Gapentin

Gapentin - Precautions | Dosage | Effects

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

Gapentin is a medicine that contains an active substance called gabapentin. It works by changing the pain-related responses, which is why it is used in the treatment of neuropathic pain. Neuropathic pain is a chronic condition that occurs as a result of damage of the nervous system. The most common form of neuropathic pain seen in practice is diabetic peripheral neuropathy.

Gapentin can be used in the treatment of epilepsy, although studies have not revealed the mechanism of antiepileptic effects of this medicine.

Precautions

Robert G. et all conducted a pharmacoepidemiological study on the effect of gabapentin on increasing the risk of suicidal attempts. They concluded that this drug increases the risk of suicidal attempts only in psychiatric patients and has no effect in non-psychiatric patients.

In 2008, the FDA issued a warning that all antiepileptic drugs should be used with caution due to the possible risk of suicidal thoughts and ideas. Physicians should alert the patient and his/her family to the possible occurrence of suicidal thoughts/ideation, and the patient should talk to their doctor if he / she notices any psychological changes, e.g. aggressive behavior, hallucinations, frequent mood swings, and others.

Although Gapentin is used to treat neuropathy, cases of polynuropathy have been reported in patients who have been using this medicine. If you notice a worsening of the symptoms of neuropathy while you are taking this medicine, you should contact your doctor immediately.

Kruszewski SP.et all reported the case of a 38-year-old man who was on the Gapentin therapy and who developed dependence and delirium. The authors of this case report believe that dependence occurred most likely due to the possible action of Gabacor on gamma-aminobutyric acid. Patients who have a positive history of alcohol or drug dependence must use this medicine with extra precaution.

Patients who have kidney damage must use this medicine very cautiously, because cases of neurological damage have been reported in patients who have renal impairment and are using Gapentin.

Gapentin can cause cholestasis (liver disorder), and you should contact your doctor immediately if you notice signs of liver damage, such as: jaundice (yellowing of the skin and eyes), dark urine, pain in the right abdomen, nausea, excessive itching and light-colored stool.

Gapentin can cause sexual dysfunction, including loss of libido, impotence and anorgasmia (impossibility of achieving orgasm despite adequate stimulation), even when taken in low doses (300 mg).

Gapentin should not be abruptly discontinued, as it abrupt discontinuation increases the risk of a withdrawal syndrome, which can cause status epilepticus (life-threatening condition). Your doctor will determine which dose is best for you and how to take this medicine. Never change the dose of Gapentin on your own. Make sure you never forget to take a dose of Gapentin.

In a study involving 2203 patients who used this drug, 8 sudden deaths were reported. However, a cause-effect relationship couldn't be determined and it is not ruled out that the death occurred due to an epileptic seizure itself and not due to the drug.

Multi-organ hypersensitivity, more commonly known as DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms), can occur in patients taking Gapentin. DRESS may have a fatal outcome, and it is necessary to contact your doctor immediately if you notice an enlargement of lymph nodes, rash or fever. Multi-organ hypersensitivity can cause damage to the liver, kidneys and heart muscle, which can endanger the patient's life.

Dosage

The recommended dosage in patients over 12 years of age (for the treatment of epilepsy and neuropathy) is shown in the table below:

Days of Therapy Recommended dose
Day 1 300 mg once a day
Day 2 300 mg two times a day
Day 3 300 mg three times a day
After Day 3 Dose should be gradually increased until an appropriate therapeutic effect is achieved

Gapentin capsules can be taken independently of meals.

Gapentin should not be taken at the same time with alcoholic beverages, as this increases the risk of side effects.

Gapentin, Pregnancy and Breastfeeding

FDA: Class C.

Gapentin is classified in category C because studies in animals indicate that Gapentin may disrupt the ossification of certain bones of the fetus and lead to malformations. To date, there are no adequate studies on the use of Gapentin during pregnancy, and therefore its use during pregnancy should be avoided.

Gapentin is secreted into breast milk and should not be used during breastfeeding.

Interactions

Gapentin should not be used concurrently with opioid analgesics, such as: buprenorphine, propoxyphene, levomethadyl acetate and others. Concomitant use with these medicines increases the risk of side effects. Concomitant use with opioid analgesics can cause respiratory depression and coma!

Gapentin should not be used concomitantly with sodium oxybate (a drug used to treat narcolepsy). Concomitant use can lead to coma!

Side Effects

Gapentin can cause the following side effects:

  • Respiratory infections.
  • Urinary infections.
  • Inflammation of the ear.
  • Multi-organ hypersensitivity (early signs include fever and enlargement of the lymph nodes).
  • Hallucinations.
  • Agitation.
  • Liver damage.
  • Tinnitus.
  • Visual disturbances.
  • High blood pressure.
  • Back pain.
  • Loss of libido.
  • Impotence.
  • Leukopenia.
  • Headache.
  • Paresthesia.
  • Emotional liability.
  • Allergic reactions.

Tell your doctor if you are experiencing any side effects.

References

  1. FDA link 1
  2. NCBI link 1
  3. NCBI link 2
  4. NCBI link 3
  5. NCBI link 4
  6. NCBI link 5
  7. NCBI link 6

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If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional.

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