Gabapentin is indicated for:

• Postherpetic neuralgia in adults
• Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization, in adults and pediatric patients 3 years and older with epilepsy

Neuralgia

Seizure

Postherpetic Neuralgia 

• Dose can be titrated up as needed to a dose of 1800 mg/day 
• Day 1: Single 300 mg dose 
• Day 2: 600 mg/day (i.e., 300 mg two times a day)
• Day 3: 900 mg/day (i.e., 300 mg three times a day)

Epilepsy with Partial Onset Seizures 

• Patients 12 years of age and older: starting dose is 300 mg three times daily; may be titrated up to 600 mg three times daily 
• Patients 3 to 11 years of age: starting dose range is 10 to 15 mg/kg/day, given in three divided doses; recommended dose in patients 3 to 4 years of age is 40 mg/kg/day, given in three divided doses; the recommended dose in patients 5 to 11 years of age is 25 to 35 mg/kg/day, given in three divided doses. The recommended dose is reached by upward titration over a period of approximately 3 days 
• Dose should be adjusted in patients with reduced renal function

Most common adverse reactions were: 

• Postherpetic neuralgia: Dizziness, somnolence, and peripheral edema 
• Epilepsy in patients >12 years of age: Somnolence, dizziness, ataxia, fatigue, and nystagmus 
• Epilepsy in patients 3 to 12 years of age: Viral infection, fever, nausea and/or vomiting, somnolence, and hostility

Somnolence

Dizziness

Edema

Ataxia

• Drug Reaction with Eosinophilia and Systemic Symptoms (Multiorgan hypersensitivity):  If an alternative etiology cannot be established, the treatment should be discontinued.
• Anaphylaxis and Angioedema: Stop immediately and evaluate the patient.
• If Gabapentin is abruptly discontinued, patients with seizure disorders may experience an increase in seizure frequency.
• Driving Impairment; Somnolence/Sedation and Dizziness: Warn patients not to drive until they have gained sufficient experience to assess whether their ability to drive or operate heavy machinery will be impaired
• Suicidal Behavior and Ideation: Suicidal thoughts/behavior should be monitored.