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- Pharmacology For Gabapentin + Nortriptyline
Gabapentin + Nortriptyline Pharmacology
Gabapentin + Nortriptyline
About Gabapentin + NortriptylineN/AMechanism of Action of Gabapentin + NortriptylineN/APharmacokinets of Gabapentin + NortriptylineN/AOnset of Action for Gabapentin + NortriptylineN/ADuration of Action for Gabapentin + NortriptylineN/AHalf Life of Gabapentin + NortriptylineN/ASide Effects of Gabapentin + NortriptylineN/AContra-indications of Gabapentin + NortriptylineN/ASpecial Precautions while taking Gabapentin + NortriptylineN/APregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationNot recommendedIndications for Gabapentin + NortriptylineNeuropathic painInteractions for Gabapentin + NortriptylineN/ATypical Dosage for Gabapentin + NortriptylineN/ASchedule of Gabapentin + NortriptylineN/AStorage Requirements for Gabapentin + NortriptylineN/AEffects of Missed Dosage of Gabapentin + NortriptylineN/AEffects of Overdose of Gabapentin + NortriptylineN/AGabapentin
About GabapentinA GABA analogue, Anticonvulsant, Mood stabilizer.Mechanism of Action of GabapentinGabapentin is a GABA derivative and it bounds to lipophilic molecule. The mechanism of action of Gabapentin is not exactly known. It crosses blood brain barrier and enhances release of GABA.Pharmacokinets of GabapentinAbsorption: It is not well absorbed after oral administration. The bioavailability is not dose dependent. Distribution: Gabapentin is distributed in the body in unbound form. Drug crosses blood brain barrier. Metabolism: Gabapentin undergoes insignificant metabolism. Excretion: Drug is excreted mainly in urine.Onset of Action for GabapentinWithin few weeksDuration of Action for Gabapentin6 - 8 hoursHalf Life of Gabapentin5 -8hoursSide Effects of Gabapentin1.Dizziness
2.Somnolence
3.Tremor
4.Ataxia
5.Nausea
6.Vomiting
7.Convulsions
8.Dyspepsia
9.Headache
10.Fatigue
11.Diplopia
12.Nystagmus
13.Anorexia
14.Leukopenia
Contra-indications of Gabapentin1.Hypersensitivity to GabapentinSpecial Precautions while taking Gabapentin1.Renal impairment
2.Slowly withdraw the drug with caution
3.Use caution when driving vehicle, operating machine or performing other hazardous activities.
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with caution.Breast Feeding Related InformationUse with caution.Children Related InformationUse with caution.
NEONATES: contraindicatedIndications for Gabapentin1.Antiepileptic(Treatment of partial seizure)
2.Treatment of neuropathic pain
Interactions for GabapentinN/ATypical Dosage for GabapentinAdult: Initial dose: 300 mg / day increase the dose by 300 mg/day for next 2 days (up to 900 mg / day in 3 divided doses). Thereafter increase the dose until sufficient therapeutic response is obtained.
Maintenance dose: 900-1800mg /day in 3 divided doses
Maximum dose: 3.6 g /day
Children above 12 years: 10mg / kg / day in 3 divided doses, then gradually increase the dose until sufficient therapeutic response is obtained.
Schedule of GabapentinN/AStorage Requirements for GabapentinStore at 15 - 30 degree C. Protect from heat and moisture.Store the Gabapentin solution at refrigerator.Effects of Missed Dosage of GabapentinTake the missed dose as soon as noticed. If it the time for next dose then skips the missed dose and continue the regular schedule. Do not double the doseEffects of Overdose of GabapentinGive supportive measures and symptomatic treatment. Haemodialysis can be done if needed Nortriptyline
About NortriptylineA second-generation tricyclic antidepressant(Secondary Amine), Anti-depressant,migraine prophylatic.Mechanism of Action of NortriptylineNortriptyline acts by inhibiting the re-uptake of Noradrenaline and Serotonin (5 HT) in the CNS nerve terminals .This will result in an increased concentration of neurotransmitters in the synaptic cleft and produces antidepressant effect. It also possesses central anticholinergic activities.
It is also useful in migraine prophylaxis. The monoamine uptake blocking property is related to migraine prophylactic activity. These are suited for patient with depression.
