Uses
Pending revision, the material in this section should be considered in light of more recently available information in the MEDWATCH notification at the beginning of this monograph.
Seizure Disorders
Management (in combination with other anticonvulsants) of partial seizures with or without secondary generalization in adults and children >12 years of age.
Management (in combination with other anticonvulsants) of partial seizures in children 3–12 years of age.
Neuropathic Pain
Management of postherpetic neuralgia in adults.
Treatment of pain associated with diabetic neuropathy†. 40% of patients who receive gabapentin for pain associated with diabetic neuropathy obtain good pain relief.
Some evidence of benefit for the relief of chronic neurogenic pain† in a variety of conditions including trigeminal neuralgia†, pain and control of paroxysmal symptoms of multiple sclerosis†, complex regional pain syndromes†, HIV-related peripheral neuropathy†, and neuropathic pain associated with cancer†. Also has been used in the treatment of restless legs syndrome†. Additional study needed to further elucidate precise role in the management of these conditions.
Vasomotor Symptoms
Has been used for the management of vasomotor symptoms (e.g., hot flashes) in women with breast cancer†.
Has been used for the management of vasomotor symptoms (e.g., hot flashes) associated with menopause†.
Dosage and Administration
General
Seizure Disorders
- Monitoring of plasma gabapentin concentrations is not necessary to optimize therapy. Because addition of gabapentin to existing anticonvulsant therapy does not appreciably alter steady-state plasma concentrations of concomitantly administered anticonvulsants, additional monitoring of plasma concentrations of anticonvulsants generally is not necessary. (See Specific Drugs under Interactions.)
- Discontinuance of gabapentin and/or addition of an alternative anticonvulsant drug to therapy should be done gradually over ≥1 week.
Administration
Oral Administration
Administer orally without regard to meals.
If Neurontin® film-coated scored tablets containing 600 or 800 mg of gabapentin are to be used in patients requiring a 300- or 400-mg dose, divide the tablet in half to allow administration of the appropriate dose. Instruct patients to take one-half tablet and to use the remaining half-tablet for the next dose. Half-tablets that are not used within several days should be discarded.
Seizure Disorders
Administer orally 3 times daily. The interval between doses in this schedule should not exceed 12 hours.
Dosage
Pending revision, the material in this section should be considered in light of more recently available information in the MEDWATCH notification at the beginning of this monograph.
Pediatric Patients
Seizure Disorders
Partial Seizures
Oral
Children 3–12 years of age: Initially, 10–15 mg/kg daily in 3 divided doses. Maintenance dosage of 40 mg/kg daily in 3 divided doses for children 3 or 4 years of age and 25–35 mg/kg daily in 3 divided doses for children 5–12 years of age.
Children >12 years of age: Initially, 300 mg 3 times daily. Maintenance dosage of 900 mg to 1.8 g daily in 3 divided doses.
Adults
Seizure Disorders
Partial Seizures
Oral
Initially, 300 mg 3 times daily. Maintenance dosage of 900 mg to 1.8 g daily in 3 divided doses.
Neuropathic Pain
Postherpetic Neuralgia
Oral
300 mg on the first day, 300 mg twice daily on the second day, and 300 mg 3 times daily on the third day. Increase dosage as needed for relief of pain up to a total daily dosage of 1.8 g in 3 divided doses. No evidence of additional benefit with dosages >1.8 g daily.
Diabetic Neuropathy
Oral
Dosages of 900 mg to 3.6 g daily have been used; however, pain relief generally observed in patients receiving dosages >1.8 g daily.
Vasomotor Symptoms
Oral
300 mg 3 times daily has been effective; higher dosages may provide additional benefit.†
Prescribing Limits
Pediatric Patients
Children 3–12 years of age: Dosages up to 50 mg/kg daily in divided doses have been tolerated as adjunctive therapy in the management of partial seizures.
Children >12 years of age: Dosage of 3.6 g daily has been tolerated as adjunctive therapy in the management of partial seizures.
Adults
Dosage of 3.6 g daily has been tolerated as adjunctive therapy in the management of partial seizures.
Special Populations
Dosage in Renal Impairment
Not studied in children <12 years of age with renal impairment.
In adults and children ≥12 years of age, base dosage on measured or estimated Clcr:
Dosage for Adults and Children ≤12 Years of Age with Renal Impairment
| Clcr (mL/min) |
Total Daily Dosage (mg/day) |
Dosage Regimen |
| ≥60 |
900–3600 |
300 –1200 mg 3 times daily |
| 30–59 |
400–1400 |
200 –700 mg twice daily |
| 15–29 |
200–700 |
200 –700 mg once daily |
| 15a |
100–300 |
100 –300 mg once daily |
| ESRD patients undergoing hemodialysis |
— |
125–350 mgb |
|
aIn patients with Clcr <15 mL/min, reduce dosage proportionally (e.g., a patient with a Clcr of 7.5 mL/min should receive one-half the dosage that a patient with a Clcr of 15 mL/min should receive).
bGive maintenance doses based on Clcr, with supplemental doses (125–350 mg) given after each 4-hour hemodialysis session. |
Geriatric Patients
Select dosage carefully, usually initiating therapy at the low end of the dosage range. Adjust dosage based on Clcr.
Print
Email
Save
FDA Alerts
Media Gallery
Medicare's drug plans are subsidized by the US federal government and offered through insurers.
