Buy Gabavant Alternative Online

Warnings

Some people have thoughts about suicide while taking this medicine. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Seizure control is very important during pregnancy, and having a seizure could harm both mother and baby. Do not start or stop taking gabapentin for seizures without your doctor's advice, and tell your doctor right away if you become pregnant.

Gabapentin can pass into breast milk, but effects on the nursing baby are not known. Tell your doctor if you are breast-feeding.

Interactions

HydrOXYzine: May enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Lofexidine: May enhance the CNS depressant effect of CNS Depressants. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Monitor therapy

Zolpidem: CNS Depressants may enhance the CNS depressant effect of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Consider therapy modification

Food interaction

Take without regard to meals.

Avoid alcohol.

Pregnancy

• Do not initiate therapy in females of reproductive potential until pregnancy testing is performed with confirmed negative results.
• Tell your doctor if you are pregnant or breastfeeding, or if you have anemia, blood clotting problems, diabetes, heart disease, osteoporosis, pituitary gland problems, or adrenal gland problems.

Overview

Only the most current official instructions for the use of medicines! The instructions for medicines on our website are published unchanged, in which they are attached to the drugs.

DRUGS FOR PRESCRIPTION HOLIDAYS ARE APPOINTED TO THE PATIENT ONLY BY THE DOCTOR. THIS INSTRUCTION IS FOR MEDICAL WORKERS ONLY.

Description of the active substance Gabapentin / Gabapentinum.

Formula: C9H17NO2, chemical name: 1- (aminomethyl) cyclohexane acetic acid.
Pharmacological group: neurotropic drugs / antiepileptic drugs.
Pharmachologic effect: analgesic, anticonvulsant.

Pharmacological properties

Gabapentin prevents the development of epileptic seizures during the induction of seizures by pentylenetetrazole and maximum electroshock in rats and mice, as well as in other preclinical models (for example, lines with genetically determined epilepsy and others). In human epilepsy, the relevance of these models has not been established.
Gabapentin is similar in structure to the neurotransmitter gamma-aminobutyric acid. But at the same time, gabapentin is not metabolized to gamma-aminobutyric acid or an agonist of its receptors, does not change the binding of gamma-aminobutyric acid to its receptors, and does here inhibit the destruction or uptake of gamma-aminobutyric acid. In experiments using the radioligand binding method, gabapentin at a concentration of up to 100 μM affinity for other receptors, including glutamate, benzodiazepine, N-methyl-D-aspartate, kainate, quisqualate, glycine (strychnine-sensitive and insensitive), adenosine A1 and A2beta- alpha1- and alpha2-adrenergic, nicotinic and muscarinic cholinergic, H1-histamine, dopamine D1 and D2, opiate mu- delta and kappa, serotonin 5-HT1 and 5-HT2, cannabinoid 1, did not show. Also, gabapentin did not show affinity for the binding sites of voltage-sensitive sodium channels (labeled with 20-alpha-benzoate-batrachotoxinin A) or voltage-sensitive calcium channels (labeled with diltiazem or nitrendipine), did not affect cell uptake of norepinephrine, dopamine, serotonin.
In in vitro studies using radionuclide-labeled gabapentin, drug binding sites were found in rat brain tissue, including the hippocampus and neocortex. The protein in rat brain, which had a high affinity for gabapentin, was recognized as an additional subunit of the voltage-activated calcium channel. So far, the clinical significance of this fact has not been established.
In experimental studies, gabapentin prevents hyperalgesia and allodynia, especially the pain response in various models of neuropathic pain in mice Gabavant rats (models of spinal cord injury, streptozocin-induced diabetes, and others). The drug also reduces the pain response in peripheral inflammation models, but does not affect the immediate behavior that is caused by pain. For pain in humans, the relevance of these models has not been established. In studies on rats and mice that received oral gabapentin at a dose of more than 8000 mg / kg, a lethal dose was not established. The following symptoms of acute poisoning were noted in animals: shortness of breath, ataxia, ptosis, decreased activity, sedation, agitation.
In standard in vivo and in vitro tests, gabapentin did not show genotoxic or mutagenic properties. No effects on reproduction and fertility were detected in rats that received gabapentin at a dose of up to 2000 mg / kg (about 5 times the maximum recommended dose for humans when converted to mg / m2). A study in rats and mice that had been mixed with food for 2 years revealed a significant increase in the incidence of carcinoma and acinar-cell pancreatic adenoma in male rats that received 2000 mg / kg per day. At this dose, the peak plasma concentration of gabapentin in rats was 10 times higher than that in humans who received gabapentin at a dose of 3600 mg per day. Acinar cell carcinoma of the pancreas did not detect local invasion, did not metastasize, and did not affect survival. The relevance of these findings to carcinogenic risk in humans has not been established.
In the human body, gabapentin is not significantly metabolized. The bioavailability of the drug decreases with increasing dose and is equal to 60, 47, 34, 33 and 27%, respectively, when taking 900, 1200, 2400, 3600 and 4800 mg per day (divided into 3 doses). Eating slightly affects the degree and rate of absorption of gabapentin (the area under the concentration-time curve and the maximum concentration increase by 14%). The drug binds to plasma proteins less than 3%, the apparent volume of distribution with intravenous administration of 150 mg is 58 ± 6 liters. In patients with epilepsy, the minimum concentration in the cerebrospinal fluid is approximately 20% of the corresponding plasma concentration. Gabapentin is excreted by the kidneys. The elimination half-life makes 5 - 7 hours and does not depend on a dose and the further repeated administration of drug. Plasma and renal clearance, constant rate of excretion of gabapentin are directly proportional to creatinine clearance. In elderly patients and in patients with impaired renal function, the plasma clearance of gabapentin is reduced. Gabapentin can be removed from plasma during hemodialysis. Dose adjustment is necessary for the elderly, patients on hemodialysis and with impaired renal function. Since gabapentin is not metabolized by the liver, no studies have been conducted in people with impaired liver function.

