Gabapentin (Systemic)
  
Gabapentin (Systemic)
US Brand Names
• Neurontin
Canadian Brand Names
• Neurontin
• Novo-Gabapentin
Another commonly used name is GBP.
Description
Gabapentin (GA-ba-pen-tin) is used to help control some types of seizures in the treatment of epilepsy. This medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to take it.
This medicine is also used to manage a condition called postherpetic neuralgia (pain after "shingles").
Gabapentin is available only with your doctor's prescription, in the following dosage form:
Oral
• Capsules (U.S. and Canada)
• Oral Solution (U.S.)
• Tablets (U.S. and Canada)
Special Considerations
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For gabapentin, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to gabapentin. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy
Gabapentin has not been studied in pregnant women. However, studies in pregnant animals have shown that gabapentin may cause bone or kidney problems in offspring when given to the mother in doses larger than the largest human dose. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.
Breast-feeding
Children
This medicine has been tested in children 3 years to 12 years of age. Children may be sensitive to the effects of gabapentin. This may increase the chance of side effects during treatment. Certain side effects may be especially likely to occur in children. It is especially important that you discuss with the child's doctor the good that this medicine may do as well as the risks of using it..
Teenagers
This medicine has been tested in a small number of patients 12 to 18 years of age. In effective doses, gabapentin has not been shown to cause different side effects or problems than it does in adults.
Older adults
Gabapentin is removed from the body more slowly in elderly people than in younger people. Higher blood levels may occur, which may increase the chance of unwanted effects. Your doctor may give you a different gabapentin dose than a younger person would receive.
Other medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking gabapentin, it is especially important that your health care professional know if you are taking any of the following:
• Antacids (e.g., Maalox)-Lower blood levels of gabapentin may occur, so gabapentin may not work properly; gabapentin should be taken at least 2 hours after any antacid is taken.
• Morphine (e.g., Kadian, MS Contin)-Higher blood levels of gabapentin may occur and there is an increased chance of side effects from the medicine. A lower dose of either medicine may be needed.
Other medical problems
The presence of other medical problems may affect the use of gabapentin. Make sure you tell your doctor if you have any other medical problems, especially:
• Kidney disease-Higher blood levels of gabapentin may occur, which may increase the chance of unwanted effects; your doctor may need to change your dose
Administration
Take this medicine only as directed by your doctor , to help your condition as much as possible. Do not take more or less of it, and do not take it more or less often than your doctor ordered.
Gabapentin may be taken with or without food or on a full or empty stomach. However, if your doctor tells you to take the medicine a certain way, take it exactly as directed.
When taking gabapentin 3 times a day, do not allow more than 12 hours to pass between any 2 doses.
If you have trouble swallowing capsules, you may open the gabapentin capsule and mix the medicine with applesauce or juice. Mix only one dose at a time just before taking it. Do not mix any doses to save for later , because the medicine may change over time and may not work properly.
Dosing
The dose of gabapentin will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of gabapentin. If your dose is different, do not change it unless your doctor tells you to do so.
The number of capsules that you take depends on the strength of the medicine.
• For oral dosage form (capsules):
o For epilepsy:
§ Adults and teenagers 12 years of age and older-At first, 300 milligrams (mg) three times a day. Your doctor may increase the dose gradually if needed. However, the dose is usually not more than 1800 mg a day.
§ Children 3 to 12 years of age-Dose is based on body weight. To start, 10 to 15 mg per kilogram (4.5 to 6.8 mg per pound) of body weight a day, divided into three doses. Your doctor may increase your dose as needed. The usual dose for children 5 years of age and older is 25 to 35 mg per kilogram (11.3 to 15.9 mg per pound) of body weight a day, divided into three doses. The usual dose for children 3 to 5 years of age is 40 mg per kilogram (18.1 mg per pound) of body weight a day, divided into three doses.
§ Children less than 3 years of age-Use and dose must be determined by your doctor.
§ Older adults-Dose must be determined by your doctor, but it is usually not more than 600 mg three times a day.
o For postherpetic neuralgia
§ Adults and teenagers- At first, 300 milligrams (mg) on day 1. On day 2, 300 milligrams (mg) two times a day. On day 3, 300 milligrams (mg) three times a day. Your doctor may want to increase your dose to a maximum daily dose of 1800 milligrams (600 milligrams three times a day).
• For oral dosage form (oral solution):
o For epilepsy:
§ Adults and teenagers 12 years of age and older-At first, 300 milligrams (mg) three times a day. Your doctor may increase the dose gradually if needed. However, the dose is usually not more than 1800 mg a day.
§ Children 3 to 12 years of age-Dose is based on body weight. To start, 10 to 15 mg per kilogram (4.5 to 6.8 mg per pound) of body weight a day, divided into three doses. Your doctor may increase your dose as needed. The usual dose for children 5 years of age and older is 25 to 35 mg per kilogram (11.3 to 15.9 mg per pound) of body weight a day, divided into three doses. The usual dose for children 3 to 5 years of age is 40 mg per kilogram (18.1 mg per pound) of body weight a day, divided into three doses.
§ Children less than 3 years of age-Use and dose must be determined by your doctor.
§ Older adults-Dose must be determined by your doctor, but it is usually not more than 600 mg three times a day.
o For postherpetic neuralgia
§ Adults and teenagers- At first, 300 milligrams (mg) on day 1. On day 2, 300 milligrams (mg) two times a day. On day 3, 300 milligrams (mg) three times a day. Your doctor may want to increase your dose to a maximum daily dose of 1800 milligrams (600 milligrams three times a day).
