EpilepsyAdult & childn >12 yr 900-1,800 mg daily. Initially 300 mg 3 times daily on day 1 or by titrating the dose as: 300 mg once on day 1, 300 mg twice daily on day 2 & 300 mg 3 times daily on day 3. Thereafter, the dose can be increased in 3 equally divided doses up to a max dose of 2,400 mg daily. Childn 3-12 yr Initially 10-15 mg/kg daily in 3 equally divided doses. The effective dose reached by upward titration over a period of approriximately 3 days; ≥5 yr Effective dose: 25-35 mg/kg daily in 3 equally divided doses; 3 to <5 yr 40 mg/kg daily in 3 equally divided doses. Doses up to 50 mg/kg daily have been well tolerated in a long-term clinical study. Max time interval between doses should not exceed 12 hr. Neuropathic painAdult Initially 300 mg once on day 1; 300 mg twice daily on day 2; 300 mg 3 times daily on day 3. Max: 1,800 mg daily. Impaired renal function in patients w/ neuropathic pain or epilepsy CrCl ≥80 mL/min 900-2,400 mg daily, 50-79 mL/min 600-1,200 mg daily, 30-49 mL/min 300-600 mg daily, 15-29 mL/min 150 mg (administered as 300 mg every other day) to 300 mg daily, <15 mL/min 150 mg (administered as 300 mg every other day). Total daily dose should be administered as 3 times/day regimen. Patients undergoing hemodialysis Loading dose: 300-400 mg, then 200-300 mg following each 4 hr of hemodialysis.
May be taken with or without food: Take at least 2 hr after antacids containing Mg or Al.
Contraindications
Hypersensitivity. Patients w/ acute pancreatitis. Not for primarily generalized seizures eg, absences. Patients w/ galactosemia due to their lactose content.
Abrupt w/drawal may precipitate status epilepticus. Not for treatment of absence seizures. Concomitant use of CNS depressants including opioids. Drug rash w/ eosinophilia & systemic symptoms (DRESS). Discontinue treatment if signs & symptoms of anaphylaxis occurs. Evaluate patients for history of drug abuse &/or psychiatric disorders. May impair ability to drive a car or operate potentially dangerous machinery. Pregnancy & lactation. Childn <3 yr (for epilepsy) & <18 yr (for neuropathic pain).
Resp depression, sedation & death may occur w/ CNS depressants including opioids, also considered particular concerns in frail patients, elderly, serious underlying resp disease, w/ polypharmacy & w/ substance abuse disorder. Reduced bioavailability w/ Al- & Mg-containing antacids. Alcohol or centrally acting drugs of abuse may exaggerate some gabapentin CNS side effects. False +ve readings w/ Ames N-Multistix SG dipstick-test in concomitant use w/ other anticonvulsant drugs.
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