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In adults with postherpetic neuralgiaNEURONTIN may be initiated on Day 1 as a single 300 mg doseon Day 2 as 600 mg/day300 mg two times a dayand on Day 3 as 900 mg/day300 mg three times a dayThe dose can subsequently be titrated up as needed for pain relief to a dose of 1800 mg/day600 mg three times a dayIn clinical studiesefficacy was demonstrated over a range of doses from 1800 mg/day to 3600 mg/day with comparable effects across the dose rangehoweverin these clinical studiesthe additional benefit of using doses greater than 1800 mg/day was not demonstrated.

One study compared NEURONTIN 1200 mg/dayin three divided doses with placeboResponder rate was 2314/61in the NEURONTIN group and 96/66in the placebo groupthe difference between groups was statistically significantResponse ratio was also better in the NEURONTIN group0.199than in the placebo group0.044a difference that also achieved statistical significance.

Gabapentin bioavailability is not dose proportionali.eas dose is increasedbioavailability decreasesBioavailability of gabapentin is approximately 60473433and 27following 900120024003600and 4800 mg/day given in 3 divided dosesrespectivelyFood has only a slight effect on the rate and extent of absorption of gabapentin14increase in AUC and Cmax

Approximately 7of the 2074 patients12 years of age and approximately 7of the 449 pediatric patients 3 to 12 years of age who received NEURONTIN in premarketing clinical trials discontinued treatment because of an adverse reactionThe adverse reactions most commonly associated with withdrawal in patients12 years of age were somnolence1.2ataxia0.8fatigue0.6nausea and/or vomiting0.6and dizziness0.6The adverse reactions most commonly associated with withdrawal in pediatric patients were emotional cheap blue pill. lability1.6hostility1.3and hyperkinesias1.1

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