Indications

Partial epileptic seizures with or without secondary generalization in patients over 12 years of age; partial seizures in children 3 to 12 years old (as an additional tool); neuropathic pain in adults.

Dosage and administration of gabapentin

Gabapentin is taken orally, regardless of the meal. For neuropathic pain: on the 1st day of therapy, take 300 mg once a day, on the 2nd day - in 2 doses of 1600 mg per day, on the 3rd day in 3 doses - 900 mg per day; if necessary, in the future, the dose can be increased to 1800 mg per day (in 3 divided doses). With epilepsy: patients older than 12 years - 900 - 1800 mg per day (in 3 divided doses); the initial dose is 300 mg 3 times a day, if necessary, increase the dose to 1800 mg per day; the daily dose should not be more than 3600 mg. For children 3-12 years old - the initial dose is 10-15 mg / kg per day (in 3 doses); an effective dose for 3 days is selected by titration. For children 5 years of age and older, the effective dose is 25 - 35 mg / kg per day, for children 3-4 years old - 40 mg / kg per day (in 3 divided doses). The interval between doses should not exceed 12 hours. Adding another anticonvulsant to the treatment and / or canceling gabapentin must be carried out gradually over a period of at least 7 days. In patients older than 12 years with impaired renal function (with creatinine clearance less than 60 ml / min) or patients who receive hemodialysis treatment, the dose is reduced. With a clearance of more than 60 ml / min - 900 - 3600 mg per day, 30 - 59 ml / min - 400 - 1400 mg per day, 15 - 29 ml / min - 200 - 700 mg per day, less than 15 ml / min - 100 - 300 mg per day. For patients who are on hemodialysis, an additional post-hemodialysis dose is 125 to 350 mg after each 4-hour hemodialysis session.
During therapy with gabapentin it is not recommended to drive vehicles and engage in other activities where the speed of psychomotor reactions and increased attention are required.
When determining protein in urine using the Ames N-Multistix SG test, false-positive results are possible when gabapentin is used with other anticonvulsants, therefore it is recommended to use more specific methods (for example, sulfosalicylic acid precipitation method).
Abrupt Gabavant of anticonvulsant treatment in patients with partial seizures can lead to seizure status. If necessary, reduce the dose, cancel gabapentin or replace it with another drug must be gradually over a period of at least 7 days.
Gabapentin is not an effective treatment for abscess convulsive seizures.
During the period of therapy, do not allow alcohol.
When taking gabapentin, the risk of suicide and suicidal thoughts is increased, so patients should be monitored accordingly.

Contraindications

Hypersensitivity, age up to 12 years with neuropathic pain (safety and efficacy studies have not been conducted) and Gabavant to 3 years with partial epileptic seizures (effectiveness as an additional drug has not been established), acute pancreatitis.

Application restrictions

Renal failure, advanced age.