Adult Dosing & Uses
Dosing Forms & Strengths
capsule: Schedule V
- 25mg
- 50mg
- 75mg
- 100mg
- 150mg
- 200mg
- 225mg
- 300mg
oral solution : Schedule V
- 20mg/mL
Diabetic Peripheral Neuropathic Pain
Initial: 50 mg PO q8hr; may increase to 100 mg PO q8hr within 1 week; not to exceed 600 mg/day
Postherpetic Neuralgia
Initial: 150 mg/d PO divided q8-12hr; increase within 1 week
Recommended: 150-300 mg/d PO divided q8-12hr, increase within 1 week; not to exceed 600 mg/day
Fibromylagia
Initial: 150 mg/d PO divided q12hr; may increase to 300 mg/d PO divided q12hr within 1 week
Recommended: 300-450 mg/day divided q12hr
Epilepsy
Initial: 150 mg/d divided q8-12hr PO; may increase to 600 mg/day
Geriatric Dosing
Diabetic Peripheral Neuropathic Pain
- Initial: 50 mg PO q8hr; may increase to 100 mg PO q8hr within 1 week; not to exceed 600 mg/day
Postherpetic Neuralgia
- Initial: 150 mg/d PO divided q8-12hr; increase within 1 week
- Recommended: 150-300 mg/d PO divided q8-12hr, increase within 1 week; not to exceed 600 mg/day
Fibromylagia
- Initial: 150 mg/d PO divided q12hr; may increase to 300 mg/d PO divided q12hr within 1 week
- Recommended: 300-450 mg/day divided q12hr
Epilepsy
- Initial: 150 mg/d divided q8-12hr PO; may increase to 600 mg/day
Renal Impairment
CrCl 30-60 mL/min: give half dose
CrCl <30 mL/min: reduce further, see manufacturer's package insert
Pediatric Dosing & Uses
Safety/efficacy not established
Drug Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
Dose-dependent; percentages according to highest reported
>10%
Ataxia
Dizziness
Peripheral edema
Somnolence
Tremors
Weight gain
1-10%
Abnormal thinking
Accidental injury
Asthenia
Blurry vision
Confusion
Euphoria
Incoordination
Pain
Constipation
Xerostomia
Postmarketing Reports
Headache
Nausea
Diarrhea
Gynecomastia and breast enlargement
Contraindications & Cautions
Contraindications
Hypersensitivity
Cautions
Discontinue gradually over at least 1 week
History of angioedema, concurrency with drugs associated with angioedema risk (eg, ACEIs)
Increased risk of angioedema, peripheral edema, dizziness, somnolence and weight gain
Potential risk of male-mediated teratogenicity
May impair ability to drive or perform hazardous tasks
See FDA Warning on potential suicidal behavior
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Do not nurse
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Pharmacology
Mechanism of Action
Precise mechanism unknown; binds to a subunit of voltage-gated calcium channels in CNS; may inhibit excitatory neurotransmitter release.
Pharmacokinetics
Bioavailability: >90%
Half-Life, Elimination: 6.3 hr
Peak Plasma Time: 1.5 hr
Vd: 0.5 L/kg
Protein Bound: None
Metabolism: Minimal
Excretion: Urine
