gabapentin Nursing Considerations & Management

 Drug Name

Generic Name :  gabapentin

Brand Name: Apo-Gabapentin (CAN), Gen-Gabapentin (CAN), Neurontin

Classification: Antiepileptic

Pregnancy Category C

Dosage & Route

Available forms : Capsules—100, 300, 400 mg; tablets—100, 300, 400, 600, 800 mg; oral solution—250 mg/5 mL

  • Epilepsy: Starting dose is 300 mg PO tid, then titrated up as needed. Maintenance: 900–1,800 mg/day PO in divided doses tid PO; maximum interval between doses should not exceed 12 hr. Up to 2,400–3,600 mg/day has been used.
  • Postherpetic neuralgia: Initial dose of 300 mg/day PO; 300 mg bid PO on day 2; 300 mg tid PO on day 3.
  • Initially, 10–15 mg/kg/day PO in three divided doses; adjust upward over about 3 days to 25–35 mg/kg daily in three divided doses in children > 5 yr, and up to 40 mg/kg/day in three divided doses in children 3–4 yr.
Therapeutic actions
  • Gabapentin is structurally related to the neurotransmitter GABA but is neither a GABA agonist nor antagonist. Gabapentin-binding sites have been identified throughout the brain tissues e.g. neocortex and hippocampus. However, the exact mechanism of action is still unknown.
  • Adjunctive therapy in the treatment of partial seizures with and without secondary generalization in adults and children 3–12 yr with epilepsy
  • Orphan drug use: Treatment of amyotrophic lateral sclerosis
  • Management of postherpetic neuralgia or pain in the area affected by herpes zoster after the disease has been treated
  • Unlabeled uses: Tremors of MS, neuropathic pain, bipolar disorder, migraine prophylaxis
Adverse effects
  • Somnolence, dizziness, ataxia, weakness, paraesthesia, fatigue, headache; nystagmus, diplopia; nausea, vomiting, wt gain, dyspepsia; rhinitis; tremor; leucopenia; altered LFTs; Stevens-Johnson syndrome.
  • Hypersensitivity. Lactation.
Nursing considerations
  • History: Hypersensitivity to gabapentin; lactation, pregnancy
  • Physical: Weight; T; skin color, lesions; orientation, affect, reflexes; P; R, adventitious sounds; bowel sounds, normal output
  • Give drug with food to prevent GI upset.
  • Arrange for consultation with support groups for people with epilepsy.
  • WARNING: If overdose occurs, hemodialysis may be an option.
Teaching points
  • Take this drug exactly as prescribed; do not discontinue abruptly or change dosage, except on the advice of your health care provider.
  • Wear a medical alert ID at all times so that any emergency medical personnel will know that you have epilepsy and are taking antiepileptic medication.
  • You may experience these side effects: Dizziness, blurred vision (avoid driving or performing other tasks requiring alertness or visual acuity); GI upset (take drug with food or milk, eat frequent small meals); headache, nervousness, insomnia; fatigue (periodic rest periods may help).
  • Report severe headache, sleepwalking, rash, severe vomiting, chills, fever, difficulty breathing.