Other Brands/Names

Alpentin, Nepatic, Epiven, Neurontin, Gabapentin, Neurontin, Gabexal, Sipentin, Ganin.

How It Works

Gabapentin is a gamma-aminobutyric acid (GABA) analog with effects similar to GABA-agonists. It is used to treat epilepsy and also provides analgesic benefits. In addition, it may help prevent neuronal death in amyotrophic lateral sclerosis (ALS).

Gabapentin interacts with calcium-sensitive neurons and can cross lipid membranes to enter cells. In animal testings, it shows seizure-suppressing activity; however, in humans, its precise antiepileptic mechanism remains uncertain.

Indications

Gabapentin is indicated for epilepsy, neuropathic pain, and post-herpetic neuralgia.

Contraindication

Gabapentin is contraindicated in patients with a known allergy or hypersensitivity to this medicine.

Side Effects

Side effects can occur in some cases of gabapentin usage, they are:

• Anaphylaxis
• Angioedema
• Suicidal ideation and behavior
• Acute pancreatitis
• New seizure types
• Increased seizure frequency
• Dizziness
• Drowsiness
• Confusion
• Mental disorders
• Drug abuse and dependence
• Withdrawal symptoms
• Neuropsychiatric reactions in children (for example, emotional lability, thought disturbances, hyperkinesia).

Gabapentin use can also cause disorders in several organs, they are:

• Blood and lymphatic system disorders: leukopenia.

• Ear and balance disorders: otitis media, vertigo.

• Eye disorders: visual disturbances such as amblyopia and diplopia.

• Gastrointestinal disorders: nausea, vomiting, diarrhea, abdominal pain, dry mouth or throat, flatulence, dyspepsia, constipation, dental abnormalities, gingivitis.

• General disorders and administration-site conditions: fever, fatigue, asthenia, pain, peripheral edema, abnormal gait, flu-like symptoms, bone fractures.

• Infections and infestations: viral infections.

• Injuries, poisoning, and procedural complications: accidental injury.

• Metabolic and nutritional disorders: anorexia, increased appetite.

• Musculoskeletal and connective tissue disorders: arthralgia, myalgia, twitching, back pain.

• Nervous system disorders: headache, ataxia, amnesia, dysarthria, abnormal sensations such as paresthesia, tremor, incoordination, nystagmus, altered reflexes (increased, decreased, or absent), abnormal thinking.

• Psychiatric disorders: anxiety, depression, insomnia, nervousness.

• Renal and urinary disorders: urinary tract infection.

• Reproductive system and breast disorders: impotence.

• Respiratory, thoracic, and mediastinal disorders: pneumonia, respiratory infections, shortness of breath, bronchitis, pharyngitis, cough, rhinitis.

• Skin and subcutaneous tissue disorders: rash, pruritus, acne, purpura, abrasions.

• Vascular disorders: hypertension, vasodilation.

Types

100 mg and 300 mg capsules.

Dosage

Treatment of epilepsy

Adults: 300 mg once daily on day 1, 300 mg twice daily on day 2, and 300 mg three times daily on day 3. Based on clinical response, increase by 300 mg every 2–3 days. Usual total dose: 900–3,000 mg per day in three divided doses.

6 years old and above: initial total daily dose 10–15 mg/kg; titrate every 3 days to an effective dose. Maximum 50 mg/kg per day.

Post-herpetic neuralgia

Adults: 300 mg once on day 1, then 300 mg every 12 hours on day 2, and 300 mg every 8 hours on day 3. The dose may be increased further as needed up to 600 mg every 8 hours.

Safety

Pregnant women:

FDA Category C (Animal studies have shown adverse effects on the fetus, but there are no controlled studies in pregnant women). This drug should only be used if the expected benefit outweighs the potential risks.

Breastfeeding mothers:

Gabapentin may be present in breast milk. Do not use without consultation and approval from a doctor.

Drug Interactions

Co-administration with antacids may reduce gabapentin bioavailability, and combining with central nervous system depressants (for example, opioids, benzodiazepines, antidepressants, antihistamines) may increase the risk of respiratory and CNS depression.

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