Gabapentin was synthesized with the aim of creating an active principle capable of exerting an agonist action against the receptors of gamma-aminobutyric acid (GABA), one of the most important inhibitory neurotransmitters of the central nervous system. The goal, therefore, was to create a drug with a GABA-mimetic action that could be useful in the treatment of epilepsy, similarly to other active ingredients with similar action (such as barbiturates and benzodiazepines). Paradoxically, gabapentin does not exhibit any type of GABA-mimetic activity, but its site of action is believed to be on the calcium channels. Nevertheless, the exact mechanism of action by which this active ingredient manages to control the epileptic seizures and with which it manages to induce analgesia in the presence of peripheral neuropathic pain seems not yet fully understood.
In order to exert its action, gabapentin must be taken orally. In fact, the medicines that contain it are in the form of capsules or coated tablets. The dispensing of these medicines can take place upon presentation of a non-repeatable medical prescription (RNR); however, it is a Class A drug whose cost can therefore be reimbursed by the National Health System (SSN).
Curiosity
Gabapentin is also known by the feminine name of gabapentin.
Examples of Medicinal Products containing Gabapentin
- Keneil®
- Gabapentin Almus®
- Gabapentin DOC®
- Gabapentin EG®
- Gabapentin Mylan®
- Gabapentin Pfizer®
- Neurontin®
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Gabapentin can be prescribed both as a supportive treatment (combination therapy) to other antiepileptic therapy when it is unable to fully control the seizures, and as a sole treatment (monotherapy) in adults and children over 12 years of age. .
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In any case, as a precaution, before taking gabapentin-based medicines, it is advisable to inform the doctor of one's health conditions, making him aware of the possible presence of ailments or diseases of any kind.
Also, if symptoms such as nausea, vomiting and persistent stomach pain appear during treatment with gabapentin, you should contact your doctor immediately as they may indicate the onset of acute pancreatitis.
It is also important to inform your doctor immediately during gabapentin treatment if symptoms such as:
- Thoughts of suicide and self-harm
- Muscle weakness
- Soreness and pain
- Malaise;
- Fever;
- Urine discoloration
- Abnormal blood tests and, in particular, increased blood creatine phosphokinase levels.
Please Note
Cases of abuse and dependence have been reported following the marketing of gabapentin-containing medicines (post-marketing experience).
Finally, please note that taking gababentin could cause side effects capable of altering the ability to drive and / or use machines (for example, sleepiness, dizziness, and tiredness). Therefore, extreme caution and avoidance are recommended. similar activities should the aforementioned side effects occur.
;However, before starting gabapentin therapy, you should tell your doctor if you are taking, or have recently been taking, any medications or products of any kind, including non-prescription drugs (SOP ), over-the-counter (OTC) medicines, herbal and phytotherapeutic products and homeopathic products.
manifesting side effects different in type and intensity, or not manifesting them at all.
However, some of the main side effects that may occur during gabapentin treatment are listed below.
Blood disorders
Treatment with gabapentin could cause leukopenia and thrombocytopenia.
Disorders of the nervous system
The intake of gabapentin could lead to the appearance of:
- Drowsiness;
- Dizziness
- Headache;
- Ataxia;
- Dysarthria;
- Tremors
- Hypoesthesia;
- Disorders of coordination;
- Alterations of reflexes;
- Convulsions;
- Nystagmus;
- Alterations of cognitive functions.
Psychiatric disorders
Treatment with gabapentin could promote the appearance of:
- Confusional states;
- Nervousness and agitation;
- Anxiety;
- Depression;
- Emotional instability;
- Suicidal and self-harming thoughts.
Cardiovascular Disorders
Administration of gabapentin could lead to the onset of vasodilation, hypertension and palpitations.
Gastrointestinal disorders
Taking gababentin can cause:
- Nausea and / or vomiting;
- Abdominal pain;
- Dyspepsia;
- Diarrhea or constipation
- Flatulence.
In rare cases, pancreatitis may also arise.
