From the Guidelines
Neurontin (gabapentin) is typically prescribed for neuropathic pain, with specific medical criteria guiding its use, including documented nerve pain conditions such as diabetic neuropathy, postherpetic neuralgia, or fibromyalgia, and dosing usually starting at 100-300 mg nightly, increasing to 900-3600 mg daily in divided doses 2 to 3 times a day, as recommended by the study 1.
Medical Criteria for Neurontin Use
The medical criteria for Neurontin use include:
- Documented nerve pain conditions such as diabetic neuropathy, postherpetic neuralgia, or fibromyalgia
- Evaluation of kidney function, as dose adjustments are necessary for patients with renal impairment, as noted in the study 1
- Monitoring for mood changes, as gabapentin carries a small risk of suicidal ideation, as mentioned in the study 1
Dosing and Administration
The dosing and administration of Neurontin include:
- Starting dose of 100-300 mg nightly, increasing to 900-3600 mg daily in divided doses 2 to 3 times a day, as recommended by the study 1
- Gradual titration to minimize side effects, such as dizziness and somnolence, as noted in the study 1
- Dose adjustments for patients with renal insufficiency, as recommended by the study 1
Side Effects and Monitoring
The side effects and monitoring of Neurontin include:
- Common side effects such as dizziness, somnolence, and peripheral edema, as mentioned in the study 1
- Monitoring for mood changes, as gabapentin carries a small risk of suicidal ideation, as noted in the study 1
- Regular follow-up appointments to assess efficacy and manage side effects, as recommended by the study 1
From the FDA Drug Label
Dosage and Administration 2. 1 Dosage for Postherpetic Neuralgia In adults with postherpetic neuralgia, gabapentin may be initiated on Day 1 as a single 300 mg dose, on Day 2 as 600 mg/day (300 mg two times a day), and on Day 3 as 900 mg/day (300 mg three times a day). 2. 2 Dosage for Epilepsy with Partial Onset Seizures Patients 12 years of age and above The starting dose is 300 mg three times a day. 2. 3 Dosage Adjustment in Patients with Renal Impairment Dosage adjustment in patients 12 years of age and older with compromised renal function or undergoing hemodialysis is recommended, as follows The medical criteria for Neurontin (gabapentin) include:
- Postherpetic Neuralgia: initiate with 300 mg on Day 1,600 mg/day on Day 2, and 900 mg/day on Day 3, with a maximum dose of 1800 mg/day.
- Epilepsy with Partial Onset Seizures: start with 300 mg three times a day, with a recommended maintenance dose of 300 mg to 600 mg three times a day.
- Renal Impairment: dosage adjustment is recommended for patients 12 years and older with compromised renal function or undergoing hemodialysis, based on creatinine clearance values 2.
From the Research
Neurontin Medical Criteria
- Neurontin, also known as gabapentin, is used to treat various medical conditions, including neuropathic pain, partial-onset seizures, and anxiety disorders 3.
- The US Food and Drug Administration (FDA) approved gabapentin for the treatment of neuropathic pain associated with diabetic peripheral neuropathy and postherpetic neuralgia 3.
- Gabapentin is also used as an adjunctive treatment for adults with partial-onset seizures 3.
- The medication has been shown to be effective in reducing pain scores and improving sleep in patients with neuropathic pain 3, 4.
- Common adverse effects of gabapentin include somnolence, dizziness, and headache 3.
- The dosage of gabapentin can vary depending on the condition being treated, with typical doses ranging from 300 to 3600 mg/day 4, 5.
- Gabapentin can be used as monotherapy for the treatment of focal epilepsy, although the evidence is limited and the quality of the studies is variable 5.
- Other medications, such as pregabalin, may be more effective than gabapentin for certain conditions, such as neuropathic pain in spinal cord injury patients 4.
- The choice of medication and dosage should be individualized based on the patient's specific needs and medical history 6, 7.