Gabapentin is frequently used as an analgesic in patients with chronic kidney disease. Although gabapentin is well known for its favorable pharmacokinetics, it is exclusively eliminated renally, and patients with chronic kidney disease are at risk for toxicity. Existing literature on such risk is lacking. Per Lexicomp, Gabapentin’s recommended dose in patients with renal impairment is as follows: CrCl >15 to 29 mL/minute: 200 to 700 mg once daily. CrCl 15 mL/minute: 100 to 300 mg once daily. This is why we must take special care with its dosage, with concomitant medications and the patient’s co-morbidities, and why, after prescribing gabapentin, we must be watchful for any signs of muscle toxicity or kidney failure and quickly discontinue the drug if necessary. .table_layout tbody td{ font-size:0.95em;} Usual Gabapentin Dosing (Adults) Usual initial gabapentin dose: 300mg q8h. Usual maintenance dose: 300-600mg q8h. Maximum dosage/day: 3600 mg Gabapentin Renal Dosing [>60 ml/min]: Give usual dosage : Dosage range: 400-1400mg/day (divided doses - Usually bid) : Dosage range: 200-700mg/day. : 100-300 mg/day. Use lower end of this range for CRCL Patients with chronic kidney disease often receive inappropriately high gabapentin dosage for their kidney function, occasioning overt toxicity; advanced age and comorbidity predispose these patients for toxicity. Gabapentin is widely used in the management of pain. It is entirely excreted through the renal system so this needs to be considered in any patient becoming acutely ill and developing renal failure. We describe a patient who developed significant deterioration in her conscious level due to iatrogenic gabapentin overdose. Conclusion. In summary, gabapentin can be used in patients with stage 3 kidney disease, but only under careful medical supervision and with appropriate dosage adjustments. Never attempt to self-medicate or adjust dosages without consulting your doctor. Gabapentin is approved by the FDA for treating seizure disorders and neuropathic pain, except for trigeminal neuralgia. However, it is frequently used off-label to treat other pain conditions and psychological disorders, such as anxiety. Unlike other drugs, gabapentin is not metabolized in the liver and is solely excreted by the kidneys. With a growing chronic kidney disease epidemic,22, 23 an increasing number of patients with chronic kidney disease will be exposed to gabapentin. This study demonstrates that gabapentin dosage for patients with chronic kidney disease has been insufficiently adjusted and that the risk of gabapentin toxicity has been underrecognized. The short answer is: yes, gabapentin can be problematic for individuals with kidney failure and chronic kidney disease (CKD). While gabapentin is often prescribed for pain management, particularly nerve pain, and sometimes for seizures, its primary elimination pathway is through the kidneys. Gabapentin is frequently used as an analgesic in patients with chronic kidney disease. Although gabapentin is well known for its well recieved pharmacokinetics, it is exclusively eliminated renally, and patients with chronic kidney disease are at risk for toxicity. For patients with chronic kidney dys-function, gabapentin dosage should be adequately adjusted for kidney clear-ance. Gabapentin dosage should be examined on an ongoing basis. Gabapentin toxicity in patients with kidney dysfunction, especially those with advanced age and multiple comor-bidities, should be suspected in appro- Gabapentin is an anticonvulsant medication commonly used to treat epilepsy and neuropathic pain. Rare cases of liver and kidney damage have been reported with Gabapentin use. Individuals with pre-existing liver or kidney conditions may be at a higher risk. Regular monitoring of liver and kidney function is essential while taking Gabapentin. Gabapentinoids are opioid substitutes whose elimination by the kidneys is reduced as kidney function declines. To inform their safe prescribing in older adults with chronic kidney disease (CKD), we examined the 30-day risk of serious adverse events according to the prescribed starting dose. While not a primary cause, gabapentin can lead to complications that may indirectly affect kidney function. The drug’s reliance on renal elimination makes it more of a potential stressor for compromised kidneys rather than a direct nephrotoxin. The half-life of gabapentin immediate-release formulation is 5–7 hours in patients with normal renal function and is prolonged up to 52 hours in patients with CrCl<30 mL/min. 26 The half-life of pregabalin is 16.7 hours in patients with CrCl 30–59 mL/min, 25 hours in patients with CrCl 15–29 mL/min, and 48.7 hours in patients with CrCl<15 In patients with normal renal function, the maximum dose of gabapentin is 3600mg daily in divided doses. However, gabapentin is renally cleared and so the dose needs to be adjusted according to the GFR. For patients on dialysis, the recommended dose is 100-300mg post dialysis on dialysis days only. In most cases, gabapentin doesn’t hurt the liver or kidneys, though proper dosing is important to prevent side effects. Learn how gabapentin affects the liver and kidneys here. Twenty-six million Americans have chronic kidney disease and most don't know it. If you don't know how well your kidneys are working, you may not realize that certain medications could be damaging your kidneys and other parts of your body. Both prescription and over-the-counter medications are filtered by the kidneys.
Articles and news, personal stories, interviews with experts.
Photos from events, contest for the best costume, videos from master classes.
![]() | ![]() |
![]() | ![]() |
![]() | |
![]() | ![]() |
![]() | ![]() |
![]() | ![]() |