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Dosage for Postherpetic Neuralgia. In adults with postherpetic neuralgia, gabapentin capsules may be initiated on Day 1 as a single 300 mg dose, on Day 2 as 600 mg/day (300 mg two times a day), and on Day 3 as 900 mg/day (300 mg three times a day). Titration to an effective dose can take place rapidly, over a few days, by giving 300mg Gabapentin on Day 1, 300 mg gabapentin twice a day on Day 2, and 300 mg gabapentin three times a day on Day 3. Titration may be preferable for patients with renal impairment, patients Renal Calculators: CrCl Adult | CRCl - Obese PatientGeneral Renal Dosing Guidelines (agents not listed below) Click here for a specialized list of other renal medication dosing NOT listed in the alphabetical main section (simple renal dosing guidelines). A few examples are listed below. AGGRENOX® (aspirin/extended-release dipyridamole) Capsules Alendronate Sodium Tablets: Azathioprine Find medical information for gabapentin on epocrates online, including its dosing, contraindications, drug interactions, and pill pictures. renal dosing Detailed Gabapentin dosage information for adults and children. Includes dosages for Restless Legs Syndrome, Epilepsy and Postherpetic Neuralgia; plus renal, liver and dialysis adjustments. TABLE 1. NEURONTIN Dosage Based on Renal Function; TID = Three times a day; BID = Two times a day; QD = Single daily dose * For patients with creatinine clearance <15 mL/min, reduce daily dose in proportion to creatinine clearance (e.g., patients with a creatinine clearance of 7.5 mL/min should receive one-half the daily dose that patients with a creatinine clearance of 15 mL/min receive). 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 Dosing recommendations for individual drugs can be found in Drug Prescribing in Renal Failure: Dosing Guidelines for Adults. 4 The guidelines are divided into three broad GFR categories (less than Gabapentin dosing guidelines for adult with renal impairment are summarized in Table 3. Dosing guidelines for gabapentin immediate-release are also applicable for adolescents 12 years of age and older with renal impairment. DOSE AS PER RENAL FUNCTION Dose adjustments are necessary for people with poor renal function because gabapentin is cleared renally. Refer to the following table for maximum dosing recommendations.1,5 GABAPENTIN – DOES THE DOSE FIT? 1 4PROVIDE CLEAR DOSING AND TITRATION GUIDELINES 4DOSE AS PER RENAL FUNCTION 4DO NOT STOP ABRUPTLY IF USED FOR The starting dose range is 10 mg/kg/day to 15 mg/kg/day, given in three divided doses, and the recommended maintenance dose reached by upward titration over a period of approximately 3 days. 4. Renal Dosing Recommendations. Mild Kidney Problems (CrCl 60-90 mL/min): Dose Adjustment: 900 - 3600 mg/day TID. How Often to Take: 3 times a day. Notes: Monitor for dizziness or double vision. Moderate Kidney Problems (CrCl 30-59 mL/min): Dose Adjustment: 400-1400 mg/day BID; How Often to Take: Twice a Day; Notes: Your doctor will decide the Max dosage 3600mg if patient already on gabapentin; Taper dose > 7 days to discontinue; Pediatric Dosing Partial seizures. Adjunct for partial seizures with out secondary generalization in patients> 12yo with epilepsy; also adjunctive therapy for partial seizures in patients 3-12 years <3 years: Safety and efficacy not established Loading dose of 300–400 mg in patients who have never received gabapentin. Maintenance dose of 200–300 mg after each HD : session and increase according to tolerability. Child 6–11 years 10 mg/kg once daily (max. per dose 300 mg) on day 1, then 10 mg/kg twice daily (max. per dose 300 mg) on day 2, then 10 mg/kg 3 times a day (max. per dose 300 mg) on day 3; usual dose 25–35 mg/kg daily in 3 divided doses, some children may not tolerate daily increments; longer intervals (up to weekly) may be more appropriate, daily dose maximum to be given in 3 divided at least 2 hours before or after taking gabapentin.5 DOSE AS PER RENAL FUNCTION Dose adjustments are necessary for people with poor renal function because gabapentin is cleared renally. Refer to the following table for maximum dosing recommendations.1,5 GABAPENTIN – DOES THE DOSE FIT? 1 4PROVIDE CLEAR DOSING AND TITRATION GUIDELINES Gabapentin is eliminated from the systemic circulation by renal excretion as unchanged drug. Gabapentin is not appreciably metabolized in humans. Gabapentin elimination half-life is 5 to 7 hours and is unaltered by dose or following multiple dosing. Gabapentin elimination rate constant, plasma clearance, and renal clearance are directly The starting dose range is 10 mg/kg/day to 15 mg/kg/day, given in three divided doses, and the recommended maintenance dose reached by upward titration over a period of approximately 3 days. The recommended maintenance dose of gabapentin in patients 3 to 4 years of age is 40 mg/kg/day, given in three divided doses. The recommended Usual initial gabapentin dose: 300mg q8h. Usual maintenance dose: 300-600mg q8h. Maximum dosage/day: 3600 mg. [15-29]: Dosage range: 200-700mg/day. [<15]: 100-300 mg/day. Use lower end of this range for CRCL <7.5 ml/min. TABLE 1. Gabapentin Dosage Based on Renal Function. TID = Three times a day; BID = Two times a day; QD = Single daily dose. a. Medscape - Seizure dosing for Neurontin, Gralise (gabapentin), frequency-based adverse effects, comprehensive interactions, contraindications, pregnancy & lactation schedules, and cost information.
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