gabapentin
Neurontin
Nursing Considerations
• As needed, open gabapentin capsules and
mix contents with water, fruit juice, applesauce,
or pudding before administration.
• Administer initial dose at bedtime to minimize
adverse reactions, especially ataxia,
dizziness, fatigue, and somnolence.
• Give drug at least 2 hours after an antacid.
• Don’t exceed 12 hours between doses on a
3-times-a-day schedule.
• Be aware that routine monitoring of blood
gabapentin level isn’t needed.
WARNING To discontinue drug or switch to
an a different anticonvulsant, expect to
change gradually over at least 1 week, as
prescribed, to avoid loss of seizure control.
•Monitor renal function test results, and
expect to adjust dosage, if needed.
•Monitor patient closely for evidence of
suicidal thinking or behavior, especially
when therapy starts or dosage changes.
PATIENT TEACHING
• If patient has trouble swallowing gabapentin
capsules, advise him to open them and
sprinkle contents in juice or on soft food
immediately before use.
• Instruct patient not to take drug within
2 hours after taking an antacid.
• Urge patient to take a missed dose as soon
as he remembers. If the next dose is in less
than 2 hours, tell him to wait 1 to 2 hours
before taking it and then resume his regular
schedule. Caution against doubling the
dose.
• Caution patient not to stop drug abruptly.
• Inform patient about possible ataxia,
dizziness, drowsiness, and nystagmus.
Advise him to avoid hazardous activities
until drug’s CNS effects are known.
• To prevent complications from adverse
oral reactions (such as gingivitis), encourage
patient to use good oral hygiene and
to seek routine dental care.
• Explain that adverse effects usually are
mild to moderate and decline with time.
• Urge patient to keep follow-up appointments
with prescriber to check progress.
• Urge caregivers to watch closely for evidence
of suicidal tendencies, especially
when therapy starts or dosage changes,
and to report concerns immediately.
• Urge woman who becomes pregnant while
taking gabapentin to enroll in the North
American antiepileptic drug pregnancy
registry by calling 1-888-233-2334.
Explain that this registry is collecting
information about the safety of antiepileptic
drugs during pregnancy.
