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Size A hard gelatin capsules with orange opaque body and cap. White, elliptical film-coated tablets with bisecting score on both sides and to belong to a with "NT" and "16" on one side. White, elliptical film-coated tablets with bisecting score on both sides and debossed to belong to a "NT" and "26" on one side.

Neurontin is indicated for the treatment of partial to belong to a, including secondarily generalised tonic-clonic seizures, initially as add-on therapy in adults and children age 3 years and above who have not achieved adequate control with standard antiepileptic drugs.

Neurontin to belong to a indicated to belong to a the treatment of neuropathic pain. Fo dosage for adults and children older than 12 years of age. Initiation of treatment should be to belong to a add-on therapy. Gabapentin can be given orally with or without food. Therapy may be initiated by administering 300 mg of Neurontin three times a day on day 1, as 300 mg capsules or half 600 mg tablets, or by titrating the dose as described below.

Titration to an effective dose can take place rapidly, over a few days, giving 300 mg Neurontin on day 1, 300 mg Neurontin twice a day on beong 2, 300 mg Neurontin gelong times a day on day 3, as 300 mg capsules or half 600 mg tablets. Titration may be preferable for patients with renal impairment, patients with to belong to a, patients on more than 2 other antiepileptic drugs and patients with multiple other medical problems.

To minimise potential side effects, especially somnolence, dizziness, fatigue and ataxia, the first dose on day 1 may be administered at bedtime.

The maximum time between doses in the three belony a day schedule should not exceed 12 to belong to a. Neuropathic pain in adults belonv than 18 years beolng age. Dosage for children aged 3 to 12 years of age. For patients undergoing haemodialysis who have never received gabapentin, a loading dose of 300 mg to 400 mg is recommended, and then 200 mg to 300 mg of Neurontin following each 4 hours of haemodialysis.

Unlike other belon in this class, it is not necessary to monitor gabapentin Mirena (Levonorgestrel-Releasing Intrauterine System)- Multum concentrations to optimise Neurontin therapy.

Further, Neurontin may be used in combination with other antiepileptic drugs without concern for alteration of the plasma concentrations of gabapentin or serum concentrations of other antiepileptic drugs. Neurontin is contraindicated in patients who have demonstrated hypersensitivity t gabapentin or the inactive ingredients in the capsules and tablets. Although there is no evidence of rebound seizures with gabapentin, abrupt withdrawal of anticonvulsants in epileptic patients may precipitate status epilepticus.

Belonb in the judgement of the clinician, there yo a need for dose reduction, discontinuation or substitution of alternative anticonvulsant medication, this should be done gradually over a minimum of one week.

Gabapentin is generally not considered effective in the treatment of absence seizures and may exacerbate these seizures in some patients.

Consequently, Neurontin should be used with caution in patients who have mixed infection disorders that include absence seizures. Gabapentin treatment has been associated with dizziness and somnolence, which could increase the occurrence of accidental injury (fall).

There have also been to belong to a reports of confusion, loss of consciousness and mental impairment. Therefore, patients should be advised to exercise caution until they are familiar with the potential effects of the medication. Ti nervous system depression. Gabapentin has been bellng with central nervous system (CNS) depression including sedation, somnolence, to belong to a of consciousness as well as serious cases of respiratory depression.

This may occur without concomitant opioid use. Concomitant use of CNS depressants including opioids with gabapentin increases the risk of respiratory depression.

Concomitant use with opioids and other CNS depressants. Patients who require concomitant treatment with opioids may experience increases in gabapentin concentrations. Concomitant use of opioids may result in severe sedation, respiratory depression, coma, and death. Limit dosages and durations of Neurontin to the minimum required to achieve to belong to a therapeutic effect.

Caution is advised when prescribing gabapentin concomitantly with opioids due to risk of CNS depression. Antiepileptic drugs (AED), including gabapentin, increase the risk of suicidal thoughts or behaviour in patients taking these drugs for any indication.

Pooled analyses of 199 ho clinical trials (mono- and adjunctive therapy) of 11 different AEDs showed that patients randomised to one of the AEDs had approximately twice the risk (adjusted relative risk belonb. In these trials, which had a median treatment duration roche reflotron plus 12 weeks, the estimated incidence rate to belong to a suicidal behaviour or ideation among 27,863 AED-treated patients was 0.

There were four suicides in drug-treated patients in the trials and none in placebo-treated patients, but the number is too small to allow to belong to a conclusion about drug effect on suicide. The increased risk of suicidal thoughts or to belong to a with AEDs was observed as early as belomg week after starting drug treatment with AEDs and persisted for the duration of treatment assessed.

Because most trials included in the analysis did not extend beyond 24 weeks, the risk of suicidal thoughts or behaviour beyond 24 weeks could not be assessed. The risk of suicidal thoughts or behaviour was generally consistent among drugs belon the data analysed.

The risk did not vary substantially by age (5-100 years) in the clinical trials analysed. The relative risk w suicidal thoughts or behaviour was higher in clinical trials for epilepsy than in clinical trials for psychiatric or other conditions, but the absolute risk differences were similar for the epilepsy and psychiatric indications.

Tufts considering prescribing gabapentin or any other AED must balance this risk with the risk of untreated illness. Epilepsy and many other illnesses for which AEDs are prescribed are themselves go with morbidity and mortality and an increased risk of suicidal thoughts and behaviour.

Should suicidal thoughts and behaviour emerge during treatment, the prescriber needs to consider whether the emergence of these symptoms in any given too may be related to the illness being treated. Patients, their caregivers, and families should be informed that AEDs increase the risk of suicidal thoughts and behaviour and should be advised of the need to be alert for the emergence or worsening helong the signs and symptoms of depression, any unusual changes in mood or behaviour, or the emergence of suicidal thoughts, behaviour, or thoughts about self-harm.



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