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Anticonvulsant / Neuropathic Pain

Gabapentin

Brand names: Neurontin

Gabapentin is a gabapentinoid used for neuropathic pain and as an adjunct in focal epilepsy.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

2 DOSAGE AND ADMlNlSTRATION Postherpetic Neuralgia (2.1) Dose can be titrated up as needed to a dose of 1800 mg/day Day 1: Single 300 mg dose Day 2: 600 mg/day (i.e., 300 mg two times a day) Day 3: 900 mg/day (i.e., 300 mg three times a day) Epilepsy with Partial Onset Seizures (2.2) Patients 12 years of age and older: starting dose is 300 mg three times daily; may be titrated up to 600 mg three times daily Patients 3 to 11 years of age: starting dose range is 10 to 15 mg/kg/day, given in three divided doses; recommended dose in patients 3 to 4 years of age is 40 mg/kg/day, given in three divided doses; the recommended dose in patients 5 to 11 years of age is 25 to 35 mg/kg/day, given in …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-04-02. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

Gabapentin binds the alpha-2-delta subunit of voltage-gated calcium channels, reducing excitatory neurotransmitter release in sensitised neurons.

Prescribing in practice

  • Titrate up gradually to balance efficacy against sedation and dizziness, and taper when stopping rather than stopping abruptly.
  • Reduce the dose in renal impairment, as it is cleared renally.
  • It is a controlled drug in the UK; be alert to misuse and to additive respiratory depression with opioids or other sedatives.

Monitoring

No routine blood monitoring; review pain or seizure response, sedation, mood, and renal function where relevant.

Counselling the patient

  • Drowsiness and dizziness are common at first and usually settle — take care driving until you know how it affects you.
  • Do not stop suddenly.
  • Tell your clinician about low mood or thoughts of self-harm.

Evidence & guidelines

Gabapentin is a first-line option for neuropathic pain (other than trigeminal neuralgia) per NICE CG173.

Reference: NICE NG193 (Neuropathic Pain); MHRA Class C Reclassification 2019; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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