Neurontin Dosage/Direction for Use

General: Gabapentin is given orally with or without food.
When in the judgment of the clinician there is a need for dose reduction, discontinuation, or substitution with an alternative medication, this should be done gradually over a minimum of 1 week.
Epilepsy: Adults and pediatric patients older than 12 years of age: In clinical trials, the effective dosing range was 900 mg/day to 3600 mg/day. Therapy may be initiated by administering 300 mg three times a day on Day 1 or by titrating the dose (Table 2). Thereafter, the dose can be increased in three equally divided doses up to a maximum dose of 3600 mg/day. Doses up to 4800 mg/day have been well tolerated in long-term open-label clinical studies. The maximum time between doses in the three times a day schedule should not exceed 12 hours to prevent breakthrough convulsions. (See Table 2.)

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Pediatric patients aged 3 to 12 years: The starting dose should range from 10 to 15 mg/kg/day given in equally divided doses (three times a day), and the effective dose reached by upward titration over a period of approximately 3 days. The effective dose of gabapentin in pediatric patients aged 5 years and older is 25 to 35 mg/kg/day given in equally divided doses (three times a day). The effective dose in pediatric patients aged 3 to less than 5 years is 40 mg/kg/day given in equally divided doses (three times a day). Doses up to 50 mg/kg/day have been well tolerated in a long-term clinical study. The maximum time interval between doses should not exceed 12 hours.
It is not necessary to monitor gabapentin plasma concentrations to optimize gabapentin therapy. Further, gabapentin may be used in combination with other antiepileptic drugs without concern for alteration of the plasma concentrations of gabapentin or serum concentrations of other antiepileptic drugs.
Neuropathic pain in adults: The starting dose is 900 mg/day given in three equally divided doses, and increased if necessary, based on response, up to a maximum dose of 3600 mg/day. Therapy should be initiated by titrating the dose (Table 2).
Dose adjustment in impaired renal function in patients with neuropathic pain or epilepsy: Dose adjustment is recommended in patients with compromised renal function (Table 3) and/or in those undergoing hemodialysis. (See Table 3.)

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Dose adjustment in patients undergoing hemodialysis: For patients undergoing hemodialysis who have never received gabapentin, a loading dose of 300 mg to 400 mg is recommended, and then 200 mg to 300 mg of gabapentin following each 4 hours of hemodialysis.