gabapentin, Neurontin, Gralise
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: gabapentin
BRAND NAME: Neurontin, Gralise
DRUG CLASS AND MECHANISM: Gabapentin is an anti-sizure (anti-convulsant) drug that is used for preventing seizures and for treating post-herpetic neuralgia, the pain that follows an episode of shingles. The mechanism of action of gabapentin is not known. Gabapentin structurally resembles the neurotransmitter gamma aminobutyric acid (GABA). (Neurotransmitters are drugs that nerves use to communicate with one another.) It is possible that this similarity is related to gabapentin's mechanism of action. In animal models used for testing the anticonvulsant and analgesic (anti-pain) activities of drugs, gabapentin prevents seizures and reduces pain-related responses. The FDA approved gabapentin in December 1993.
GENERIC AVAILABLE: Yes
STORAGE: Tablets and capsules should be stored between 15 C to 30 C (59 F to 86 F). Gabapentin solution should be refrigerated between 2 C to 8 C (36 F to 46 F).
PRESCRIBED FOR: Gabapentin is approved for treating seizure disorders and nerve damage from herpes zoster (shingles, postherpetic neuralgia). There are many non-approved uses for gabapentin. These include alcohol withdrawal, cocaine withdrawal, hiccups, restless leg syndrome, hyperhidrosis, headaches, diabetic neuropathy, hot flashes, and fibromyalgia.
DOSING: Gabapentin may be taken with or without food.
The recommended dose for postherpetic neuralgia is 1800 mg daily in 3 divided doses (Neurontin) or 1800 mg once daily (Gralise). Gralise is not interchangeable with other gabapentin products. Seizures are treated with 900-1800 mg/daily in 3 divided doses (Neurontin). Withdrawal of treatment should occur slowly over a week.
DRUG INTERACTIONS: Antacids reduce the concentration of gabapentin in blood. Therefore, gabapentin should be administered 2 hours or more after taking antacids. Morphine significantly increases blood concentrations of gabapentin and may increase central nervous system-related adverse events associated with gabapentin.
PREGNANCY: Safety in pregnancy has not been established.
NURSING MOTHERS: Gabapentin is secreted in human breast milk. Nursing mothers should only use gabapentin if the benefits outweigh the unknown risk to the fetus.
SIDE EFFECTS: The most common side effects of gabapentin are dizziness, sleepiness, ataxia, fatigue, and drowsiness. Fluid retention (edema), hostility, nausea and vomiting also occur. Other adverse effects associated with gabapentin include weight gain, joint pain, motion sickness, blurred vision, and viral infection.
Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.
REFERENCE: FDA Prescribing Information
Last Editorial Review: 2/11/2014
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