ADMINISTRATION ROUTES:
PO, NG
ALTERNATIVE NAMES:
Neurontin, Nupentin
ICU INDICATIONS:
- Treatment of pain (particularly neuropathic pain)
Note: Gabapentin is an anticonvulsant but is not generally used for this indication in ICU
PRESENTATION AND ADMINISTRATION:
PO:
Capsules:
Neurontin 100 mg capsules (white), Neurontin 300 mg capsules (yellow), Neurontin 400 mg capsules (orange)
Nupentin 100 mg capsules (white), Nupentin 300 mg capsules (yellow), Nupentin 400 mg capsules (orange)
Note: Neurontin capsules can be opened and contents mixed with 10 mL of water for administration via NG tube
Tablets:
Neurontin 600 mg tablets (white)
DOSAGE:
PO / NG:
Begin at 100 mg q8h
Increase as tolerated to maximum 1800 mg total per day (given in divided doses)
Total dosage up to 3600 mg total per day (given in divided doses) have occasionally been used
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
Dose in renal impairment [GFR (mL/min)]
| GFR (ml/min) | DOSE |
|---|---|
| <15 | 300 mg alternate days |
| 15-30 | 300 mg OD |
| 31-60 | 300 mg BD |
| 61-90 | 400 mg TDS |
Dose in renal replacement therapy
| MODALITY | DOSE |
|---|---|
| CAPD | 300 mg alternate days |
| HD | 200 - 300 mg after each dialysis session |
| CVVHDF | rarely indicated; increased doses may be required |
DOSAGE IN PAEDIATRICS:
PO:
2 mg/kg TDS
Increase to maximum 15 mg/kg or higher if tolerated
CLINICAL PHARMACOLOGY:
Gabapentin is structurally related to the neurotransmitter GABA (gamma-aminobutyric acid). Its mechanism of action is unknown.
CONTRAINDICATIONS:
- Hypersensitivity to gabapentin
WARNINGS:
When gabapentin is used as an anticonvulsant, abrupt withdrawal may precipitate seizures
PRECAUTIONS:
General:
See WARNINGS
Laboratory Tests:
No tests in addition to routine ICU tests are required
Drug/Laboratory Test Interactions:
Because false positive readings were reported with the Ames N-Multistix SG dipstick test for urinary protein when gabapentin was added to other antiepileptic drugs, the more specific sulfosalicylic acid precipitation procedure is recommended to determine the presence of urine protein
IMPORTANT DRUG INTERACTIONS IN ICU:
None of note
ADVERSE REACTIONS:
Body as a Whole:
Headache, abdominal pain
Digestive System:
Diarrhoea, dry mouth, constipation, nausea, vomiting, flatulence
Metabolic and Nutritional Disorders:
Weight gain, Hyperglycaemia
Nervous System:
Dizziness, Somnolence, Ataxia, Abnormal gait, Incoordination, Amnesia, Hypesthesia
Skin and Appendages:
Rash