Gabapentin + Nortriptyline Pharmacology

Gabapentin + Nortriptyline

About Gabapentin + Nortriptyline
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Mechanism of Action of Gabapentin + Nortriptyline
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Pharmacokinets of Gabapentin + Nortriptyline
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Onset of Action for Gabapentin + Nortriptyline
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Duration of Action for Gabapentin + Nortriptyline
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Half Life of Gabapentin + Nortriptyline
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Side Effects of Gabapentin + Nortriptyline
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Contra-indications of Gabapentin + Nortriptyline
N/A
Special Precautions while taking Gabapentin + Nortriptyline
N/A
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Not recommended
Indications for Gabapentin + Nortriptyline
Neuropathic pain
Interactions for Gabapentin + Nortriptyline
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Typical Dosage for Gabapentin + Nortriptyline
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Schedule of Gabapentin + Nortriptyline
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Storage Requirements for Gabapentin + Nortriptyline
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Effects of Missed Dosage of Gabapentin + Nortriptyline
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Effects of Overdose of Gabapentin + Nortriptyline
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Gabapentin

About Gabapentin
A GABA analogue, Anticonvulsant, Mood stabilizer.
Mechanism of Action of Gabapentin
Gabapentin 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 Gabapentin
Absorption: 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 Gabapentin
Within few weeks
Duration of Action for Gabapentin
6 - 8 hours
Half Life of Gabapentin
5 -8hours
Side Effects of Gabapentin
1.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 Gabapentin
1.Hypersensitivity to Gabapentin
Special Precautions while taking Gabapentin
1.Renal impairment
2.Slowly withdraw the drug with caution
3.Use caution when driving vehicle, operating machine or performing other hazardous activities.
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Use with caution.
Children Related Information
Use with caution.
NEONATES: contraindicated
Indications for Gabapentin
1.Antiepileptic(Treatment of partial seizure)
2.Treatment of neuropathic pain
Interactions for Gabapentin
N/A
Typical Dosage for Gabapentin
Adult: 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 Gabapentin
N/A
Storage Requirements for Gabapentin
Store at 15 - 30 degree C. Protect from heat and moisture.Store the Gabapentin solution at refrigerator.
Effects of Missed Dosage of Gabapentin
Take 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 dose
Effects of Overdose of Gabapentin
Give supportive measures and symptomatic treatment. Haemodialysis can be done if needed

Nortriptyline

About Nortriptyline
A second-generation tricyclic antidepressant(Secondary Amine), Anti-depressant,migraine prophylatic.
Mechanism of Action of Nortriptyline
Nortriptyline 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 Nortriptyline
Absorption: 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 Nortriptyline
2 - 4 weeks
Duration of Action for Nortriptyline
Up to 6 weeks
Half Life of Nortriptyline
36 hours
Side Effects of Nortriptyline
1. 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 Nortriptyline
1. Hypersensitivity to Nortriptyline
2. Myocardial infarction
3. Severe convulsions
Special Precautions while taking Nortriptyline
1. 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 Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
NEONATES: Contraindicated

NEONATES: contraindicated
Indications for Nortriptyline
1. Depressive illness
2. Panic disorder
3. Nocturnal enuresis
4. Migraine prophylaxis
Interactions for Nortriptyline
Anticholinergics: 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 Nortriptyline
Adult: 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 Nortriptyline
H
Storage Requirements for Nortriptyline
Store at 15 - 30 degree C. Keep out of the reach of children.
Effects of Missed Dosage of Nortriptyline
Take 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 Nortriptyline
Give 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.