Gabacor

Gabacor - Dosage | Pregnancy | Interactions

This article was medically reviewed by M.Pharm, Marko Tanaskovic on August 12, 2018. To read more about an author, click here.

Gabacor is a drug containing an active substance called gabapentin. It works by binding to the auxiliary subunit of the voltage-sensitive calcium channels in the brain, which prevents seizures in patients who have generalized and partial tonic-clonic seizures. Gabacor does not bind to GABA-A and GABA-B receptors in the brain, although in vitro studies have shown that Gabacor modulates the action of enzymes involved in the synthesis of gamma-aminobutyric acid.

Gabacor also reduces the responses associated with neuropathic pain.

Due to these effects, Gabacor is used to treat epilepsy and peripheral neuropathic pain, such as diabetic neuropathy and postherpetic neuralgia.

Precautions

Like all other antiepileptic medicines, Gabacor can also cause suicidal thoughts. A meta-analysis involving as much as 199 placebo-controlled studies has shown that the use of antiepileptic medicines increases the risk of suicidal thoughts with an approximate incidence of 1 in 530 patients. The majority of patients develop suicidal thoughts in the first week of therapy. Patients and their closest friends or family must be aware of the risk of this side effect and contact a doctor if any psychiatric changes occur (e.g. panic attacks, aggressive behavior or sudden mood swings). Patients suffering from epilepsy have a higher risk of suicidal thought than patients who have neuropathy.

The use of Gabacor should not be abruptly discontinued as it may lead to status epilepticus. Status epilepticus is a condition that is manifested by the occurrence of more than 3 epileptic seizures in less than 30 minutes and may have a fatal outcome. For this reason, do not ever stop taking Gabacor abruptly and make sure you do not skip the dose. When your doctor considers that treatment with Gabacor should be discontinued, he/she will explain how to gradually reduce the dose and stop taking this medicine.

Although studies in mice have showed a high risk of pancreatic adenocarcinoma in male rats, data from human clinical studies on the use of Gabacor for a total of 2085 patient-years of exposure showed that carcinomas occurred in 10 patients (two breast cancers, two lung cancers, three brain cancers, one adrenal gland cancer, one endometrial cancer and one non-Hodgkin's lymphoma).

In a clinical study involving 2203 patients who used gabapentin for the treatment of epilepsy, 8 cases of sudden death have been reported, however, it cannot be ruled out that sudden death occurred due to epilepsy itself and not due the effects of the drug.

Drug reaction with eosinophilia and systemic symptoms (DRESS) has been reported in patients taking Gabacor. If you are experiencing skin rash, fever and enlargement of one or more lymph nodes, you should contact your doctor immediately as these are early signs of DRESS. DRESS can be life-threatening to the patient.

Gabacor can often cause dizziness and drowsiness (including somnolence), and if you are experiencing these side effects, you should not drive a car or operate machinery.

Dosage

Gabacor may be found in the form of capsules (at doses of 100 mg, 300 mg and 400 mg) as well as in form of film-coated tablets (at doses of 600 mg and 800 mg).

The recommended dose in patients over 12 years in the treatment of peripheral neuropathy and epilepsy (if used as monotherapy) is 300 mg/day on the Day 1 of treatment, 600 mg/day on the Day 2 of the treatment and 900 mg/day on the Day 3 of the treatment. After the Day 3, the dose should be increased gradually until the therapeutic effect is achieved. Maximum daily dose of 1800 mg should not be exceeded.

Gabacor can be taken regardless of the meal, because the food does not change absorption of Gabacor. If you break the tablet in half, keep in mind that the remaining half of the tablet must be taken within 2 days, because if you do not take it within 2 days, then you should throw it away.

The recommended starting dose in the treatment of epilepsy in children aged 3-12 years is 10-15 mg / kg / day divided into three equal doses. The dose may be increased gradually until an appropriate therapeutic effect is achieved. The effective dose for children 3-4 years of age is 40 mg / kg / day, and 25-35 mg / kg / day in children older than 5 years, respectively.

Your doctor will determine the proper dose for you.

Gabacor, Pregnancy and Breastfeeding

Studies in mice in which Gabacor was administered at doses 1-4 times higher than the maximum recommended dose in humans, it was observed that Gabacor negatively affects the ossification of the skull and vertebra in the fetus. Studies on rabbits have shown that Gabacor can also cause fetal loss. For now, there are no adequate studies on the use of Gabacor in human pregnancy. For this reason, the FDA classifies this drug in group C, which is why it should not be used during the pregnancy unless the benefit to the mother is greater than the risk for the fetus.

Consult your doctor if you are pregnant or if you are planning a pregnancy.

Gabacor is secreted into breast milk and should not be used in breastfeeding mothers.

Interactions

Gabacor should not be used concurrently with the following medicines:

  • Propoxyphene - analgesic agent used to treat mild and moderate pain. Concomitant use increases the risk of side effects, such as: impaired concentration, drowsiness, confusion and dizziness.
  • Buprenorphine - partial opioid agonist used to treat opioid addiction. Concomitant use may lead to depression of the central nervous system, respiratory depression and may result in coma.
  • Levomethadyl acetate (brand name Orlaam) - synthetic opioid analgesic. Concomitant use increases the risk of side effects, such as: low blood pressure, motor coordination disorder, difficulty breathing, and others.
  • Sodium oxybate - depressant of the central nervous system used in the treatment of narcolepsy. Concomitant use increases the risk of side effects, such as: drowsiness, slow breathing, difficulty breathing, hypotension, dizziness, and depression.
  • Antacids (medicines used to treat gastroesophageal reflux and ulcers). These drugs reduce the absorption of Gabacor medication by 25%, and must be taken separately, at intervals of at least four hours, from Gabacor.

Tell your doctor about all the medicines you are taking.

Side Effects

Gabacor may cause the following side effects:

  • Decrease in the number of leukocytes in the blood, resulting in weakened immune system.
  • Increase or decrease in blood glucose levels in diabetics.
  • Decrease in the number of blood platelets that can lead to bruising or prolonged bleeding.
  • Depression.
  • Anxiety.
  • Confusion.
  • Enlargement of the lymph nodes.
  • Loss of memory.
  • Hallucinations.
  • Tremor.
  • Insomnia.
  • Loss of consciousness.
  • Decrease in blood sodium concentration.
  • Double vision.
  • Palpitations.
  • High blood pressure.
  • Hair loss.
  • Acute renal failure.
  • Fever.
  • Flu-like syndrome.
  • Pain in the muscles and joints.
  • DRESS.
  • Rhabdomyolysis.
  • Allergic reactions.

Tell your doctor if you are experiencing any side effects.

References

  1. FDA link 1
  2. FDA link 2

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