (involuntary eye movement)
- Peripheral edema
- Sleepiness
- Viral infection
- Vomiting
How to use Gabantin
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Gabantin may be taken with or without food, but it is better to take it at a fixed time.
How Gabantin works
Gabantin is an antiepileptic medication. When given for epilepsy, it is believed to work by reducing the abnormal electrical activity in the brain, thus preventing seizures. It is also used to treat nerve pain where it blocks pain by interfering with pain signals travelling through the damaged nerves and the brain.
What if you forget to take Gabantin?
If you miss a dose of Gabantin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Epilepsy, Neuropathic pain, Partial Seizures, Hot flashes, Fibromyalgia, Postherpetic Neuralgia, Pain from diabetic neuropathy.
Administration
May be taken with or without food.
Adult Dose
Partial Seizures
Adjunctive therapy for partial seizures with or without secondary generalization
Initial: 300 mg PO q8hr
May increase up to 600 mg PO q8hr; up to 2400 mg/day administered and tolerated in clinical studies; up to 3600 mg administered for short duration and tolerated
Postherpetic Neuralgia
Day 1: 300 mg PO qDay
Day 2: 300 mg PO q12hr
Day 3: 300 mg PO q8hr
Maintenance: Subsequently titrate as needed up to 600 mg PO q8hr; doses >1800 mg/day have demonstrated no additional benefit
Restless legs syndrome
100-300 mg PO 2 hr before bedtime on first day; may titrate every 2 weeks until symptom relieve achieved (range 300-1800 mg/day)
Diabetic Neuropathy
900 mg/day PO initially; may increase gradually q3Days to 1800-3600 mg/day
Hot flashes-cancer related
200-1600 mg PO qDay to q6hr for 4-8 weeks
Child Dose
Partial Seizures
Adjunctive therapy for partial seizures with or without secondary generalization in patients older than 12 years of age with epilepsy; also indicated as adjunctive therapy for partial seizures in pediatric patients aged 3-12 years
<3 years: Safety and efficacy not established
3-12 years (initial dose): 10-15 mg/kg/day PO divided q8hr initially; titrate up in approximately 3 days to effective maintenance dose
3-4 years (maintenance dose): 40 mg/kg/day PO divided q8hr
5-12 years (maintenance dose): 25-35 mg/kg/day PO divided q8hr
>12 years (initial dose): 300 mg PO q8hr; may increase up to 600 mg PO q8hr
Renal Dose
Renal impairment
CrCl >60 mL/min: 300-1200 mg PO TID
CrCl 30-60 mL/min: 200-700 mg q12hr
CrCl 15-29 mL/min: 200-700 mg qDay
CrCl <15 mL/min: 100-300 mg qDay
Hemodialysis (CrCl <15 mL/min): Administer supplemental dose (range 125-350 mg) posthemodialysis, after each 4 hr dialysis interval; further dose reduction should be in proportion to CrCl (eg, CrCl of 7.5 mL/min should receive one-half daily posthemodialysis dose)
Contraindication
Hypersensitivity. Lactation.
Mode of Action
Gabapentin is structurally related to the neurotransmitter GABA but is neither a GABA agonist nor antagonist. High affinity gabapentin binding sites are located throughout the brain. These sites correspond to the presence of voltage-gated Ca channels particularly controlling the ?-2/?-1 subunit. This channel appears to be located presynaptically and may modulate the release of excitatory neurotransmitters which participate in epileptogenesis and nociception.
Precaution
Discontinuation or transfer from other antiepileptics, history of psychotic illness; renal impairment; pregnancy. Gradual withdrawal over at least 7 days to prevent an increase in seizure frequency.
Lactation: Enters breast milk; use with caution
Side Effect
>10%
Ataxia (1-13%),Dizziness (16-20%),Drowsiness (5-21%),Fatigue (11-15%),Somnolence (16-20%)
1-10%
Diplopia (6-10%),Nystagmus (6-10%),Tremor (6-10%),Amblyopia (1-5%),Back pain (1-5%),Constipation (1-5%),Depression (1-5%),Dry mouth (1-5%),Dysarthria (1-5%),Dyspepsia (1-5%),Hostility (5-8% children),Hyperkinesia (3-5%),Increased appetite (1-5%),Leukopenia (1-5%),Myalgia (1-5%),Nervousness (1-5%),Peripheral edema (1-5%),Pharyngitis (1-5%),Pruritus (1-5%),Rhinitis (1-5%),Vasodilation (1-5%),Weight gain (1-5%),Abnormal vision (>1%),Anorexia (>1%),Arthralgia (>1%),Asthenia (>1%),HTN (>1%),Malaise (>1%),Paresthesia (>1%),Purpura (>1%),Vertigo (>1%)
Interaction
May increase plasma level w/ morphine. Reduced absorption w/ antacids.