Primary Epilepsy Drug Name: Neurontin
Chemical Name: Gabapentin
What is Neurontin?
Neurontin (Gabapentin) is indicated as adjunctive therapy in the
treatment of partial seizures with and without secondary generalization
in patients over 12 years of age with epilepsy. Neurontin is also
indicated as adjunctive therapy in the treatment of partial seizures
in pediatric patients age 3 – 12 years. Neurontin (gabapentin)
is indicated for the management of postherpetic neuralgia in adults.
Postherpetic neuralgia (post-her-PET-tick noo-RAL-juh) —
or PHN — is a pain that lasts after shingles has healed. PHN
may result from nerve damage that is caused by shingles. People
with PHN often describe their pain as burning, stabbing, and shock-like.
The pain can hit at any time.
top of page
Neurontin Side Effects
The most frequent clinical adverse events occurring in all clinical
studies were: somnolence, dizziness, ataxia, headache, nystagmus,
tremor, fatigue, diplopia, nausea and/or vomiting and rhinitis.
From data drawn from placebo controlled studies, adverse events
are listed in descending order of frequency both by bodily system
and by associated adverse events:
Nervous system: Somnolence, dizziness, ataxia,
nystagmus, tremor, dysarthria, amnesia, confusion, insomnia, twitching,
abnormal co-ordination, paresthesia, vertigo.
Body as a whole: Fatigue, headache, weight increase,
back pain, peripheral oedema, viral infection, fever.
Digestive System: Nausea and vomiting, dyspepsia,
abdominal pain, dry mouth or throat, constipation, dental abnormalities,
diarrhoea, increased appetite.
Special Senses: Diplopia, amblyopia.
Respiratory System: Rhinitis, pharyngitis, coughing,
respiratory tract infection.
Skin and Appendages: Rash, pruritus, abrasion, acne, maculopapular
rash.
Psychobiologic Function: Nervousness, depression, thinking
abnormal, emotional lability.
Laboratory Deviations: White blood cells decreased.
Urogenital System: Impotence.
Musculoskeletal System: Myalgia, fracture.
Cardiovascular System: Vasodilation.
Haemic & Lymphatic System: Leucopenia, purpura.
Sudden and Unexplained Deaths: During the course
of premarketing development of Neurontin, 8 sudden and unexplained
deaths were recorded among a cohort of 2203 patients treated (2103
patient-years of exposure). Some of these could represent seizure-related
deaths in which the seizure was not observed e.g. at night. This
represents an incidence of 0,0038 deaths per patient-year. Although
this rate exceeds that expected in a healthy population matched
for age and sex, it is within the range of estimates for the incidence
of sudden unexplained deaths in patients with epilepsy not receiving
Neurontin (ranging from 0.0005 for the general population of epileptics,
to 0,003 for a clinical trial population similar to that in the
Neurontin program, to 0,005 for patients with refractory epilepsy).
Consequently, whether these figures are reassuring or raise further
concern depends on comparability of the populations reported upon
to the Neurontin cohort and the accuracy of the estimates provided.
Additional post-marketing adverse events reported include pancreatitis,
erythema multiforme, Stevens-Johnson syndrome and elevated liver
function tests (LFTS).
top of page
Neurontin Mechanism of Action
The mechanism by which Neurontin (Gabapentin) exerts its analgesic
action is unknown. However, it is postulated that Neurontin allodynia
(pain-related behavior in response to a normally innocuous stimulus)
and hyperalgesia (exaggerated response to painful stimuli). In particular,
Neurontin (Gabapentin) prevents pain-related responses in several
models of neuropathic pain in animal models (e.g. spinal nerve ligation
models, streptozocin-induced diabetes model, spinal cord injury
model, acute herpes zoster infection model). Neurontin (Gabapentin)
also decreases pain-related responses after peripheral inflammation
(carrageenan footpad test, late phase of formalin test). Neurontin
(Gabapentin) did not alter immediate pain-related behaviors (rat
tail flick test, formalin footpad acute phase, acetic acid abdominal
constriction test, footpad heat irradiation test). The relevance
of these models to human pain is not known. The mechanism by which
Neurontin (Gabapentin) exerts its anticonvulsant action is unknown,
but in animal test systems designed to detect anticonvulsant activity,
Neurontin (Gabapentin) prevents seizures as do other marketed anticonvulsants.
Neurontin (Gabapentin) exhibits antiseizure activity in animals
in both the maximal electroshock and pentylenetetrazole seizure
models and other preclinical models (e.g., strains with genetic
epilepsy, etc.). The relevance of these models to human epilepsy
is not known. Neurontin (Gabapentin) is structurally related to
the neurotransmitter GABA (gamma-aminobutyric acid) but it does
not modify GABAA or GABAB radioligand binding, it is not converted
metabolically into GABA or a GABA agonist, and it is not an inhibitor
of GABA uptake or degradation. Gabapentin was tested in radioligand
binding assays at concentrations up to 100 µM and did not
exhibit affinity for a number of other common receptor sites, including
benzodiazepine, glutamate, N-methyl-D-aspartate (NMDA), quisqualate,
kainate, strychnine-insensitive or strychnine-sensitive glycine,
alpha 1, alpha 2, or beta adrenergic, adenosine A1 or A2, cholinergic
muscarinic or nicotinic, dopamine D1 or D2, histamine H1, serotonin
S1 or S2, opiate mu, delta or kappa, cannabinoid 1, voltage-sensitive
calcium channel sites labeled with nitrendipine or diltiazem, or
at voltage-sensitive sodium channel sites labeled with batrachotoxinin
A 20-alpha-benzoate. Furthermore, gabapentin did not alter the cellular
uptake of dopamine, noradrenaline, or serotonin. In vitro studies
with radiolabeled gabapentin have revealed a gabapentin binding
site in areas of rat brain including neocortex and hippocampus.
