Category: Gabapentin

You can not buy gabapentin online if you have following health conditions:

1. kidney disease (or if you are on dialysis);
2. liver disease;
3. heart disease; or
4. (for patients with RLS) if you are a day sleeper or work a night shift.
5. being pregnant, it is not known whether this medicine will harm an unborn baby, but you need talk to a local Doctor;
6. breast-feeding a baby, Gabapentin can pass into breast milk and may harm a nursing baby;
7. Having suicide thoughts.
8. epilepsy or other seizure disorder;
9. diabetes;
10. a history of depression, mood disorder, drug abuse;
11. You have sent fraud check and not a reliable patient.

It does not mean you cannot take gabapentin. If you have above health conditions, you must go to your local street doctor and let the doctor have your health checked.

You should not use this medication if you are allergic to gabapentin.

Before taking gabapentin, tell your doctor if you have kidney, liver, or heart disease.

You may have thoughts about suicide while taking gabapentin. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Do not stop taking gabapentin for seizures without first talking to your doctor, even if you feel fine. You may have increased seizures if you stop using gabapentin suddenly. You may need to use less and less before you stop the medication completely.

Contact your doctor if your seizures get worse or you have them more often while taking gabapentin.

Wear a medical alert tag or carry an ID card stating that you take gabapentin. Any doctor, dentist, or emergency medical care provider who treats you should know that you take seizure medication.

Gabapentin comes as:

• 100 mg, 300 mg, and 400 mg capsules
• 300 mg, 600 mg, and 800 mg tablets
• a 250 mg/5 mL oral (by mouth) solution.

Inactive ingredients in the capsules include lactose, cornstarch, and talc.

• The 100-mg capsule shell also contains: gelatin and titanium dioxide.
• The 300-mg capsule shell also contains: gelatin, titanium dioxide, and yellow iron oxide.
• The 400-mg capsule shell also contains: gelatin, red iron oxide, titanium dioxide, and yellow iron oxide. The imprinting ink contains FD&C Blue No. 2 and titanium dioxide.

Inactive ingredients in the tablets include poloxamer 407, copolyvidonum, cornstarch, magnesium stearate, hydroxypropyl cellulose, talc, candelilla wax, and purified water.

Inactive ingredients in the oral solution include glycerin, xylitol, purified water, and artificial flavor

Usual Adult Dose for Epilepsy:

Initial dose: 300 mg orally on day one, 300 mg orally twice a day on day two, then 300 mg orally 3 times a day on day three.
Maintenance dose: 900 to 1800 mg orally in 3 divided doses. If necessary, the dose may be increased using 300 mg or 400 mg capsules three times a day up to 1800 mg/day. Dosages up to 2400 mg/day have been well tolerated in long-term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated. The maximum time between doses in the three times a day schedule should not exceed 12 hours.

The safety and effectiveness of gabapentin available under the trade name Gralise (R) or Horizant (R) in patients with epilepsy has not been studied.

Usual Adult Dose for Postherpetic Neuralgia:

Initial dose: 300 mg orally on day one, 300 mg orally twice a day on day two, then 300 mg orally 3 times a day on day three.

The dose may be titrated up as needed for pain relief to a daily dose of 1800 mg.
Maintenance dose: 900 to 1800 mg orally in 3 divided doses.

Efficacy was demonstrated in clinical studies over a range of 1800 mg/day to 3600 mg/day. However, no additional benefit was demonstrated from the use of doses over 1800 mg/day.

Gabapentin available under the trade name Gralise (R):

Maintenance dose: Gralise (R) should be titrated to 1800 mg orally once daily with the evening meal.

Recommended titration schedule:
Day 1: 300 mg orally with the evening meal
Day 2: 600 mg orally with the evening meal
Days 3 through 6: 900 mg orally with the evening meal
Days 7 through 10: 1200 mg orally with the evening meal
Days 11 through 14: 1500 mg orally with the evening meal
Day 15: 1800 mg orally with the evening meal

Gralise (R) is not interchangeable with other gabapentin products because of differing pharmacokinetic profiles that affect the frequency of administration.

Gabapentin enacarbil extended release tablets available under the trade name Horizant (R):

The recommended dosage is 600 mg orally twice daily. Therapy should be initiated at a dose of 600 mg orally in the morning for 3 days of therapy, then increased to 600 mg twice daily (1,200 mg/day) on day four.

Gabapentin enacarbil extended release tablets available under the trade name Horizant (R) and gabapentin are not interchangeable.

