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Description of pharmacological action

Prevents the occurrence of epileptic seizures when convulsions are induced by maximal electroshock and pentylenetetrazole in mice and rats, as well as on other preclinical models (for example, a line with genetically conditioned epilepsy, etc.) buy gabapentin online. The relevance of these models for epilepsy in humans is not established.

Indications for use

According to the Physicians Desk Reference (2003), gabapentin is indicated for partial epileptic seizures with or without secondary generalization in adults and children over 12 years of age (as an additional measure), partial epileptic seizures in children 3-12 years of age (as an additional measure), And also for the treatment of postherpetic neuralgia in adults buy neurontin online without dr approval.

Form of issue

Tablets, coated with a coating.

Gabapentin 600 mg, 300 mg, 400 mg

Auxiliary substances: poloxamer 407; Copovidone; corn starch; Magnesium stearate; Opadry White; talc; Hydroxypropyl cellulose; Polishing wax, buy gabapentin online over the counter

Neurontin cost without prescription

Pharmacodynamics

Anticonvulsant drug. Gabapentin cost online is similar in structure to GABA, but its mechanism of action is different from that of some other drugs interacting with GABA receptors, including valproate, barbiturates, benzodiazepines, GABA transaminase inhibitors, GABA capture inhibitors, GABA agonists and prodrugs of GABA: it does not possess GABA -ergic properties and does not affect the capture and metabolism of GABA. Preliminary studies indicate that gabapentin binds to the α2-δ subunit of voltage-dependent calcium channels and suppresses the flow of calcium ions, which plays an important role in the onset of neuropathic pain. Other mechanisms buy gabapentin online without prescription involved in the action of generic gabapentin in neuropathic pain are: reduction of glutamate-dependent neuronal death, an increase in GABA synthesis, inhibition of the release of neurotransmitters of the monoamine group. Gabapentin does not bind to receptors of other common drugs or neurotransmitters, including the GABAA, GABAB, benzodiazepine, glutamate, glycine or N-methyl-d-aspartate (NMDA) receptors at clinically significant concentrations. Unlike phenytoin and carbamazepine, gabapentin cost does not interact with sodium channels in vitro. Gabapentin partially attenuated the effects of the glutamate NMDA receptor agonist in some in vitro tests, but only at a concentration of more than 100 μmol, which is not achieved in vivo. Gabapentin somewhat reduces the release of monoamine neutron transimmitters in vitro.

The administration of gabapentin to rats resulted in increased GABA exchange in some parts of the brain; This effect was similar to that of sodium valproate, although it was observed in other parts of the brain. The significance of these effects of gabapentin for its anticonvulsant activity is not established. In animals, gabapentin easily penetrates the brain tissue and prevents seizures caused by maximal electroshock, chemical preparations, including inhibitors of GABA synthesis, as well as caused by genetic factors buy gabapentin online.

Pharmacokinetics

Suction

After oral administration of Cmax gabapentin in plasma is achieved after 2-3 hours. The bioavailability of gabapentin is not proportional to the dose; So, with an increase in the dose, it decreases. Absolute bioavailability of gabapentin in capsules is about 60%. Food, incl. With a high fat content, does not affect the pharmacokinetics.

The elimination of gabapentin without prescription from the plasma is linear.

Metabolism

There are no signs of metabolism in humans buy gabapentin online over the counter, the drug does not induce oxidative liver enzymes with a mixed function involved in the metabolism of drugs.

Distribution

Pharmacokinetics does not change with repeated application; Equilibrium concentrations in plasma can be predicted based on the results of a single dose of the drug. Gabapentin 600 mg tablet price without prescription practically does not bind to plasma proteins (less than 3%), Vd is about 57.7 liters.

Excretion

T1 / 2 from the plasma is dose-independent and averages 5-7 hours.

Excreted by the kidneys unchanged.

Pharmacokinetics in special clinical cases

The clearance of gabapentin cost from plasma decreases in elderly people and in patients with impaired renal function. The rate of elimination constant, clearance from plasma and renal clearance are directly proportional to QC. Gabapentin for sale is removed from the plasma during hemodialysis. In patients with impaired renal function and patients receiving hemodialysis treatment, dose adjustment is recommended.

It was found that gabapentin 300 mg price without prescription online concentrations in plasma in children aged 4 to 12 years are generally similar to those in adults.

Using

Use during pregnancy

Data on the safety and efficacy of the drug during pregnancy are not available, so use in pregnancy is possible only if the intended benefit for the mother justifies the possible risk to the fetus buy gabapentin online without prescription.

Gabapentin over the counter is excreted in breast milk. The effect of Neuronthin on an infant is unknown, so during lactation the drug should be given only if the expected benefit of therapy for the mother exceeds the potential risk for the infant

Use in case of impaired renal function

Caution should be used in cases of kidney failure. Patients with renal failure are recommended to reduce the dose of Neuronthin neurontin generic cheap price.

