The primary issue with gabapentin dosage is that in order to get to optimal therapeutic gabapentin dosage of patient needs to start at a lower gabapentin dosage than is likely to help with the symptoms and gradually taper the gabapentin dosage up to an effective gabapentin dosage.
Gabapentin side effects are very common, especially with the initiation of therapy. For this reason many physicians recommend an even slower start in gabapentin dosage than is on the FDA approved gabapentin dosage regimen. In the package insert for gabapentin the recommended dosage for neuropathic pain is to take 3 mg daily for the first day, 300 mg twice on the second day and then three to milligrams three times daily. The dosage can then be gradually increased up to a maximum of 1200 mg three times a day for neuropathic pain. In many physicians experience the chances of significant gabapentin side effects including sedation, uncoordinated movements and dizziness when dosing is increased this quickly is very high. Sometimes patients need to begin as low as 100 mg bedtime as an initial gabapentin dosage and then taper up by increasing as little as 100 mg every few days using their symptoms as team a guide to the rate at which they increase the gabapentin dosage. Although obviously initiating therapy this slowly will take longer to get to therapeutic gabapentin dosage and may delay pain relief it can alleviate discontinuation of gabapentin prior to getting to therapeutic gabapentin dosage.
The typical gabapentin dosage for both postherpetic neuralgia and other neuropathic pain like diabetic peripheral neuropathy is 600 mg three times a day. Some patients will get adequate relief with as little as three to milligrams at bedtime but usually patients benefit from increasing the gabapentin dosage to at least 18 your hundred milligrams daily.
The available gabapentin dosage options that are easily commercially available include 100 mg, 300 mg, 400 mg, 600 mg and 800 mg tablets or capsules as well as a 50 mg per ML liquid preparation and a 250 mg per ML liquid preparation. As with most medications using the highest milligram of gabapentin dosage per pill or capsule that meets patients dosage regimen needs usually makes taking the needed gabapentin dosage simplest and least expensive.
Tapering of gabapentin dosage is very important in patients using gabapentin for seizure disorder. Abrupt discontinuation of gabapentin dosage in patients with seizures can greatly increase the risk of having seizures. Even in patients taking their gabapentin dosage for neuropathic pain or other indications should discontinue their gabapentin dosage over at least seven days.
Some gabapentin side effects are directly related to the gabapentin dosage used. These gabapentin side effects dizziness, sleepiness, loss of balance and ataxia, fatigue, nausea or vomiting, blurry vision, and abnormal thinking. Other gabapentin side effects are about is likely to happen at one gabapentin dosage is another and include leukopenia, thrombocytopenia, erythema multiforme, Stevens-Johnson syndrome and fever. This is not intended to be a complete list of gabapentin side effects the reader should consult the manufacturers prescribing guidelines for complete list of gabapentin side effects.
Gabapentin is pregnancy category C drug and so animal studies do show adverse fetal effects there are no controlled human studies and the safety of gabapentin pregnancy has not been studied at various gabapentin dosage levels. Gabapentin is felt be probably safe during lactation but again there is no data available on how gabapentin dosage relates to the potential safety concerns in breast-feeding women.
Gabapentin is not metabolized in the liver, does not use the CYP 450 enzyme system, and is essentially 100% excreted in the urine unchanged. Gabapentin dosage does not affect the renal excretion of gabapentin and its server concentrations are felt to be linear, meaning that the increase in certain levels of gabapentin is directly related to the gabapentin dosage ingested.
An alternative to gabapentin is Lyrica which has the advantage of not requiring the slow tapering that is necessary with gabapentin dosage. The initial dose of Lyrica can be as high as 75 mg twice a day which is often a therapeutic dosage. The big disadvantage Lyrica is that is not available as a generic product and has a much higher co-pay on most commercial insurance plans then gabapentin. Even though gabapentin is available as a generic product is still not an inexpensive medication. The typical cost of a 600 mg three times a day gabapentin dosage through discount pharmacies is approximately $90-$100 a month.
The trade name drug originally marketed for gabapentin was Neurontin. Neurontin was and remains available in the same dosage forms as gabapentin although use of generic gabapentin is come so widespread that few patients use the brand name product Neurontin.
There are a number of cautions and contraindications to the use of gabapentin in these include concurrent use of alcohol, use of other central nervous system depressant drugs, significant renal impairment and use in patients with major depression. Of course in patients with hypersensitivity to gabapentin the use of any gabapentin dosage is contraindicated.
In summary the most commonly used effective gabapentin dosage for neuropathic pain is 600 mg three times a day. It’s very important to slowly increase gabapentin dosage from as little as 100 to 300 mg on the first day in order to avoid the anticipated side effects of a more accelerated institution of gabapentin dosage.