Pharmacokinets of NortriptylineAbsorption: Nortriptyline is rapidly absorbed after oral administration.
Distribution: It is widely distributed in the body in protein bound form.
Metabolism: Nortriptyline is metabolised in the liver.
Excretion: Drug is excreted mainly through urine and small amount is excreted through faeces also.
Onset of Action for Nortriptyline2 - 4 weeksDuration of Action for NortriptylineUp to 6 weeksHalf Life of Nortriptyline36 hoursSide Effects of Nortriptyline1. Dryness of mouth
2. Constipation
3. Nausea
4. Vomiting
5. Difficulty in accommodation
6. Difficulty in micturition
7. Tachycardia
8. Hypotension
9. Arrhythmia
10. Drowsiness
11. Dizziness
12. Confusion
13. Headache
14. Mild sedation
15. Urticaria
16. Rash
17. Pruritis
18. Jaundice
19. Anorexia
Contra-indications of Nortriptyline1. Hypersensitivity to Nortriptyline
2. Myocardial infarction
3. Severe convulsions
Special Precautions while taking Nortriptyline1. Renal impairment
2. Hepatic impairment
3. Cardiac arrhythmia
4. Myocardial infarction
5. Tachycardia
6. Heart failure
7. Strokes
8. Angle closure glaucoma
9. History of urine retention
10. Seizure
11. Hyperthyroidism
12. Alcoholics
13. Patient on MAOI therapy (Discontinue the MAO inhibitor at least 2 weeks before Nortriptyline is started)
14. Slowly withdraw the drug with caution
15. Patient should be cautioned against driving vehicle, operating machine and activities requiring mental alertness, judgment
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with caution
NEONATES: Contraindicated
NEONATES: contraindicated
Indications for Nortriptyline1. Depressive illness
2. Panic disorder
3. Nocturnal enuresis
4. Migraine prophylaxis
Interactions for NortriptylineAnticholinergics: Enhaned effect of anticholinergics may occur.
Barbiturates: Serum levels of nortriptyline decreased; additive respiratory depressant effect.
Clonidine: Hypertensive crisis.
Dicoumarol: Increase in anticoagulation effects.
Disulfiram: Acute organic brain syndrome.
Fluoxetine & Haloperidol: Potentiate action of nortriptyline.
Levodopa: Its bioavailability is reduced, hypertensive episodes.
MAOIs, Furazolidone: Seizures, sweating, coma, hyperexcitability, hyperthermia, tachycardia, mydriasis, confusion, DIC and death.
Oral Contraceptives and Phenothiazines: Increase plasma levels of nortriptyline.
Smoking: Increases metabolic bio-transformation.
Alcohol: Sedative effect of alcohol potentiated. Typical Dosage for NortriptylineAdult: 25 mg 3 - 4 times a day or as single dose at night; dose can be gradually increased up to 150 mg / day.
Maximum daily dose: 300 mg
Children :
Nocturnal enuresis
Children (5 - 12 years): 25 mg/ day to be taken 1 hour before bed time.
Children above 12 years: 50 mg to be taken 1 hour before bed time.
Maximum dose: 5 mg / kg / day
Schedule of NortriptylineHStorage Requirements for NortriptylineStore at 15 - 30 degree C. Keep out of the reach of children.Effects of Missed Dosage of NortriptylineTake the missed dose as soon as noticed and if it is the time to take the next dose then skip the missed dose.
If the drug taken only at night is missed then skip the missed dose.
Effects of Overdose of NortriptylineGive supportive measures and treatment. Drug can be removed from the body by inducing emesis and gastric lavage. Activated charcoal can be given to reduce the absorption of the drug. Seizure can be treated with Diazepam or Phenytoin, arrhythmia with Lidocaine and acidosis with Sodium bicarbonate.Home Delivery for Gabapentin + Nortriptyline in Your City
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Gabapentin + Nortriptyline is a generic medicine name and there are several brands available for it. Some of the brands for gabapentin + nortriptyline might be better known than gabapentin + nortriptyline itself. If the pharmacy that's willing to deliver medicines to your home doesn't have gabapentin + nortriptyline in stock, you can ask for one of the branded alternatives for gabapentin + nortriptyline.