Contraindications for use

  • children's age till 3 years;
  • hypersensitivity to gabapentin 600 mg tablet cheap price online and other components of the drug.

Caution should be used in cases of kidney failure.

Side effects

Neuronthin is most often used in combination with other anticonvulsants, so it was impossible to determine which medication caused side effects (if there was such a connection at all). On the part of the body as a whole: at least 1% - asthenia, general malaise, face swelling, fatigue, fever, headache, viral infection, peripheral edema, weight gain buy gabapentin online overnight.

From the cardiovascular system: not less than 1% - symptoms of vasodilation or hypertension. On the part of the digestive system: at least 1% - flatulence, anorexia, gingivitis, abdominal pain, constipation, dental diseases, diarrhea, dyspepsia, increased appetite, dry mouth or throat, nausea and / or vomiting.

On the part of the hemopoietic system: at least 1% - purpura (most often it was described as bruising caused by physical trauma), leukopenia.

From the musculoskeletal system: at least 1% - arthralgia, back pain, fractures, myalgia.

From the side of the central nervous system and peripheral nervous system: at least 1% - dizziness, hyperkinesia, strengthening, weakening or lack of reflexes, paresthesia, anxiety, hostility, amnesia, ataxia, confusion, coordination disorder, depression, dysarthria, emotional lability, insomnia, nervousness , Nystagmus, drowsiness, impaired thinking, tremor, muscle twitching.

  • On the part of the respiratory system: at least 1% - pneumonia, cough, pharyngitis, rhinitis.
  • Dermatological reactions: at least 1% - abrasions, acne, skin itching, skin rash.
  • From the urinary system: at least 1% - urinary tract infection, impotence.
  • From the sense organs: not less than 1% - visual impairment, amblyopia, diplopia buy gabapentin online otc.

These side effects were mild or moderate.

Against the background of monotherapy, no new or unexpected side effects were noted. When comparing the tolerability of the drug at doses of 300 mg / day and 3.6 g / day, the dose-dependence of such phenomena as dizziness, ataxia, drowsiness, paresthesia and nystagmus was noted.

The side effects observed in children with additional therapy at a frequency of about 2% or higher are listed below, compared with placebo buy neurontin generic over the counter.

On the part of the body as a whole: a viral infection, fever, weight gain, fatigue. From the digestive system: nausea and / or vomiting.

From the central nervous system and peripheral nervous system: drowsiness, hostility, emotional lability, dizziness, hyperkinesia. On the part of the respiratory system: bronchitis, respiratory infection.

Other: more than 2% of children (frequency in the placebo group were similar or higher) included pharyngitis, upper respiratory tract infections, headache, rhinitis, convulsions, diarrhea, anorexia, cough and otitis media where to buy gabapentin online.

Side effects, which most often required the withdrawal of a drug used as an auxiliary therapy - drowsiness, ataxia, dizziness, fatigue, nausea and / or vomiting; As a monotherapy - dizziness, nervousness, weight gain, nausea and / or vomiting and drowsiness.

Undesirable effects that most often led to the withdrawal of the drug in children - drowsiness, hyperkinesia and hostility.

Post-registration application experience

Cases of sudden unexplained death have been reported, whose association with treatment with cost of gabapentin 600 mg tablet has not been established. Other adverse events are acute renal failure, allergic reactions (including urticaria, angioedema), alopecia, fluctuations in blood glucose in diabetic patients, chest pain, increased activity of liver enzymes, multiform exudative erythema (including Stevens-Johnson syndrome), hallucinations, motor disorders (choreoathetosis, dyskinesia and dystonia), palpitation, pancreatitis, thrombocytopenia, tinnitus, urinary incontinence, hepatitis and jaundice buy gabapentin online without prescription.

After the abrupt reversal of therapy, Neurontin is most common - anxiety, insomnia, nausea, pain of varying localization and sweating.

In the treatment of neuropathic pain

On the part of the body as a whole: at least 1% - accidental injuries, asthenia, back pain, flu-like syndrome, headache, infection, pain of different localization, peripheral edema, weight gain.

On the part of the digestive system: at least 1% - constipation, diarrhea, dry mouth, dyspepsia, flatulence, nausea, vomiting, abdominal pain.

From the side of the central nervous system and peripheral nervous system: not less than 1% - gait disturbance, amnesia, ataxia, confusion, dizziness, hypoesthesia, drowsiness, disturbance of thinking, tremor order neurontin online.

On the part of the respiratory system: at least 1% - dyspnea, pharyngitis;

Dermatological reactions: at least 1% - skin rash.

From the sense organs: at least 1% - amblyopia.

