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Gabapentin enacarbil Disease Interactions

There are 4 disease interactions with gabapentin enacarbil.

Major

Anxiolytics/sedatives/hypnotics (applies to gabapentin enacarbil) drug dependence

Major Potential Hazard, Moderate plausibility. Applicable conditions: Drug Abuse/Dependence

Anxiolytic, sedative, and hypnotic agents have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages, and abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance, overdosage can still produce respiratory depression and death. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously and for as brief a period as possible. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with these agents. In addition, it may be prudent to refrain from dispensing large quantities of medication to such patients. After prolonged use or if dependency is suspected, withdrawal of medication should be undertaken gradually using a dosage-tapering schedule.

References

  1. Cavallaro R, Regazzetti MG, Covelli G, Smeraldi E "Tolerance and withdrawal with zolpidem." Lancet 342 (1993): 374-5
  2. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):
  3. Gericke CA, Ludolph AC "Chronic abuse of zolpidem." JAMA 272 (1994): 1721-2
  4. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  5. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  6. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  7. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
View all 7 references
Major

Gabapentin (applies to gabapentin enacarbil) renal dysfunction

Major Potential Hazard, High plausibility.

Gabapentin is primarily eliminated unchanged by the kidney. Therapy with gabapentin should be administered cautiously in patients with impaired renal function. Dosage adjustments and titration should be made in accordance with product package labeling and individual patient response.

References

  1. Vollmer KO, von Hodenberg A, Kolle EU "Pharmacokinetics and metabolism of gabapentin in rat, dog and man." Arzneimittelforschung 36 (1986): 830-9
  2. "Product Information. Neurontin (gabapentin)." Parke-Davis (2001):
  3. Mclean MJ "Clinical pharmacokinetics of gabapentin." Neurology 44 (1994): 17-22
  4. Blum RA, Comstock TJ, Sica DA, Schultz RW, Keller E, Reetze P, Bockbrader H, Tuerck D, Busch JA, Reece PA, et al. "Pharmacokinetics of gabapentin in subjects with various degrees of renal function." Clin Pharmacol Ther 56 (1994): 154-9
View all 4 references
Moderate

Antiepileptics (applies to gabapentin enacarbil) suicidal tendency

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Depression, Psychosis

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs across multiple indications in either monotherapy or adjunctive therapy for a median treatment duration of 12 weeks (up to a maximum of 24 weeks) showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. The estimated rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% for 16,029 placebo-treated patients, representing an increase of approximately 1 case for every 530 patients treated. There were 4 suicides in AED-treated patients and none in placebo-treated patients, although the number is too small to establish any causal relationship. The increased risk of suicidal thoughts or behavior was observed as early as 1 week after starting AEDs and persisted for the duration of treatment assessed. The risk did not vary substantially by age (5 to 100 years) in the clinical trials analyzed. Therapy with AEDs should be administered cautiously in patients with depression or other psychiatric disorders. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. For clinically significant or persistent symptoms, a dosage reduction or treatment withdrawal should be considered. If patients have symptoms of suicidal ideation or behavior, treatment should be discontinued.

References

  1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
  2. "Product Information. Klonopin (clonazepam)." Roche Laboratories (2001):
  3. "Product Information. Dilantin (phenytoin)." Parke-Davis (2001):
  4. "Product Information. Cerebyx (fosphenytoin)." Parke-Davis (2001):
  5. "Product Information. Mysoline (primidone)." Elan Pharmaceuticals (2001):
  6. "Product Information. Lyrica (pregabalin)." Pfizer U.S. Pharmaceuticals Group (2005):
  7. "Product Information. Sabril (vigabatrin)." Lundbeck Inc (2009):
  8. "Product Information. Potiga (ezogabine)." GlaxoSmithKline (2011):
  9. "Product Information. Qsymia (phentermine-topiramate)." Vivus Inc (2012):
  10. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  11. "Product Information. Briviact (brivaracetam)." UCB Pharma Inc (2016):
  12. "Product Information. Diacomit (stiripentol)." Biocodex USA (2018):
  13. "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC (2018):
  14. "Product Information. Fintepla (fenfluramine)." Zogenix, Inc (2020):
  15. "Product Information. Ztalmy (ganaxolone)." Marinus Pharmaceuticals, Inc (2022):
View all 15 references
Moderate

Gabapentin (applies to gabapentin enacarbil) hemodialysis

Moderate Potential Hazard, High plausibility.

Gabapentin is removed by hemodialysis and should be administered after dialysis.

References

  1. "Product Information. Neurontin (gabapentin)." Parke-Davis (2001):
  2. Wong MO, Eldon MA, Keane WF, Turck D, Bockbrader HN, Underwood BA, Sedman AJ, Halstenson CE "Disposition of gabapentin in anuric subjects on hemodialysis." J Clin Pharmacol 35 (1995): 622-6

Gabapentin enacarbil drug interactions

There are 266 drug interactions with gabapentin enacarbil.

Gabapentin enacarbil alcohol/food interactions

There is 1 alcohol/food interaction with gabapentin enacarbil.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.