Gabapentin

Definition
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Anticonvulsant and antiepileptic.

Pharmacodynamics (Effect)
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Gabapentin inhibits HVA calcium channels and thus blocks the influx of Ca++ ions into neurons of the CNS.

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Indication
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Seizures of focal origin; prurigo nodularis and neuropathic pruritus.

Dosage and method of use
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Adults: Initially start with 100 mg p.o. 3 times/day, increase by 300 mg/day every 1-3 days if needed. Maintenance dose: 900-2400 mg/day, may be increased to 3600 mg/day if needed.

Children & Adolescents > 12 yrs.: Initially start with approximately 50% of the maintenance dose. If needed, increase every 1-3 days up to the maximum dose. Maintenance dose: 30--50 mg/kg/day.

Undesirable effects
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Fatigue, ataxia, weakness, somnolence double vision, dizziness nystagmus, headache, tremor.

Interactions
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Drug interactions: So far, no clinically relevant interactions are known.

Preparations
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Gabax, Neurontin

Note(s)
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Gabapentin is characterised by its rapid dosing capability and minor interactions with other drugs. Compared to other anticonvulsants, it thus has advantages in the treatment of multimorbid epilepsy patients in old age.

A dose-response principle has not been demonstrated. However, 300 mg/day was found to be significantly less effective than 900 or 1800 mg/day.