Dosing and administration

Inside, regardless of food intake. Epilepsy. Adults and children over the age of 12: the initial dose is 300 mg 3 times a day on the first day, the effective dose is 900-3600 mg / day. The maximum daily dose is 3600 mg (for 3 equal doses). The maximum interval between taking doses when prescribing the drug 3 times a day should not exceed 12 hours buy gabapentin online. It is possible to designate according to the following scheme (the stage of dose selection). At a dose of 900 mg: on the first day - 300 mg once a day, in the second 300 mg twice a day, in the third 300 mg 3 times a day; At a dose of 1200 mg: 400 mg once a day, 400 mg twice a day, 400 mg 3 times a day on the first, second and third day, respectively. Children aged 3-12 years: an effective dose of 25-35 mg / kg / day in 3 equal doses. The dose can be titrated to an effective dose for 3 days: 10 mg / kg / day - on the first day, 20 mg / kg / day - the second and 30 mg / kg / day for the third. In a long-term clinical study, tolerability of the drug in doses up to 40-50 mg / kg / day was good. Possible appointment according to the scheme: with a body weight of 17-25 kg - 600 mg / day, respectively, at 26-36 kg - 900 mg / day, with 37-50 kg - 1200 mg / day, with 51-72 kg - 1800 mg / day . Neuropathy in adults: the initial dose is 300 mg 3 times a day, if necessary, the dose gradually increases to a maximum of 3600 mg / day. Patients with impaired renal function: with CC greater than 60 ml / min - 400 mg 3 times a day; With QC from 30 to 60 ml / min - 300 mg twice a day; With SC from 15 to 30 ml / min - 300 mg once a day; With QC less than 15 ml / min - 300 mg every other day. Patients who are on hemodialysis who have not previously received generic gabapentin price cheap, it is recommended to appoint a saturating dose of 300-400 mg, and then 200-300 mg every 4 hours of hemodialysis.

Overdose

With a single admission of Neurontin at a dose of 49 g, the following symptoms were observed: dizziness, double vision, speech impairment, drowsiness, lethargy and mild diarrhea.

In experimental studies, the lethal dose of over the counter gabapentin when ingested was not detected in mice and rats treated with doses up to 8,000 mg / kg. Signs of acute toxicity in animals included ataxia, shortness of breath, ptosis, hypoactivity or agitation.

Treatment: symptomatic therapy of buy gabapentin online over the counter. Patients with severe renal insufficiency can be shown hemodialysis.

Interactions with other drugs

With simultaneous application of Neuronthin and morphine (when morphine was taken 2 hours prior to Neurontin administration), the mean value of gabapentin price otc AUC increased by 44% compared to Neurontin monotherapy, which was accompanied by an increase in the pain threshold (cold pressor test). The clinical significance of this change has not been established, the pharmacokinetic characteristics of morphine remain unchanged. The side effects of morphine in a co-administration with Neurontin did not differ from those when taking morphine together with a placebo buy gabapentin online.

Interactions between Neurontin and phenobarbital, phenytoin, valproic acid and carbamazepine have not been observed.

The pharmacokinetics of buy gabapentin over the counter in the equilibrium state is the same in healthy people and patients receiving other anticonvulsants.

Simultaneous use of Neurontin with oral contraceptives containing norethindrone and / or ethinylestradiol was not accompanied by changes in the pharmacokinetics of both components.

Simultaneous use of Neurontin with antacids containing aluminum and magnesium is accompanied by a decrease in bioavailability of gabapentin coupon by approximately 20%. It is recommended to take gabapentin 300 mg price approximately 2 hours after taking an antacid. Probenecid does not affect renal excretion of gabapentin buy gabapentin online.

A slight decrease in renal excretion of rx gabapentin price with simultaneous administration of cimetidine is probably of no clinical significance.

Special instructions for admission

Although there was no withdrawal syndrome with the development of seizures in the application of Neurontin, nevertheless, a sharp cessation of therapy with anticonvulsants in patients with partial seizures can provoke the development of seizures neurontin coupon.

Neuronthin is not generally considered an effective treatment for absence-epilepsy.

When combined therapy with morphine may require an increase in the concentration of gabapentin. At the same time, it is necessary to ensure close monitoring of patients for the development of such a sign of CNS depression as drowsiness. In this case, the dose of Neurontin or morphine should be adequately reduced.

When Neurontin was added to other anticonvulsants, false-positive results were detected when determining the protein in the urine using Ames N-Multistix SG test strips. To determine the protein in the urine it is recommended to use a more specific method of precipitation with sulfosalicylic acid.

Use in Pediatrics

In the treatment of neuropathic pain, the efficacy and safety of the drug in children and adolescents under the age of 18 years are not established buy gabapentin online cheap.

When monotherapy of partial seizures with secondary generalization and without it, the effectiveness and safety of the drug in children under the age of 12 years are not established.

When used as an additional agent in the treatment of partial seizures with secondary generalization, the safety and efficacy of the drug in children under 3 years of age have not been established.

Influence on the ability to drive vehicles and manage mechanisms

Patients should not drive the car and work with moving mechanisms until an individual response to the drug is determined.



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