As adjunctive therapy in the treatment of partial seizures w/ & w/o secondary generalization in adults & childn ≥3 yr. Treatment of neuropathic pain in patients ≥18 yr.
EpilepsyAdult & ped >12 yr 900-1,800 mg daily. Day 1: 300 mg once daily. Day 2: 300 mg twice daily. Day 3: 300 mg 3 times daily. Thereafter dose can be increased in 3 equally divided doses to a max of 2,400 mg daily. Ped 3-12 yr Starting dose: 10-15 mg/kg/day in 3 equally divided doses daily to reach effective dose by upward titration over 3 days. Ped ≥5 yr 25-35 mg/kg/day in 3 equally divided doses daily; 3-<5 yr 40 mg/kg/day in 3 equally divided doses daily. Neuropathic pain Titrate to a max dose of 1,800 mg daily. Day 1: 300 mg once daily. Day 2: 300 mg twice daily. Day 3: 300 mg 3 times daily. Thereafter, dose can be increased using increments of 300 mg daily in 3 divided doses to a max of 1,800 mg daily. Hemodialysis patients Initially 300-400 mg daily then 200-300 mg following each 4 hr of hemodialysis.
Abrupt w/drawal of anticonvulsants in epileptic patients may precipitate status epilepticus. Not generally considered effective in the treatment of absence seizures. Concomitant treatment w/ morphine may increase gabapentin conc. Carefully observe for signs of CNS depression eg, somnolence. Severe, life-threatening systemic hypersensitivity reactions eg, drug rash w/ eosinopilia & systemic symptoms (DRESS). Discontinue if signs & symptoms of hypersensitivity eg, fever or lymphadenopathy even w/o rash & no alternative etiology can be established. May impair ability to drive a car or operate machinery. Pregnancy & lactation.
Reduced bioavailability w/ antacids containing Al & Mg. Alcohol or centrally acting drugs of abuse may exaggerate CNS side effects (eg, somnolence & ataxia). False +ve readings w/ Ames test when added to other anticonvulsant drugs.
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