Neurontin

Prescription Drug Information: Neurontin

Generic Name: Gabapentin

Neurontin is an anti-epileptic/anticonvulsant class drug which is primarily used for the treatment of epilepsy and neuropathic pain. Containing the active ingredient gabapentin, a GABA analogue, Neurontin can be used as monotherapy or in combination with other drugs in adults and children over 12 years of age.

Indication/Usage:: Initially approved for the treatment of epilepsy, Neurontin is currently being widely used for the treatment of neuropathic pain. It is also used as combination therapy for the treatment of partial seizures in 3-12-year-old children. Neurontin may also be used for various indications as follows:

• Nerve pain caused by herpes or shingles in adults,
• Post-herpetic neuralgia in adults,
• Adjunctive therapy for partial seizures with or without secondary generalization in patients 12 years or older,
• Adjunctive therapy for partial seizures in pediatric patients ages 3 to 12 years,
• Hot flashes,
• Acquired pendular nystagmus,
• Infantile nystagmus,
• Menopausal symptoms,
• Pain and spasticity in multiple sclerosis,
• Opiate withdrawal.

Dose, Administration and Dosage Forms: Neurontin is available in the following formulations: capsules in 100mg, 300mg, and 400 mg strengths; film-coated tablets in 100mg, 300mg, 400mg, 600mg, and 800mg strengths; and oral solution in 250mg/5ml strength. The initial dose for Neurontin is 300mg daily, which is gradually increased to the recommended daily dose over a period of several days. The recommended dosage for post-herpetic neuralgia is 600mg 3 times per day and 300mg to 600mg 3 times per day for seizures. Withdrawal from Neurontin should be performed gradually over the space of a week. Neurontin may be taken with or without food. Tablets and capsules should be stored at room temperature (15 C - 30 C), while oral solution should be refrigerated (2 C - 8 C).

Mechanism of Action: Neurontin contains gabapentin as an active ingredient which is an anticonvulsant class drug. Though its anticonvulsant mechanism is not known, it is possible that Neurontin works via GABA receptors since it is structurally similar to the gamma aminobutyric acid (GABA) neurotransmitter. Neurontin's analgesic mechanism is also not known, but it exerts analgesic action in both allodynia and hyperalgesia stimuli.

Side-effects and Safety Profile: Neurontin is reported to cause various serious side-effects, such as aggravated seizures, increased risks of suicidal attempts, chest pains, irregular heart rhythm, dyspnea, jaundice, swollen glands, memory problems, blurred vision, etc.

Various moderately-serious side-effects related to the use of Neurontin include body pain, flu, skin rash, confusion, bruising, bleeding, loss of appetite, rapid weight gain, tingling, cough, numbness, trouble concentrating, muscular weakness, altered urination, dark urine, fever, stomachache, yellow skin, somnolence, changes in behavior, loss of coordination, fluid retention, hypertension, etc.

Various non-serious side-effects related to Neurontin are nausea, vomiting, diarrhea, constipation, swelling, headache, dry mouth, dizziness, drowsiness, restlessness, weakness, tiredness, etc.

Warnings and Contraindications:

• Neurontin is contraindicated in patients who are allergic to gabapentin.
• Neurontin may increase the risks of suicidal behavior, ideation and attempt; therefore, patients must be regularly monitored for unusual changes in mood and behavior.
• Neurontin is associated with withdrawal precipitated status epilepticus seizures; therefore, it should not be discontinued abruptly.
• Pre-marketing development reports indicate that Neurontin may cause sudden unexplained death in epilepsy patients.
• Neurontin is classified as a pregnancy category C drug which means it has not been studied in pregnant women; therefore, it should only be used in pregnant women if the potential benefit justifies the potential risks to the fetus.
• Gabapentin can pass into breast milk and may harm the nursing baby; therefore, it should not be used in nursing women.

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