A high-affinity binding protein in animal brain tissue has been
identified as an auxiliary subunit of voltage-activated calcium
channels. However, functional correlates of gabapentin binding,
if any, remain to be elucidated.
Neurontin Canada - Is Neurontin from Canada
Safe?
Canadian Interenet Pharmacies with the CIPA
seal are a part of the Canadian International Pharmacy Association
Canada and only ship drugs that are of the highest quality, and
as safe as in the United States. Neurontin is one of the many drugs
that established Canadian Pharmacies deliver.
CIPA Certified Canadian Pharmacies dispense only Health Canada approved
prescription drugs such as Neurontin from Canada.
Health Canada is the equivalent to the US FDA and has standards
that match those of the FDA.
Prescription drugs from a Cipa Certified Canadian pharmacies are
just as good as those purchased in the United States and the generic
drugs, commonly purchased from online Canadian pharmacies, are of
the highest standard in the world. When purchasing your prescriptions
from an online Canadian Pharmacy you will notice that generic versions
of many popular brand names drugs are readily available.
Neurontin from Canada and other Prescription drugs from
Canada points to note:
- All Drugs are approved by Health Canada
- Health Canada is Canada's equivilent to the FDA
- Canadian Generics are of the highest quality in the world
- Prescrition medications from Canada really are of the highest
quality in the world
top of page
Neurontin Drug Interactions
There is no interaction between gabapentin, phenobarbitone, phenytoin,
valproic acid, carbamazepine or carbamazepine 10,11-epoxide. Neurontin
(Gabapentin) steady-state pharmacokinetics are similar for healthy
subjects and patients with epilepsy receiving anti-epileptic agents.
Co-administration of Neurontin (Gabapentin) with oral contraceptives
containing norethindrone and/or ethinyl estradiol, does not influence
the steady-state pharmacokinetics of either component.
Co-administration of Neurontin (Gabapentin) with a magnesium-and
aluminium-containing antacid reduces Neurontin (Gabapentin) bioavailability
by approximately 24%. It is recommended that gabapentin be taken
about two hours following antacid administration. Renal excretion
of Neurontin (Gabapentin) is unaltered by probenecid. A slight decrease
in renal excretion of gabapentin observed when it is co-administered
with cimetidine is not expected to be of clinical importance.
False positive tests for proteinuria may occur with Ames Multistix-SG.
top of page
Neurontin Precautions
Although there is no evidence of rebound seizures with Neurontin
(Gabapentin), abrupt withdrawal of anticonvulsants in epileptic
patients may precipitate status epilepticus. When in the judgement
of the clinician there is a need for dose reduction, discontinuation,
or substitution of alternative anticonvulsant medication, this should
be done gradually over a minimum of one week.
Neurontin (Gabapentin) is not generally considered effective in
the treatment of absence seizures. Special care should be taken
by patients driving, operating machinery or performing any hazardous
tasks.
Usage in Pregnancy:
Neurontin (Gabapentin) did not increase the incidence of malformations,
compared to controls, in the offspring of mice, rats, or rabbits
at doses up to 50, 30 and 25 times, respectively, the daily human
dose of 3600 mg, (four, five or eight times, respectively, the human
daily dose of a mg/m² basis.) There are, however, no adequate
and well-controlled studies in pregnant women. Because animal reproduction
studies are not always predictive of human response, this drug should
be used during pregnancy only if the potentialbenefit to the patient
justifies the potential risk to the foetus.
Usage in Nursing Mothers:
It is not known if gabapentin is excreted in human breast milk.
A decision should be made whether to discontinue nursing or to discontinue
the drug, taking into account the importance of the drug to the
mother.
top of page
Neurontin Dose / Supply
NEURONTIN (Gabapentin) is available in five convenient doses. NEURONTIN
(Gabapentin) comes as a 100mg, 300mg, 400mg, 600mg and 800mg capsule.
Neurontin should not be cut in half and may be taken without regards
to meals.
top of page
Neurontin Patient Information
Patients should be instructed to take Neurontin only as prescribed.
Patients should be advised that Neurontin may cause dizziness, somnolence and other symptoms and signs of CNS depression. Accordingly, they should be advised neither to drive a car nor to operate other complex machinery until they have gained sufficient experience on Neurontin to gauge whether or not it affects their mental and/or motor performance adversely. Patients who require concomitant treatment with morphine may experience increases in gabapentin concentrations. Patients should be carefully observed for signs of CNS depression, such as somnolence, and the dose of Neurontin or morphine should be reduced appropriately (see Drug Interactions).
top of page
Antidepressant
Medication and Information - Lexapro
Side Effects - Paxil
Side Effects - Paxil
CR Side Effects - Zoloft
Side Effects - Arthritis
Medication and Information - Arcoxia
Side Effects- Celebrex
Side Effects - Mobic
Side Effects - Asthma
Medication and Information - Advair
Side Effects - Cholesterol
Medication and Information - Advicor
Side Effects - Crestor
Side Effects -
Lescol Side Effects - Lipitor
Side Effects - Pravachol
Side Effects - Zetia
Side Effects - Zocor
Side Effects - Epilepsy
Medication and Information - Neurontin
Side Effects - Osteoporosis
Medication and Information - Actonel
Side Effects - Fosamax
Side Effects
Link
to Us
*Legal Disclaimer - All of the information
provided in and through this Web site is intended solely for general
information and should NOT be relied upon for any particular diagnosis,
treatment, or care. This website strongly encourages patients and
their families to consult with qualified medical professionals for
treatment advice on individual cases.
|
Discount
Canadian Pharmacy