Usual Adult Dose for Restless Legs Syndrome:

Gabapentin enacarbil available under the trade name Horizant (R):
600 mg orally once daily with food at about 5 PM

Usual Pediatric Dose for Epilepsy:

Less than 3 years: Effectiveness has not been established.

Greater than or equal to 3 and less than 12 years:
Starting Dose: ranges from 10 to 15 mg/kg/day in 3 divided doses.
Effective Dose: reached by upward titration over a period of approximately 3 days. The effective dose of gabapentin in patients 5 years of age and older is 25 to 35 mg/kg/day and given in divided doses (three times a day). The effective dose in pediatric patients ages 3 and 4 years is 40 mg/kg/day and given in divided doses (three times a day). Gabapentin may be administered as the oral solution, capsule, or tablet, or using combinations of these formulations. Dosages 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.

Greater than 12 years:
Initial dose: 300 mg orally on day one, 300 mg orally twice a day on day two, then 300 mg orally 3 times a day on day three.
Maintenance dose: 900 to 1800 mg orally in 3 divided doses. If necessary, the dose may be increased using 300 mg or 400 mg capsules three times a day up to 1800 mg/day. Dosages up to 2400 mg/day have been well tolerated in long term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated. The maximum time between doses in the three times a day schedule should not exceed 12 hours.

Dose Adjustments

Because elderly patients are more likely to have decreased renal function, the dose of this drug should be adjusted based on CrCl values.

GRALISE (R):
-If the dose of this drug under the trade name Gralise (R) is reduced, discontinued, or substituted with an alternative medication, this should be done gradually over a minimum of 1 week or longer or as directed by the physician.

HORIZANT (R):
-If the dose of this drug available under the trade name Horizant (R) is discontinued, patients with RLS receiving 600 mg or less once daily can discontinue the drug without tapering. If the recommended dose is exceeded, the dose should be reduced to 600 mg daily for 1 week prior to discontinuation to minimize the potential of withdrawal seizure.
-Patients with PHN receiving Horizant (R) twice daily should reduce the dose to once daily for 1 week prior to discontinuation to minimize the potential for withdrawal seizure.

Precautions

-Safety and efficacy have not been established in patients younger than 18 years in the management of postherpetic neuralgia.
-Safety and efficacy have not been established in patients younger than 3 years in the adjunctive treatment of partial seizures.
-Safety and efficacy have not been established in patients younger than 18 years for gabapentin available under the trade names Gralise (R) or Horizant (R).

Consult WARNINGS section for additional precautions.

A lethal dose of gabapentin was not identified in mice and rats receiving single oral doses as high as 8000 mg/kg. Signs of acute toxicity in animals included ataxia, labored breathing, ptosis, sedation, hypoactivity, or excitation.

Acute oral overdoses of NEURONTIN up to 49 grams have been reported. In these cases, double vision, slurred speech, drowsiness, lethargy, and diarrhea were observed. All patients recovered with supportive care. Coma, resolving with dialysis, has been reported in patients with chronic renal failure who were treated with NEURONTIN.

Gabapentin can be removed by hemodialysis. Although hemodialysis has not been performed in the few overdose cases reported, it may be indicated by the patient’s clinical state or in patients with significant renal impairment.

f overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, slurred speech, weakness.

Get emergency medical help if you have signs of an allergic reaction to gabapentin: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a skin rash with symptoms of a serious allergic reaction that can affect other parts of your body, including: fever, dark urine, blood in your urine, swollen glands, sore throat, extreme weakness or tiredness, unusual bruising or bleeding, muscle pain, or jaundice (yellowing of the skin or eyes).

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• increased seizures;
• severe weakness or tiredness;
• upper stomach pain;
• chest pain, new or worsening cough with fever, trouble breathing;
• severe tingling or numbness;
• rapid back and forth movement of your eyes;
• kidney problems–little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; or
• severe skin reaction–fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Some side effects are more likely in children taking gabapentin. Contact your doctor if the child taking this medication has any of the following side effects:

• changes in behavior;
• memory problems;
• trouble concentrating; or
• acting restless, hostile, or aggressive.

Common gabapentin side effects may include:

• dizziness, drowsiness; or
• headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Take gabapentin exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

The Horizant brand of gabapentin should not be taken during the day. For best results, take Horizant with food at about 5:00 in the evening.

Both Gralise and Horizant should be taken with food.

Neurontin can be taken with or without food.

If you break a Neurontin tablet and take only half of it, take the other half at your next dose. Any tablet that has been broken should be used as soon as possible or within a few days.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

If your doctor changes your brand, strength, or type of gabapentin, your dosage needs may change.Ask your pharmacist if you have any questions about the new kind of gabapentin you receive at the pharmacy.

