Gaba

Description

Gabapentin Capsules, containing gabapentin, are used in Pakistan to manage partial seizures in epilepsy when combined with other medications and to relieve neuropathic pain, such as that from diabetic neuropathy or post-herpetic neuralgia. Extended-release tablets (e.g., Horizant) treat restless legs syndrome. Widely prescribed for nerve-related issues in diabetic patients or those with chronic pain in urban centers like Karachi or rural Sindh, it’s available in strips of 10 capsules (e.g., 100mg, 300mg), priced around Rs. 199-222 per strip, prescription-only, and distributed through DRAP-registered pharmacies.

How It Functions

Gabapentin binds to the alpha-2-delta subunit of voltage-gated calcium channels in the brain, reducing excitatory neurotransmitter release to control seizures and dampen pain signals in neuropathic conditions. Chemically, it’s 1-(aminomethyl)cyclohexaneacetic acid. Effects begin within hours for pain, with seizure control improving over days; peak plasma levels occur in 2-3 hours, lasting 6-12 hours.

Dosage Information

Adults: For seizures, start at 300mg on day 1, increasing to 900-1800mg/day in 3 divided doses (e.g., 300mg three times daily); max 3600mg/day. For neuropathic pain, 300-600mg three times daily, starting at 100-300mg. For restless legs syndrome (extended-release), 600mg once daily at 5 PM. Children (3-12 years): 10-15mg/kg/day in 3 doses. Take capsules with water, with or without food, at evenly spaced intervals (no more than 12 hours apart). Swallow whole; do not crush. Adjust for kidney function; consult physician for duration or tapering.

Side Effects

• Very Common (>1 in 10): Dizziness, somnolence (extreme sleepiness), fatigue.
• Common (up to 1 in 10): Tremors, ataxia (loss of coordination), headache, nausea, weight gain.
• Rare: Mood changes (anxiety, depression), allergic reactions (rash, swelling), suicidal thoughts, severe drowsiness.

Drug Interactions

Gabapentin may interact with:

• Antacids (aluminum/magnesium): Reduces absorption; space 2 hours apart.
• CNS depressants (e.g., opioids, benzodiazepines): Increases sedation.
• Morphine: Enhances gabapentin levels, risking toxicity.
• Antiepileptics (e.g., phenytoin): May alter seizure control.
• Alcohol: Heightens drowsiness.

Indications

Approved for:

• Adjunctive therapy for partial seizures (with/without secondary generalization) in epilepsy.
• Neuropathic pain (e.g., diabetic neuropathy, post-herpetic neuralgia).
• Restless legs syndrome (extended-release tablets).

When Not to Use

Avoid in:

• Hypersensitivity to gabapentin or excipients.
• Severe kidney failure without dose adjustment.
• Patients with acute pancreatitis.

Precautions

• Use cautiously in kidney impairment or hemodialysis; adjust dose based on creatinine clearance.
• Monitor for mood changes or suicidal thoughts, especially in psychiatric history.
• Avoid abrupt discontinuation; taper over at least 1 week to prevent seizures.
• Elderly patients: Higher risk of dizziness or falls; start low.
• Buy from DRAP-registered pharmacies; check holograms to avoid counterfeits.
• Limit alcohol to reduce sedation risk, common in social settings in Pakistan.

Warnings

• Suicidal behavior: Rare risk; report mood changes or suicidal thoughts immediately.
• CNS depression: May cause severe drowsiness; avoid driving or machinery.
• Kidney function: Risk of toxicity in renal impairment; monitor closely.
• Seizure risk: Abrupt stopping may trigger seizures; taper gradually.
• Allergic reactions: Stop if rash, swelling, or breathing issues occur; seek urgent care.

Additional Notes

• Pregnancy Category: Consult physician; category C, use only if benefits outweigh fetal risks.
• Breastfeeding: Passes into milk; consult physician, monitor infant for drowsiness.
• Availability: Common in urban and rural pharmacies; generics like Neurontin available.
• Stability: Stable at room temperature; discard expired capsules.
• Reporting: Log batch for side effects; report to DRAP for quality control.

Doctor Review

Dr. Saeed Anwar, a neurologist in Lahore, notes Gabapentin’s effectiveness for neuropathic pain and seizure control in diabetic patients, prevalent in Pakistan. DRAP data supports its adjunctive role, but Dr. Anwar emphasizes monitoring for drowsiness and tapering to avoid withdrawal seizures.

Disclaimer

This is general product information, not a prescription or medical advice. Consult your doctor or pharmacist for personal guidance.