Disorders of the lungs and airways
Gabapentin therapy could favor the onset of:
- Cough;
- Dyspnea;
- Bronchitis;
- Pharyngitis;
- Rhinitis;
- Respiratory depression.
Disorders of the skin and subcutaneous tissue
Treatment with gabapentin could lead to the appearance of:
- Skin rashes;
- Acne;
- Itching:
- Stevens-Johnson Syndrome;
- Erythema multiforme;
- Alopecia;
- Rash with eosinophilia and systemic symptoms.
Disorders of the musculoskeletal system and connective tissue
Taking gabapentin could cause:
- Arthralgia;
- Myalgia;
- Muscle twitching
- Myoclonus;
- Rhabdomyolysis.
Other side effects
Other side effects that may occur during gabapentin treatment include:
- Allergic reactions, even severe ones, in sensitive individuals;
- Anorexia;
- Increased appetite;
- Hypoglycemia or hyperglycemia (side effects seen mainly in patients with diabetes);
- Infections (respiratory, ear, urinary);
- Visual disturbances;
- Tinnitus;
- Dizziness;
- Dry mouth
- Gingivitis and other dental disorders
- Fatigue;
- Fever;
- Peripheral or generalized edema;
- Liver and / or kidney diseases and disorders;
- Impotence and sexual dysfunctions.
Overdose
Acute toxicity characterized by symptoms such as:
- Drowsiness;
- Lethargy
- Dizziness
- Speech disturbances;
- Double vision;
- Diarrhea;
- Loss of consciousness.
Treatment of excessively high doses of the active ingredient is generally symptomatic and supportive. Hemodialysis may prove useful in patients with kidney problems.
In any case, in the event of an overdose of gabapentin - whether it is known or suspected - it is advisable to go immediately to the nearest emergency room, taking care to take the package of the medicine used with you.
with regard to peripheral neuropathic pain is not yet fully understood. However, its site of action is believed to be on voltage-gated calcium channels. More specifically, gababentin has been shown to bind with high affinity to the alpha-2-delta (α-) subunit. 2-δ) of the aforementioned channels. Therefore, it has been hypothesized that this link leads to a series of responses that could be responsible for both the anticonvulsant activity (through the reduction of the release of excitatory neurotransmitters in some areas of the brain), and the "analgesic activity.peripheral neuropathic in adults, the starting dose usually used varies from 300 mg up to 1800 mg of gabapentin per day, to be taken in divided doses according to medical indications. Thereafter, the amount of drug administered can be gradually increased by the doctor up to a maximum of 3600 mg of gabapentin per day.
For the treatment of epilepsy in children aged six years and over, however, the average dose of gabapentin needed to control seizures is 25-35 mg / kg body weight per day.
In any case, the exact dosage (dose and duration of treatment) of gabapentin must be established by the physician on an individual basis for each patient and may vary according to the type of disorder that needs to be treated (epilepsy or peripheral neuropathic pain), and as a function of the patient's response to the same treatment.
Please Note
Patients with kidney disease and disorders, hemodialysis patients and elderly patients may need a reduction in usually administered doses.
?The risk of gabapentin in pregnant women is unknown; however, animal studies have shown reproductive toxicity.
Furthermore, studies conducted on other antiepileptic drugs have highlighted the possibility of undergoing alterations in the development of the fetus. In particular, the combination of several antiepileptic drugs increases the risk of onset of congenital malformations (for example, cleft lip, cardiac malformations, neural tube defects).
In light of the foregoing, therefore, the use of gabapentin in pregnant women should be avoided unless the potential expected benefits to the mother outweigh the possible risks to the fetus. In such situations, the drug could be used but only under the strict supervision of the doctor.
Women of childbearing age who are undergoing gabapentin therapy, on the other hand, should resort to contraceptive methods in order to avoid a possible pregnancy.
As for nursing mothers, since gababentin is excreted in breast milk and the effects it may have on the baby are not known, it is advisable to avoid breastfeeding during treatment with the active ingredient in question.