Do not stop using gabapentin suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor’s instructions about tapering your dose.

Wear a medical alert tag or carry an ID card stating that you take gabapentin. Any medical care provider who treats you should know that you take seizure medication.

Gabapentin can cause you to have a false positive urine protein screening test. If you provide a urine sample for testing, tell the laboratory staff that you are taking gabapentin.

Store tablets and capsules at room temperature away from light and moisture.

Store the liquid medicine in the refrigerator. Do not freeze.

You should not use gabapentin if you are allergic to it.

To make sure gabapentin is safe for you, tell your doctor if you have:

• kidney disease (or if you are on dialysis);
• epilepsy or other seizure disorder;
• diabetes;
• liver disease;
• a history of depression, mood disorder, drug abuse, or suicidal thoughts or actions;
• heart disease; or
• (for patients with RLS) if you are a day sleeper or work a night shift.

Some people have thoughts about suicide while taking this medicine. Your doctor will need to check your progress at regular visits while you are using gabapentin. Your family or other caregivers should also be alert to changes in your mood or symptoms.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Gabapentin can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

Indigestion remedies (antacids) containing aluminium or magnesium may reduce the absorption of gabapentin from the gut. Indigestion remedies should therefore not be taken at the same time as a dose of gabapentin, or in the two hours before a dose.

It is recommended that people who are taking any antiepileptic medicines should avoid taking the herbal remedy St John’s wort (Hypericum perforatum). This is because St John’s wort may affect the level of antiepileptic medicines in the blood and could increase the risk of seizures.

This medicine is not known to interact significantly with other medicines. However, if it makes you feel sleepy or dizzy, this effect is likely to be increased if you take it in combination with other medicines that can cause drowsiness, in particular morphine, or with alcohol. If you are prescribed morphine in combination with gabapentin you should let your doctor know if it makes you feel sleepy, or if any drowsiness gets worse.

This medicine does not affect hormonal contraceptives such as the pill.

Other medicines containing the same active ingredient

Gabapentin tablets and capsules are also available without a brand name, ie as thegeneric medicine.

Gabapentin has been recommended as a possible treatment for migraines by the National Institute for Health and Care Excellence (NICE), but recent research has suggested it may not be effective in preventing attacks and concerns have been raised about the quality of earlier research into the medication.

 

Neuropathic pain is a common and potentially treatable cause of considerable lifelong morbidity. Effective pharmacological treatments are scarce, but one group of drugs that has shown promise is the antiepileptics.

Gabapentin has become popular as a first-line treatment for neuropathic pain because of its efficacy as an antineuropathic agent and relatively benign side-effect profile. However, its mechanism of action is far from clear.

Neuropathic pain is pain coming from damaged nerves. It differs from pain messages carried along healthy nerves from damaged tissue (a fall, cut, or arthritic knee). Neuropathic pain is treated by different medicines than pain from damagedtissue. Medicines like paracetamol or ibuprofen are not effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain. Our understanding of fibromyalgia (a condition of persistent, widespread pain and tenderness, sleep problems, and fatigue) is poor, but fibromyalgia can respond to the same medicines as neuropathic pain.

Glutamate is also involved in transmitting pain signals in the brain and nervous system. As gabapentin reduces the release of this neurotransmitter it can also be used to treat nerve pain occuring as a result of damage to or a disturbance in the function of nerves (neuropathic pain)

The way in which gabapentin works is not fully understood. It is thought to work by binding to calcium channels found on nerve cells in the brain and spinal cord. This is thought to affect the release of various neurotransmitters from these nerve cells.

Neurotransmitters are natural body chemicals that are stored in nerve cells. They are involved in transmitting messages between the nerve cells. Gabapentin is thought to reduce the release of a neurotransmitter called glutamate.

Glutamate is a neurotransmitter that acts as a natural ‘nerve-exciting’ agent. It is released when electrical signals build up in nerve cells and subsequently excites more nerve cells. It is thought to play a key role in causing epileptic seizures. Reducing the release of glutamate from the nerve cells in the brain is thought to help stabilise the electrical activity in the brain and prevent epileptic fits.

Gabapentin is used to prevent partial seizures, and partial seizures that spread to secondary generalised seizures.

Glutamate is also involved in transmitting pain signals in the brain and nervous system. As gabapentin reduces the release of this neurotransmitter it can also be used to treat nerve pain occuring as a result of damage to or a disturbance in the function of nerves (neuropathic pain). It probably works in other ways in this area as well.