• For oral dosage form (tablets):
o For epilepsy:
§ Adults and teenagers 12 years of age and older-At first, 300 milligrams (mg) three times a day. Your doctor may increase the dose gradually if needed. However, the dose is usually not more than 1800 mg a day.
§ Children 3 to 12 years of age-Dose is based on body weight. To start, 10 to 15 mg per kilogram (4.5 to 6.8 mg per pound) of body weight a day, divided into three doses. Your doctor may increase your dose as needed. The usual dose for children 5 years of age and older is 25 to 35 mg per kilogram (11.3 to 15.9 mg per pound) of body weight a day, divided into three doses. The usual dose for children 3 to 5 years of age is 40 mg per kilogram (18.1 mg per pound) of body weight a day, divided into three doses.
§ Children less than 3 years of age-Use and dose must be determined by your doctor.
§ Older adults-Dose must be determined by your doctor, but it is usually not more than 600 mg three times a day.
o For postherpetic neuralgia
§ Adults and teenagers- At first, 300 milligrams (mg) on day 1. On day 2, 300 milligrams (mg) two times a day. On day 3, 300 milligrams (mg) three times a day. Your doctor may want to increase your dose to a maximum daily dose of 1800 milligrams (600 milligrams three times a day).
This medicine may be given as a combination of any of the forms it comes in.
Missed dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is less than 4 hours until your next dose, do not take the missed dose and return to your regular dosing schedule. Do not allow more than 12 hours to go by between doses. If this happens, call your doctor right away. Do not double doses.
Storage
To store this medicine:
• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the capsule or tablet forms of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Store the liquid form of this medicine in the refrigerator. However, keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
Precautions
It is important that your doctor check your progress at regular visits , especially for the first few months you take gabapentin. This is necessary to allow dose adjustments and to reduce any unwanted effects.
This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; other medicines for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you are taking gabapentin .
Gabapentin may cause blurred vision, double vision, clumsiness, unsteadiness, dizziness, drowsiness, or trouble in thinking. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert, well-coordinated, or able to think or see well. If these reactions are especially bothersome, check with your doctor.
Before you have any medical tests, tell the doctor in charge that you are taking gabapentin. The results of dipstick tests for protein in the urine may be affected by this medicine.
Do not stop taking gabapentin without first checking with your doctor. Stopping the medicine suddenly may cause your seizures to return or to occur more often. Your doctor may want you to gradually reduce the amount you are taking before stopping completely.
Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
More common
Clumsiness or unsteadiness; continuous, uncontrolled, back-and-forth and/or rolling eye movements.
More common in patients 3 to 12 years of age
Aggressive behaviors or other behavior problems; anxiety; concentration problems and change in school performance; crying; false sense of well-being; hyperactivity or increase in body movements; mental depression; reacting too quickly, too emotionally, or overreacting; rapidly changing moods; restlessness; suspiciousness or distrust.
Less common
Black, tarry stools; chills; chest pain; cough; depression, irritability, or other mood or mental changes; fever; loss of memory; pain or swelling in arms or legs; painful or difficult urination; shortness of breath; sore throat; sores, ulcers, or white spots on lips or in mouth; swollen glands; unusual bleeding or bruising; unusual tiredness or weakness.
Frequency not determined
abdominal or stomach pain; blistering, peeling, loosening of skin; clay-colored stools; coma; confusion; convulsions; dark urine; decreased urine output; diarrhea; dizziness; fast or irregular heartbeat; headache; increased thirst; itching; joint pain; large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs; loss of appetite; muscle ache or pain; nausea; red irritated eyes; red skin lesions, often with a purple center; skin rash; sores, ulcers, or white spots in mouth or on lips; unpleasant breath odor; unusual tiredness or weakness; vomiting of blood; yellow eyes or skin.
Symptoms of overdose
Diarrhea; double vision; drowsiness; sluggishness; slurred speech.
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
More common
Blurred or double vision; cold or flu-like symptoms; delusions; dementia; drowsiness; hoarseness; lack or loss of strength; lower back or side pain; swelling of hands, feet, or lower legs; trembling or shaking.
Less common or rare
Accidental injury; appetite increased; back pain; bloated full feeling; body aches or pain; burning, dry or itching eyes; change in vision; change in walking and balance; clumsiness, or unsteadiness; congestion; constipation; cough producing mucus; decrease in sexual desire or ability; dementia; difficulty breathing; dryness of mouth or throat; earache; excess air or gas in stomach or intestines; excessive tearing; eye discharge; feeling faint, dizzy, or lightheadedness; feeling of warmth or heat; flushing or redness of skin, especially on face and neck; flushed, dry skin; frequent urination; fruit-like breath odor; impaired vision; increased hunger; increased sensitivity to pain; increased sensitivity to touch; increased thirst; incoordination; indigestion; low blood pressure; nervousness; noise in ears; pain, redness, rash, swelling, or bleeding where the skin is rubbed off; passing gas; redness, pain, swelling of eye, eyelid, or inner lining of eyelid; redness or swelling in ear; runny nose; shortness of breath; slurred speech; sneezing; sweating; tender, swollen glands in neck; tightness in chest; tingling in the hands and feet; troubled breathing; trouble in sleeping; trouble in swallowing; trouble in thinking; twitching; unexplained weight loss; voice changes; vomiting; weakness or loss of strength; weight gain; wheezing.
Other side effects not listed above also may occur in some patients. If you notice any other effects, check with your doctor.
Additional Information
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, gabapentin is used in certain patients:
Other than the above information, there is no additional information relating to proper use, precautions, or side effects for this use.
October 03, 2003 
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