Section 06 · Monograph
Gabapentin (once daily)
Reviewed Nov 2026FDA label
GraliseGabapentinoid
- Forms
- Tab: 300, 600mg
- Dose
- PHN: titrate to 1800mg once daily with evening meal
- MOA
- Binds α2δ Ca2+ channel subunit
Indications
- Management of postherpetic neuralgiaFDA-labeled
Mechanism of Action
- Binds the alpha-2-delta subunit of voltage-gated calcium channels, reducing release of excitatory neurotransmitters involved in neuropathic pain
Full Dosing
Adult / usual
- Titrate over 2 weeks: day 1 300mg; day 2 600mg; days 3-6 900mg; days 7-10 1200mg; days 11-14 1500mg; day 15 onward 1800mg once daily with the evening meal
- Not interchangeable with other gabapentin products
- Swallow whole; take at least 2 hours after antacids
Renal
- Renal impairment: CrCl 30-60mL/min 600-1800mg once daily; not recommended below 30mL/min
Contraindications
- Known hypersensitivity to gabapentin or its ingredients
Drug Interactions
- Opioids and other CNS depressants: additive sedation and respiratory depression
- Antacids containing aluminum/magnesium reduce bioavailability by about 20%
Adverse Effects
- Dizziness, somnolence, headache
- Peripheral edema, weight gain
- Respiratory depression with opioids or compromised respiratory function
- Suicidal ideation (antiseizure drug class effect)
Monitoring Parameters
- Renal function
- Sedation and respiratory status
- Pain response
Pregnancy & Lactation
- Possible increased risk of preterm birth and small-for-gestational-age infants; individualize
- Present in milk