Clinical beta
FMBM is currently in clinical beta. Content is for professional review/testing and must not replace local protocols, senior clinical judgment, or official prescribing references.
Drug Monograph
USE IF: Neuropathic pain, seizure adjunct therapy, and selected off-label chronic pain syndromes.
AVOID IF: Severe renal impairment without dose adjustment, high sedation-risk settings without monitoring, or misuse-risk contexts.
Gabapentin
Anticonvulsant / neuropathic pain modulator
Indication
Neuropathic pain • Seizure adjunct • Selected chronic pain syndromes
INDICATIONS (CORE USE)
- Neuropathic pain (diabetic neuropathy, postherpetic neuralgia) - Seizure adjunct
ADULT DOSE (STANDARD)
Start low (e.g., 100-300 mg) and titrate gradually Typically TID dosing
MAX DOSE
Variable; often up to about 3600 mg/day in divided doses
Route
PO
PEDIATRIC DOSE
Specialist/protocol-based
Must-not-miss safety points
Major warning
- Renal impairment -> accumulation -> sedation, confusion, or coma - CNS depression (increased risk with opioids and benzodiazepines) - Misuse/abuse potential (especially with opioids) - Withdrawal symptoms can occur if stopped abruptly (taper recommended)
Primary
Secondary
Other
STANDARD (ADULT PO)
Start low and titrate gradually; divide doses (TID is typical).
ADULT DOSE
Initiate with low oral doses and increase gradually based on pain/seizure response and CNS tolerability. Avoid rapid escalation and reassess after each adjustment.
PEDIATRIC DOSE
Protocol-based specialist dosing.
MAX DOSE
Variable by indication and tolerability; often up to about 3600 mg/day in divided doses.
Practical Note
- Renal dose adjustment is REQUIRED - Slow titration improves tolerability - Do not escalate rapidly
Clinical warnings
Pediatrics
Specialist/protocol-based
Pregnancy
Use risk-benefit assessment and specialist input where relevant; monitor maternal CNS effects and function.
Lactation
See lactation references and product labeling.
Renal impairment
Dose reduction required; renal dysfunction carries a high risk of accumulation and CNS toxicity.
Hepatic impairment
Minimal metabolism; hepatic function is less critical than renal function for dose safety.
Elderly
Increased sensitivity to sedation and fall risk; start lower and titrate cautiously.
- Oral divided dosing - Adjust for renal function - Taper when discontinuing
Clinical Picture
CNS depression, sedation, and ataxia.
Immediate Actions
Supportive care with airway support if needed.
Antidote
None specific.
Decontamination
Consider selected early decontamination only with protected airway and toxicology guidance.
Escalation
Escalate monitoring and supportive care for significant CNS or respiratory compromise.
Common mistakes, resistance logic, and bedside traps
Pharmacy Tool
suspension · oral
Pharmacist verification beta
Preparation formulas are currently in pharmacist verification beta and must be validated against institutional protocols before use.
Acknowledge the statements above to unlock volume scaling and ingredient quantities.
- Renal elimination - Minimal metabolism
- Modulates calcium channels to reduce excitatory neurotransmission
Saudi Arabia
Neurontin, Gabapentin
Global
Gralise, Neurontin (example), Gabapentin (generic)
Common trade names are curated examples only — formulations and availability vary. Verify the exact product name with your local pharmacy and national regulator before prescribing or dispensing.
Global data (no country-specific data available)
Saudi Arabia
International