Examination of the Evidence for Off-Label Use of Gabapentin

Mack, A. F.

doi:10.18553/jmcp.2003.9.6.559

Cited by 101 publications

(78 citation statements)

References 64 publications

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“…These agents were selected as they have been studied and used in the treatment of conditions other than epilepsy. [1][2][3][4][5][6][7][8][9][10][11] Statistical analysis. Patient demographics were summarized based on the most recent year (i.e., April 1, 2012, to March 31, 2013) for AED users with and without epilepsy.…”

mentioning

confidence: 99%

Antiepileptic use for epilepsy and nonepilepsy disorders

et al. 2016

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mentioning

confidence: 99%

Antiepileptic use for epilepsy and nonepilepsy disorders

et al. 2016

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“…Gabapentin is used more often for neuropathic pain than as an AED [2]. Gabapentin is well absorbed from the gastrointestinal tract with bioavailability reaching 60% [3].…”

Section: Discussionmentioning

confidence: 99%

Myoclonus in a Patient with Acute Kidney Injury: A Rare Presentation of Gabapentin Toxicity

Khan¹,

Khalid²,

Marwat³

et al. 2017

AJMCR

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Gabapentin, an anti-epileptic drug (AED) is commonly used off label for management of neuropathic pain and psychiatric disorders. Dosing of gabapentin requires taking into consideration the renal function as it is entirely cleared by the kidneys. Acute kidney injury and end stage renal disease increase the risk of developing myoclonic activity, an infrequent manifestation of gabapentin toxicity. We report a case of confusion and myoclonic activity related to gabapentin toxicity coincident with acute kidney injury that resolved with discontinuation of gabapentin and treatment with intravenous fluid hydration. As gabapentin is commonly used off label across multiple specialties, clinician recognition of the significance of renal dosing and understanding of the potential association with myoclonus and neurotoxicity is important.

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“…8,22 Notably, in the majority of reports promoting the benefi ts of off-label use, gabapentin is not the optimal treatment. 23 Existing evidence for the use of gabapentinoids in chronic lower back pain demonstrates the risk of adverse effects without any clear benefi t.…”

Section: What Are the Indications For Gabapentinoids?mentioning

confidence: 99%

Gabapentin and Pregabalin: Do the Benefits Outweigh the Harms?

Morrison

Sandilands

Webb

2017

Journal of the Royal College of Physicians of Edinburgh

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Gabapentin and pregabalin prescribing in Scotland has increased substantially over recent years. Evidence suggests that prescribers may be advocating the use of these medicines off-label to avoid prescribing opioid analgesics. The evidence to support gabapentin and pregabalin use in non-neuropathic pain disorders indicates they are less effective than several other licensed non-opioid analgesics. Notably, patients may not bene t from gabapentin and pregabalin but remain at risk of adverse drug reactions. Furthermore, greater availability has resulted in increased diversion of gabapentin and pregabalin; creating problems within the opioid misuse population and prison service. As a consequence, both gabapentin and pregabalin may soon be controlled under the Misuse of Drugs Act 1971. Prescribers should be aware of the very limited clinical evidence for use of gabapentin and pregabalin outside their licensed indications, as well as their capacity to do harm.

show abstract

Examination of the Evidence for Off-Label Use of Gabapentin

Cited by 101 publications

References 64 publications

Antiepileptic use for epilepsy and nonepilepsy disorders

Antiepileptic use for epilepsy and nonepilepsy disorders

Myoclonus in a Patient with Acute Kidney Injury: A Rare Presentation of Gabapentin Toxicity

Gabapentin and Pregabalin: Do the Benefits Outweigh the Harms?

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