Episode #37: gabapentin (Neurontin) | Podcast Show Notes
gabapentin (GA ba pen tin)
Below will be links for the full Podcast and the Drug Card for gabapentin along with a brief summary of various points on gabapentin.Â
QUESTIONS:
- Which of the following are off label indications for gabapentin? Select all that apply.Â
- A). Fibromyalgia
- B). Seizures
- C). Alcohol dependence
- D). Neuropathic pain
- E). Postherpatic neuralgia
- True or False. Gabapentin is highly protein bound.
- True or False. Gabapentin should have a gradual dose taper when discontinuing longer term therapy.Â
- What is the main path for the metabolism of gabapentin?
SUMMARY:
Gabapentin has a wide variety of uses but the main indications are for focal seizures in adults and children and for postherpatic neuralgia in adults. There are many commonly used off label indications such as for neuropathic pain, fibromyalgia, and alcohol dependence. Max dosing for gabapentin is around 3600 mg/day. Although the exact mechanism of action is unknown, it is clear that it is similar in chemical structure to GABA. This is important because GABA is responsible for modulating excitatory neurotransmitter release. Gabapentin is poorly protein bound at <3% and not metabolized. When discontinuing longer term therapies, doses should be tapered down over at least 7 days. Some of the most common side effects are dizziness, fatigue, and weight gain. The serious side effects are depression, suicidal thoughts and behaviors, and withdrawal related seizures.
ANSWERS:Â Â
- A, B, C, and D are off label uses. Postherpatic neuralgia is one of the on label indications.
- False. Gabapentin is poorly protein bound at <3%.
- True. The risk of withdrawal related seizures may occur without a dose taper over at least 7 days.Â
- Gabapentin is not metabolized and excreted in the urine proportional to renal function.
PDF of Drug Card: gabapentin
