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Neurontin pills 600mg №100
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600 mg tablets
pharmachologic effect
According to the instructions, Neurontin has a working component - Gabapentin, which helps prevent seizures. The maximum drug accumulates in the plasma in two to three hours. Food, including fat, does not affect the effect of the drug Neurontin.
Indications and usage
Indications for Neurontin are neuropathic pain in adult patients. According to the instructions, Neurontin is also used for monotherapy in the treatment of partial seizures, both with the presence of secondary generalization and without it. In this case, the drug is used by patients older than twelve years. Children under twelve years old Neurontin is used as an additional treatment for seizures.
Contraindications
According to the instructions Neurontin is contraindicated in children up to three years. The drug can not be taken in patients with hypersensitivity to the components of the drug. Neurontin reviews confirm that this drug should be taken with caution in renal failure.
Pregnancy and Breastfeeding
There are no data on the effect of Neurontin on the fetus, so taking this drug can be carried out during pregnancy only in extreme cases.During the period of breastfeeding, if Neurontin is to be taken, breastfeeding should be temporarily abandoned.
Special notes
Antiepileptic drugs, including gabapentin, may increase the risk of suicidal thoughts or behavior. Therefore, patients receiving these drugs should be carefully monitored for the occurrence or worsening of depression, the appearance of suicidal thoughts or behavior, as well as for any changes in behavior.
In the case of the development of acute pancreatitis with gabapentin intake, the possibility of drug withdrawal should be evaluated.
Although the syndrome of "withdrawal", accompanied by the development of seizures in the treatment with gabapentin is not marked, abrupt cessation of therapy with anticonvulsant drugs in patients with epilepsy can provoke the development of epileptic status (see the section "Dosage and administration").
Gabapentin is not considered an effective treatment for the absence of epilepsy.
With simultaneous use with morphine, there may be an increase in the concentration of gabapentin in the blood plasma. In this regard, the patient needs careful observation on the development of signs of depression of the central nervous system (CNS), such as drowsiness. The dose of gabapentin or morphine should be adequately reduced (see the section "Interaction with other drugs").
While taking antiepileptic drugs, includinggabapentin, cases of severe life-threatening hypersensitivity reactions, such as a drug rash with concomitant eosinophilia and systemic symptoms, have been reported. It must be remembered that early signs of a hypersensitivity reaction, such as an increase in body temperature, lymphadenopathy, can develop even in the absence of a skin rash. In the event of these symptoms, an immediate examination of the patient is necessary. If no other reasons, except for the use of gabapentin, are found, the use of the drug should be discontinued.
Gabapentin is recommended to be taken approximately 2 hours after taking an antacid. The effect of long-term therapy (more than 36 weeks) with gabapentin on the ability to learn, the intelligence and development of the child has not been sufficiently studied. It is necessary to assess the ratio of the possible risk and benefit in the appointment of long-term therapy.
As with the use of other antiepileptic drugs, with the use of gabapentin, there may be an increase in the frequency of seizures or the appearance of another type of seizures.
When gabapentin and other anticonvulsants were used together, false-positive results were detected when determining urine protein using Ames N-Multistix SG® test strips. To determine the protein in the urine, it is recommended to use a more specific method for the precipitation of sulfosalicylic acid.
Influence on ability to drive motor transport and control mechanisms
While taking the drug, patients are not recommended to drive a car or use potentially dangerous equipment until it is confirmed that the drug does not adversely affect the performance of these functions.
Composition
Tablets, coated 1 tab. gabapentin 600 mg
excipients: Poloxamer 407; copovidone; corn starch; Magnesium stearate; Opadry White; talc; hydroxypropylcellulose; polishing wax
According to the instructions Neurontin can be used regardless of the meal. If you need to change the dosage, then all changes are carried out gradually, smoothly. With neuropathic pains, the initial dose of Neurontin is 900 mg per day, it should be divided into three doses. If necessary, the dose is gradually increased to 3.6 g per day. With partial seizures, the dosage is the same - from 900 mg to 3.6 g per day. This applies to both adult patients and children from twelve years. Usually the dose is divided into three times, but the interval between doses of the drug should not exceed twelve hours to avoid repeated convulsions. Children from three years to twelve dose should be 10-15 mg per 1 kg of body weight per day. Also, Neurontin is given three times a day, the dose is increased gradually, at least for three days. Patients with renal impairment should use as small a dose as possible. Treatment must take place under the supervision of a physician.
Drug Interactions
When using 600 mg of gabapentin 2 hours after taking morphine in the form of 60 mg prolonged-release capsules, an increase in the average AUC value of gabapentin is noted by 44% compared with gabapentin monotherapy, which is associated with an increase in the pain threshold (cold pressor test). The clinical significance of this change has not been established, and the pharmacokinetic characteristics of morphine did not change. The side effects of morphine when taken together with gabapentin did not differ from those of taking morphine together with placebo. The degree of interaction of these drugs in other doses is unknown.
The interaction between gabapentin and phenobarbital, phenytoin, valproic acid and Carbamazepine was not observed. The pharmacokinetics of gabapentin in the equilibrium state are the same in healthy people and patients receiving other anticonvulsants.
Simultaneous use of gabapentin with oral contraceptives containing norethisterone and / or ethinyl estradiol is not accompanied by changes in the pharmacokinetics of both components.
The simultaneous use of gabapentin with antacids containing aluminum and magnesium is accompanied by a decrease in the bioavailability of gabapentin by about 20% (see the section "Special Instructions").
Probenecid does not affect the renal excretion of gabapentin.
A slight decrease (14%) in renal excretion of gabapentin while taking cimetidine at the same time probably has no clinical significance.
With simultaneous use of Naproxen (250 mg) and gabapentin (125 mg), gabapentin absorption increased from 12% to 15%.Gabapentin does not affect the pharmacokinetic parameters of naproxen. The indicated doses of drugs are less than the minimum therapeutic. The simultaneous use of these drugs in large doses has not been studied.
With the simultaneous use of gabapentin and hydrocodone, a dose-dependent decrease in Cmax and AUC of hydrocodone is observed compared with hydrocodone monotherapy.