|
[>60 ml/min]: Give usual dosage
[30-59]: Dosage range: 400-1400mg/day
(divided doses - Usually bid)
[15-29]: Dosage range: 200-700mg/day.
[<15]: 100-300 mg/day. Use lower end of this range for CRCL <7.5 ml/min.
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Dosage Adjustment in Patients with Renal Impairment
[Package insert]
Dosage adjustment in patients 12 years of age and older with renal impairment or undergoing hemodialysis is recommended, as follows (see dosing recommendations above for effective doses in each indication):
TABLE 1. Gabapentin Dosage Based on Renal Function
Renal Function Creatinine Clearance
(mL/min) |
Total Daily Dose Range
(mg/day) |
Dose Regimen
(mg) |
| ≥ 60 |
900 to 3600 |
300 TID |
400 TID |
600 TID |
800 TID |
1200 TID |
| >30 to 59 |
400 to 1400 |
200 BID |
300 BID |
400 BID |
500 BID |
700 BID |
| >15 to 29 |
200 to 700 |
200 QD |
300 QD |
400 QD |
500 QD |
700 QD |
| 15 a |
100 to 300 |
100 QD |
125 QD |
150 QD |
200 QD |
300 QD |
|
|
Post-Hemodialysis Supplemental Dose (mg) |
| Hemodialysis |
|
125 b |
150 b |
200 b |
250 b |
350 b |
TID = Three times a day; BID = Two times a day; QD = Single daily dose.
a. 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).
b. Patients on hemodialysis should receive maintenance doses based on estimates of creatinine clearance as indicated in the upper portion of the table and a supplemental post-hemodialysis dose administered after each 4 hours of hemodialysis as indicated in the lower portion of the table.
Creatinine clearance (CLCr) is difficult to measure in outpatients. In
patients with stable renal function, creatinine clearance can be reasonably well
estimated using the equation of Cockcroft and Gault.
The use of gabapentin capsules in patients less than 12 years of age with
compromised renal function has not been studied.
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