Gabapentin (Neurontin) Prescription

Generic Name: Gabapentin

Common Brand Name: Neurontin

Buying Gabapentin Without a Prescription

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• No prior prescription required.

Common medical uses:

• Adjunctive therapy for partial seizures with or without secondary generalization in patients older than 12 yr of age with epilepsy
• Adjunctive therapy for partial seizures in children 3 to 12 yr of age
• Management of postherpetic neuralgia in adults.

Contraindications:

• Hypersensitivity to gabapentin or any of its product ingredients

Gabapentin dosage:

• Epilepsy
  Adults and children older than 12 yr of age: 900 to 1,800 mg/day (divided 3 times daily). Initial dose: 300 mg 3 times daily.
  Children 5 to 12 yr of age: Initiate therapy at 10 to 15 mg/kg/day in divided doses (eg, 3 times daily) and titrate dose upward over a period of about 3 days to effective dose. Effective dose is 25 to 35 mg/kg/day in divided doses (eg, 3 times daily).
  Children 3 to 4 yr of age: Initiate therapy at 10 to 15 mg/kg/day in divided doses (eg, 3 times daily) and titrate dose upward over a period of about 3 days to effective dose. Effective dose is 40 mg/kg/day in divided doses (eg, 3 times daily).
• Postherpetic neuralgia
  Adults: Start with a single 300 mg dose on day 1, 600 mg on day 2 (divided twice daily), and 900 mg on day 3 (divided 3 times daily). Subsequently, titrate the dose upward as needed for pain relief to a daily dose of 1,800 mg (divided 3 times daily).

Max time between doses in 3 times daily schedule should not exceed 12 h.

Dosage adjustment:

• In elderly patients, and in patients with impaired renal function, Gabapentin plasma clearance is reduced and dosage ajustment required.

Gabapentin possible side effects:

• Cardiovascular: vasodilation (1%); hypertension (at least 1%).
• Central nervous system: dizziness (28%); somnolence (21%); ataxia (12%); fatigue (11%); nystagmus (8%); tremor (7%); asthenia (6%); abnormal thinking, headache (3%); abnormal gait, abnormal thinking, amnesia, depression, dysarthria, incoordination, nervousness (2%); hypesthesia, twitching (1%); anxiety, confusion, hostility, hyperkinesia, malaise, paresthesia, vertigo (at least 1%); abnormal movements (postmarketing).
  Children 12 yr of age and younger: Somnolence, hostility (8%); emotional lability (4%); dizziness, hyperkinesia, fatigue (3%).
• Dermatologic: abrasion, pruritus, rash (1%); erythema multiforme, Stevens-Johnson syndrome (postmarketing).
• EENT: diplopia (6%); amblyopia, rhinitis (4%); pharyngitis (3%); conjunctivitis, otitis media (1%); abnormal vision (at least 1%).
• Gastrointestinal: diarrhea (6%); dry mouth (5%); constipation, nausea (4%); abdominal pain, vomiting (3%); dental abnormalities, dyspepsia, flatulence (2%); increased appetite (1%); anorexia, gingivitis (at least 1%).
  Children 12 yr of age and younger: nausea, vomiting (8%). Genitourinary Impotence (2%).
• Genitourinary: impotence (2%).
• Hematologic-lymphatic: decreased WBC, leukopenia (1%); purpura (at least 1%).
• Hepatic: elevated LFTs, jaundice (postmarketing).
• Hypersensitivity: angioedema (postmarketing)
• Metabolic-nutritional: weight gain (3%); hyperglycemia (1%); blood glucose fluctuations, hyponatremia (postmarketing).
  Children 12 yr of age and younger: weight increase (3%).
• Musculoskeletal: back pain, myalgia (2%); fracture (1%); arthralgia, decreased or absent reflexes, increased reflexes (at least 1%).
• Respiratory: coughing (2%).
• Children 12 yr of age and younger: Bronchitis, respiratory infection (3%); pneumonia (at least 1%).
• Miscellaneous: peripheral edema (8%); infection (5%); accidental injury (3%).
  Children 12 yr of age and younger: viral infection (11%); fever (10%); face edema (at least 1%).

Precautions

• CNS depression: May cause CNS depression, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).
• Renal impairment: Use with caution in patients with severe renal impairment; dose adjustment required.
• Children: Safety and efficacy have not been established in children < 3 years of age. Children 3-12 years of age have shown increased incidence of CNS-related adverse effects, including emotional lability, hostility, thought disorder, and hyperkinesia.
• Tumorigenic potential: Male rat studies demonstrated an association with pancreatic adenocarcinoma (clinical implication unknown).

Gabapentin withdrawal
Gabapentin should not be discontinued abruptly because of the possibility of increasing seizure frequency; therapy should be withdrawn gradually to minimize the potential of increased seizure frequency, unless safety concerns require a more rapid withdrawal.

Drug Interactions:

• CNS depressants (ethanol, barbiturates, opioid analgesics, and other sedative agents): Sedative effects may be additive with other prescription CNS depressants. Monitor for increased effect.
• Herb/Nutraceutical: Avoid evening primrose (seizure threshold decreased). Avoid valerian, St John's wort, kava kava, gotu kola (may increase CNS depression).
• Test Interactions: False positives have been reported with the Ames N-Multistix SG dipstick test for urine protein

Pregnancy
Pregnancy Category C.
Animal studies have documented teratogenic effects. There are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if the potential benefit to the mother outweighs the potential risk to the fetus.

Nursing Mothers
Gabapentin is excreted in human breast milk. A nursed infant could be exposed to ~1 mg/kg/day of gabapentin; the effect on the child is not known. Use in breast-feeding women only if the benefits to the mother outweigh the potential risk to the infant.

Overdose:
Symptoms of overdose include: diarrhea, double vision, drowsiness, lethargy, slurred speech.

Storage:
Store tablets and capsules at controlled room temperature (59° to 86°F). Store oral solution in refrigerator (36° to 46°F).

Where to Buy:
If you would like to buy Gabapentin (Neurontin) without a prescription, choose the offer from the above price table.

References:

• 1. U.S. Food and Drug Administration. Gabapentin (Neurontin) Prescribing Information (PDF format)